'The Arm' shines light on perils of arm injuries in baseball
One of my favorite baseball writers, Jeff Passan of Yahoo Sports, set out to solve one question with his book 'The Arm.' How is it that Major League Baseball teams are throwing billions of dollars it its top pitchers, investing deeply in the performance of the arm, without fully understanding why so many of those arms break down?
Taking a deep dive on ulnar collateral ligament (UCL) injuries and the procedure that can correct them (Tommy John surgery), Passan's book is important because it takes a look at a messy but crucial corner of the industry and simultaneously has things to say about the younger generation.
Though it's easy for the eyes to glaze over when Passan dives into the necessary medical specifics of the arm and the surgery, he finds narrative gold in a number of peripheral places.
Notably, he captures the free agent courtship between pitcher Jon Lester and the Chicago Cubs, providing great detail on both sides to take the reader into the thrilling chase for great pitching, even as the specter of injury risk festered like a looming cloud on the horizon. Passan also takes a trip to Japan, with more fascinating detail surrounding a culture that holds baseball in even higher regard than here, complete with anachronistic traditions and perspectives that yield its own epidemic of arm injuries.
His case studies — long-tenured veteran and former Brewer Todd Coffey and young Diamondbacks ace Daniel Hudson — provide the soul of the story as perfect examples to illustrate the arduous rehab process and two different outcomes with strong emotional pull.
But the most important implications of the book are what it says to the younger generation of pitchers. While arm injuries probably shouldn't sound alarm bells as loudly as the concussion epidemic across sports, the book highlights how precious little is truly known about solving the crisis of UCL injuries, and yet how even vigilant parents and young athletes get pulled into the conflicting agendas of short-term and long-term satisfaction.
Some takeaways:
1. It's pretty common for people to consider the overhand motion 'unnatural,' especially compared to the windmill delivery of softball that is comparatively easier on the arm's biology. But Passan stresses that it's misleading to say so, pointing even to the prehistoric need for man to throw a spear. The motion itself, he says, is not unnatural; rather, the evolution to delivering a baseball close to 100 miles per hour repeatedly creates the unnatural strain on a human arm.
2. It should come as no surprise that Tommy John surgeries are on the rise among young people, even with many surgeons setting limits on how old a patient needs to be before he or she is willing to operate. Fatigued arms are much more likely to succumb to injuries, which is why pitch counts are so important at the lower levels.
3. At the same time, pitch counts are, at best, an educated guess at limiting the damage. Passan calls it a 'culture of fear' across baseball, that no two arms need the exact same protocol and care, and in the absence of truly knowing what preserves an arm, MLB managers and executives have resorted to methods that simply may or may not work. Pitchers limited to pitch counts in the upper levels have had the same injury troubles as those on larger workloads.
4. With each Major League Baseball team motivated to find an edge in maintaining pitcher health, the result is a lack of information-sharing, something that's harmful to discovering a universal solution. Teams employ their own researches and medical professionals, then guard that information to benefit their own situation. In the competitive landscape of pro sports, it's hard to see how it will change — and given the financial commitment necessary to solve the issue, it means the organizations most positioned to do something about it aren't interested in the big picture.
5. Though conventional wisdom has suggested a surplus of curveballs or other offspeed pitches with unique spin create greater strain on the arm, particularly in young people, there isn't a ton of evidence supporting that. It seems a heavy dose of fastballs are just as likely to cause harm to the UCL.
6. Why are elbow injuries and 'epidemic?' One of the bi-products of the pioneering work by Dr. Frank Jobe, who performed the reconstructive surgery on Patient Zero, borderline MLB Hall of Famer Tommy John, was a series of strengthening exercises that have better prepared shoulders. While shoulder injuries have been in sharp decline over the past decades, the stronger shoulders lead to lengthier workloads and thus greater strain on the UCL, a ligament that can't be prepped and stretched like a muscle. The shoulder-maintenance revolution also reduced the number of arm injuries that could have cropped up prior to the failure of the UCL.
7. There is hope on the horizon that methods have been developed to ultimately limit the rash of injuries. But Passan took a look at a number of self-made experts who have honed in on a particular element of the pitcher but didn't ultimately produce the evidence and results to back the claim. As crucial as the commodity of the arm has become to baseball, there is an alarming lack of concrete science around its use.
One of the younger athletes portrayed in the novel, pitcher Riley Pint, is among the top prospects in the upcoming MLB Draft and could wind up with the Brewers at the No. 5 pick. The down side to the book: it doesn't offer a prescription for improving the landscape because it's unclear exactly if such a remedy exists. Even non-elite pitchers could experience long-term health problems with overuse in high school and college, but it's hard to weigh that crapshoot against the short-term gain of success at quite possibly the final level of competitive athletics for those athletes, anyway.
Related: From Travis Wilson, pitch counts may be coming soon to WIAA baseball.
Pictured: Chris Capuano of the Brewers has endured two Tommy John surgeries in his career, making him one of the rare athletes to continue his career after two such surgeries.