What’s ailing Vinnie Pestano?

The Bullpen Mafia is no more.
The once-strong bullpen for the Cleveland Indians has gone from one of the most reliable units in baseball to one of the worst.
At the forefront of the bullpen issues is right-hander Vinnie Pestano.
Others have had their struggles with performance or injuries, but the key member to the unit has always been Pestano. However, this season he has lost himself and has spent the last two months trying to regain his form and confidence.
Pestano, 28, is now 1-2 with a 4.71 ERA in 29 appearances. He has had tougher seasons in the minors due to injuries, but has never struggled with performance as much as this season. It has been a combination of mechanics, poor performance, a drop in quality, and injury.
For comparison’s sake, check out his numbers over the last three years:
Year  ERA  WHIP  H/9  HR/9  BB/9  K/9  K:BB 
2011  2.32  1.05  6.0  0.7  3.5  12.2  3.50 
2012  2.57  1.10  6.8  0.9  3.1  9.8  3.17 
2013  4.71  1.57  9.1  1.9  5.0  9.4  1.88 
The numbers speak for themselves.
Everything from a performance perspective has spiked in the wrong direction. His ERA is over two runs higher than normal. He is allowing almost a half a runner more per inning. He is giving up twice as many home runs. The walks are up an astounding 62% from last year and his strikeout to walk ratio has been cut in half.
So what is the reason behind Pestano’s sudden struggles this season?
The number one cause may be that Pestano is not 100% healthy. He went on the disabled list in early May because of a sore right elbow, and he has not looked the same. Since his return from the disabled list on May 17th he has appeared in 21 games and compiled a 5.66 ERA, allowed five homers and 12 walks in 20.2 innings, and opposing hitters are hitting .289 off of him.
He had Tommy John surgery in 2006, then struggled with elbow problems throughout the 2009 season. He has managed to avoid his elbow issues the past three seasons, but they have cropped back up, possibly triggered by the early preparation for the World Baseball Classic this past spring.
Pestano got knocked around by the Red Sox over Memorial Day weekend, surrendering a late lead. He and the Indians both said it was mechanical, and since then his fastball velocity has been a little better – often sitting at 90-92 MPH. But there is no doubt that the injury has affected his fastball.
Here are his low, high and average fastball velocities over the past three seasons (per Fangraphs):
Year  Min  Max  Average 
2011  89.6  95.5  92.6 
2012  87.0  94.6  91.7 
2013  86.8  93.8  91.1 
Pestano’s fastball has been in steady decline the past two seasons, as his low-end fastball has dropped from 90 MPH to 87 MPH, his high-end fastball has dropped from 96 MPH to 94 MPH this season, and his average fastball velocity is down from 93 MPH to 91 MPH. That is a 2-3 MPH drop in velocity, which is significant – the lack of velocity and late life with his fastball has made him much more hittable, resulting in a jump in line drives.
Interestingly, the warning signs may have been there last season as Pestano saw a velocity drop from 90-96 MPH in 2011 to 87-95 MPH last season. 
While the problem may be physical or mechanical, it could also be mental as well. For whatever reason, Pestano has thrown his slider a lot more this season – 31.0% of the time, up from 22.9% in 2012 and 19.9% in 2011.  That is a significant change in pitch usage, which means he may have lost some confidence in his fastball.
Whether the problem, the Indians can ill afford to pitch Pestano in high leverage situations right now. He needs time to regain his form and his confidence, which is why manager Terry Francona announced on Monday that Joe Smith would move into the primary setup role in the eighth inning.
But if the Indians are to contend this season they need their bullpen to iron things out and be much more consistent. Getting Pestano healthy would be a great start.