Baseball's Billion-Dollar Injury Crisis: A Review of Jeff Passan's "The Arm"

Writing a sports book is like writing any book or project that will be sold as “longform.” You begin with a problem.

What seems simple and sorted out, is in fact complex and uncertain. The problem is a nexus where prominent trends meet. The resolution process is at a critical point.

The writer strives both to tell that problem through diligent research and to show it through human experience. Many whiff at this task. Yahoo Sports’ Jeff Passan delivers, with his new book “The Arm.”

Passan’s subtitle calls pitching injuries the “billion-dollar mystery.” This proves accurate. The arm is “the most valuable commodity in sports,” at least from an American perspective. MLB clubs spend $1.5 billion on pitchers, five times the combined salaries of NFL starting quarterbacks.

Four starting pitchers enter the 2016 season on guaranteed deals of six years or longer, averaging more than $30 million per season. Even injury-riddled Scott Kazmir signed a three-year $48 million deal in his 30s.

Injury and negligence take a horrific toll on this investment. According to Passan, $500 million of that $1.5 billion is lost every year. Fifty percent of pitchers hit the disabled list during a season. A full 25 percent have had Tommy John surgery, to repair torn ulnar collar ligaments in the elbow.

The term “Tommy John” has been deadened by overuse. Like flying on a freaking rocket into outer space, the delicate, radical surgery has become routine. It seldom warrants mention, unless a No. 1 starter is shelved for the year, or subject to an innings limit upon his return.

Spoiler: the only thing routine about “Tommy John” is its frequency.

Passan takes you inside the surgical suite. He follows two pitchers through their grueling recoveries. One is young Arizona Diamondbacks starter Daniel Hudson, who blew out after a 2011 season. The other is hefty veteran reliever Todd Coffey, known for his epic bullpen sprints, undergoing his second surgery.

He lucks out in that both pitchers and their spouses are forthright, expansive and compelling. He also “lucks out” in that neither has the expected “back in 15 months throwing stronger than ever” recovery timeline.

Passan also brings the reader behind the scenes of a major free agent pitching signing, from both the player and the front office perspective. He forays into youth baseball domestically and in Japan. The book contains multiple years worth of strong reporting.

Journalists writing books can be frustrating. There’s a tendency for them to perform a diligent survey, to offer equal treatment to all sides, then to cop out when it comes to offering incisive analysis.

Passan does not fall prey to this. His book is superb. Though the problem itself still leaves the reader frustrated.

Youth baseball is a (if not the) major culprit. It has become a specialized, year-round affair for even the very young. Up and coming pitchers throw too often and too much when they do. One eye-popper Passan offers: 56.8 percent of Tommy John surgeries over a five-year period were performed on teenagers.

Missouri baseball coach Tim Jamieson noted an uptick in a youth baseball piece Jason Lisk wrote for our site last August.

"“On our roster right now, we have four kids that have had Tommy John surgery, and three of them had it before they ever got here,” Jamieson said. “Which is really unusual, you never used to see that. Kids just didn’t get hurt that young, that early. It’s hard to pinpoint one reason why that’s happening, but I do think the fact that kids are playing year-round baseball and not another sport, or throwing without a structured throwing program, I think all those things have led to a risk of potential injuries for throwers.”"

There is a clear solution there: reform and regulate youth baseball. How that should be done and how that happens when youth baseball is a multi-million-dollar industry and top high school pitchers can earn millions running that gauntlet to the top of the draft: less clear.

At the professional level, surgeons have improved. Some headway has been made on recovery. But MLB remains flummoxed about injury prevention. Independent efforts, being kind, lack scientific rigor. MLB’s own efforts are stymied by a profound tragedy of the commons.

Baseball would be best served with a prudent collective investment, with clubs pooling resources and data and pouring millions into lengthy, ongoing research. For clubs, however, the highest expected utility in a competitive environment is to keep data housed and any insights and advancements proprietary.

Notably, James Buffi, perhaps the most promising researcher Passan highlights, gets poached by the Los Angeles Dodgers, before the book is finished.

Progress in baseball can be glacial, in the pre-climate change sense. It took more then a century (and a statistical revolution) for managers to stop pitching players past the point they were fatigued.

It’s hard to view the near term prognosis as anything but bleak.