NEW YORK -- Gerrit Cole monitors developments around the league closely, a task to which he’s had more time than usual to devote of late. Though he acknowledges that he does not have a solution, the injured Yankees ace said he is alarmed by the scores of star pitchers joining him on the injured list.

In recent days, the Guardians’ Shane Bieber, the Braves’ Spencer Strider, the Marlins’ Eury Pérez and the Athletics’ Trevor Gott have been among the pitchers diagnosed with elbow injuries, continuing a long-term trend over several decades. Cole’s Yankees teammate Jonathan Loáisiga is another, and the Astros announced on Monday that Framber Valdez will be undergoing further evaluation after being scratched from his start with elbow soreness.

“If there’s one thing everybody should be able to get on the same side about, it’s that you want your best players out there as much as possible,” Cole said.

With his spring cut short by right elbow inflammation, Cole cannot return to a big league mound until at least late May, though he did make 25 tosses at a distance of 60 feet on flat ground Monday -- his first time doing so since weathering a March scare that had the reigning American League Cy Young Award winner fearing the worst.

Following a weekend in which the MLB Players Association released a statement about the rash of injuries focused on the pitch clock, which was followed by a statement by Major League Baseball citing velocity and spin increase, Cole said that there may not be one single reason behind an increase in pitching injuries. He offered some of his own theories.

“The standard of performance is higher,” Cole said. “The league is demanding that you throw your best pitch every time because the hitters are better. The strike zone is smaller. The balls are different, the bats are different. We’ve evolved into a higher-performance product, which is good.

“But as we’ve evolved over the last 10 years, we’ve had two shortened ramp-ups [because of the COVID-19 pandemic and a labor lockout]. We’ve had the pitch clock. Guys have had to adjust to other different rules inside the game and how they go about their business. I think it’s irresponsible for either side to say any one of those things definitely has no impact on pitchers’ elbows or shoulders.”

On Saturday, MLBPA executive director Tony Clark focused on the changes made regarding the pitch clock, which was set at 15 seconds with no runners on base and 20 seconds with baserunners during the 2023 season. An 11-man competition committee trimmed the clock to 18 seconds with runners on base this past December.

“Despite unanimous player opposition and significant concerns regarding health and safety, the commissioner's office reduced the length of the pitch clock last December, just one season removed from imposing the most significant rule change in decades," Clark said.

"Since then, our concerns about the health impacts of reduced recovery time have only intensified. The league's unwillingness thus far to acknowledge or study the effects of these profound changes is an unprecedented threat to our game and its most valuable asset -- the players."

In response, MLB cited an independent study by Johns Hopkins University, which shows no evidence has been found to support that the introduction of the pitch clock has increased injuries.

“This statement [from the MLBPA] ignores the empirical evidence and much more significant long-term trend, over multiple decades, of velocity and spin increases that are highly correlated with arm injuries,” the league said.

There has been a steady rise in pitcher injuries going back years, despite game time increasing steadily prior to 2023. As the average game increased 14 minutes from the late 1990s to 2021-22, pitching injuries skyrocketed from a combined 11,668 IL days in 1995-99 to 31,558 IL days in 2023.

Despite the introduction of the pitch timer, average fastball velocity increased in 2023. The rise from 2022 to 2023 was greater than the increase from 2021 to 2022. And IL placements were down in 2023, relative to 2022.

Justin Verlander, who is Cole’s friend and former teammate, is another prominent pitcher dealing with an arm ailment, though for him it is a shoulder issue and he is expected back in a matter of weeks. Speaking after a rehab start on Sunday, Verlander pointed to modern mechanics and pitching mentality as the biggest culprit.

“The biggest thing is the style of pitching has changed so much,” Verlander said. “Everybody is throwing as hard as they possibly can and spinning the ball as hard as they possibly can. It’s hard to deny those results, obviously.”

“It’s a double-edged sword,” he continued.

“How can you go out there and tell somebody not to do that when they’re capable of throwing 100 [miles per hour]?”

As outlined recently in The Ringer, MLB has been working on a comprehensive study on pitcher health with a variety of third-party experts. At the conclusion of this study, which began in October, the plan is to create a task force empowered to make recommendations to protect pitchers and improve the future of the sport.