The phrase “Tommy John surgery” is heard so often in baseball that there must be young ballplayers who assume John is a surgeon, the way that others associate the name Tim Horton with doughnuts.
The large role that the surgical procedure − pioneered by orthopedic surgeon Dr. Frank Jobe in September 1974 − plays in the game today is startling. More than 50 percent of pitchers land on the disabled list every year. And one quarter of major-league pitchers have undergone Tommy John surgery.
Those statistics are quoted in a new book written by Yahoo Sports national baseball columnist Jeff Passan. It’s called “The Arm: Inside the Billion-Dollar Mystery of the Most Valuable Commodity in Sports,” published this week by HarperCollins.
Passan spent 3½ years researching the book, following pitchers Todd Coffey and Daniel Hudson through their surgeries, spending time with left-hander Jon Lester during free-agent negotiations after he came back from arm trouble, and even traveling to Japan to find out how pitchers’ arms are conditioned and cared for there.
Anyone who follows major-league baseball will find the book fascinating. Passan, a one-time intern at The Buffalo News, spoke by phone about the book last month.
How did he decide that the state of pitchers’ arms was worthy of a book?
“In the spring of 2012 the Toronto Blue Jays had Noah Syndergaard and Justin Nicolino and Aaron Sanchez and they were limiting them to what seemed like a pretty meager amount of innings at the time,” Passan said. “I asked” General Manager “Alex Anthopoulos why they were doing that, and his answer was, essentially, we don’t know what’s right.
“It was a very candid answer. It got me thinking, if one of the smartest and most analytical general managers out there doesn’t understand this thing on which baseball teams spend a billion and a half dollars every year, it’s likely that nobody does. And if nobody understands it, what are they doing spending a billion and a half dollars a year on something that they don’t get?”
As Passan writes in the book, “The problem is not going away. The sport’s foremost doctors believe it’s worsening. The current generation of pitchers is lost, the product of a broken system, their arms ticking time bombs.”
Matt Harvey of the Mets and Yu Darvish of the Rangers are two highly paid superstar pitchers who have undergone Tommy John surgery in recent years.
Why do so many pitchers’ arms − particularly their elbows − break down so often? As Passan shows, there are no easy answers. Some baseball people will tell you that pitchers are babied too much these days, their throwing too limited by pitch counts, so they don’t toughen up the way old-school pitchers did. But for every iron man of a previous era, every Warren Spahn, Tom Seaver or Nolan Ryan, there were hundreds of pitchers we’ve never heard of who could launch a ball like a rocket, but had their careers derailed by arm injuries.
The great Sandy Koufax, who in the last 40 years has given about as many interviews as the late J.D. Salinger, agreed to talk to Passan for the book because of his passion for the topic.
The Los Angeles Dodgers, Passan writes, employed Major League Baseball’s first full-time team statistician, Allan Roth, from 1947-64. Roth tracked pitch counts, but the team did not use them to limit their pitchers.
“The most egregious pitch counts belonged to Koufax,” Passan writes. “In a 1961 game against the Cubs, he threw 205 pitches in a 13-inning complete game. Another 13-inning outing a year earlier required 199 pitches.”
Starting in April of 1964, when Koufax was 28, his career involved pitching through pain. He took a codeine-coated aspirin, an anti-inflammatory drug called Butazolidin that’s no longer considered safe for human consumption, and got his arm, elbow and shoulder coated with a concoction called Capsolin that would dull his nerve endings. Koufax continued to pitch, logging more than 300 innings three of his last four seasons. At the end of the 1966 season, Koufax decided he’d had enough, retiring at age 30 while seemingly still in his prime. He believed the risks of continuing to pitch outweighed the rewards.
“I was hoping I would live longer after baseball than before,” Koufax tells Passan in the book. “And I’ve made it. In those days there was the question of are you going to have full use of your arm, are you going to do this or that … I thought when the doctor tells me it’s time to stop, it’s time to stop.”
Passan says he believes that 300-inning pitchers could exist today “if they were bred from a young age. And if you were willing to do what teams did in the past, which was really Darwinian. You throw guys out there and the ones that survive are the ones that throw a lot. And the ones that don’t, their careers are essentially determined fungible and you send them to the glue factory. That’s what happened with baseball.
“Sandy Koufax, I will never forget him talking about how the Dodgers would have 600-plus players in spring training. I said 600? He said yeah because the ones who got hurt, you just got rid of them. The ones that survived, you just kept going and just moving up …
“Baseball today is not a whole lot different than it was back then, which is the staggering part because we’ve had so many scientific advances, we have such better knowledge of what the arm is these days.”
One culprit in the “broken” state of pitching is youth baseball, Passan writes. Kids who are identified early as high-potential players are often encouraged to play the game year-round, rather than just as a seasonal sport. Parents in pursuit of college scholarships or major-league signing bonuses often take their child’s budding baseball “career” much too seriously. Then there is Perfect Game, a developmental program for elite baseball prospects around the U.S. that puts kids into showcase games, with scouts watching, at early ages. The young pitchers are often pressured, subtly or not, to throw hard and put up a big number on the radar gun.
“Year-round baseball is the bane of the medical community,” Passan writes. He adds that he has written about baseball for a dozen years, “And I can say with certainty that nothing unites people in the industry quite like the enmity for Perfect Game.”
Will Passan’s book open enough eyes that youth baseball in general, or Perfect Game in particular, might change their ways? The author is skeptical.
“Youth baseball is broken and we broke it,” he said. “Our desire for more, better, faster, I think has certainly correlated with the spike in elbow injuries. And I think there’s a very good argument to be made that it’s causative. The problem is, so many of the things encouraged by Perfect Game − throwing at high velocities, throwing year-round − those are things that people think work. …
“The system is broken and it’s something that I think Major League Baseball needs to take a serious look at fixing because if Major League Baseball steps in and says, we are tired of getting these pitchers who are broken coming into our system, all of a sudden I think the impetus is there for everyone to change.”