Book Review: The Arm, by Jeff Passan

"For 130 years, pitchers have thrown a baseball overhand, and for 130 years, doing so has hurt them." So begins The Arm, Jeff Passan’s exposé on the most valuable commodity in professional sport. There are two questions that nag at Passan: why do these injuries keep happening? And can we prevent them?

Passan’s three year journey in search of the answers take him across the country and across the ocean. It takes him to the operating room, where Todd Coffey has his second Tommy John surgery.

It takes him to the Perfect Game youth baseball showcases, where kids too young to shave compete year round to impress radar guns. It takes him to Japan, where the Koshien tournament pushes the limits of endurance of its high school aged competitors (in 2013, for instance, sixteen year old Tomohiro Anraku threw 772 pitches in a nine day span).

It takes him to Driveline Baseball where Casey Weathers throws a baseball 105.8 mph. And it takes him to a hundred other places where he talks to a hundred other people. Along the way, Passan spins some damn fine baseball yarns while imparting some hard truths: yes, pitching has always taken a toll on its practitioners, but there is also a good bit of willful ignorance going on that is not helping things. Maybe this epidemic isn’t curable, but it is treatable. Things don't have to be this way.

Passan also explodes some myths, including the dangers of the "inverted W", that curveballs are bad for you, and the biggest myth of them all: that throwing overhand is unnatural. His visit with biological anthropologist Dr. Neil Roach convinces him that overhand throwing is instead "nature personified" as it expanded the hunting skills of our primitive ancestors.

"What's unnatural," says Passan, "is throwing a five-and-a-quarter ounce sphere ninety-plus miles per hour one hundred times every five days."

Passan leads us through the history of arm injuries, from baseball's early days when Old Hoss Radbourn treated his arm pain with the tried and true method of pitching while sloshed, to the days of John "Bonesetter" Reece -- a sort of early 1900s version of Frank Jobe -- who supposedly healed through muscle, tendon, and ligament manipulation.

We also learn about the once widely practiced technique of arm treatment via tooth extraction (to get the infection out of the blood and keep it from traveling to the arm, of course), and the needles that let Sandy Koufax take the mound every fourth day during his last years in the baseball.

But the true heart of the book resides in the stories of Daniel Hudson and the aforementioned Todd Coffey, both of whom Passan follows through UCL surgery and rehab. These twin tales, which are interwoven throughout the book, take all the theory and anecdotes and history and science, and put skin on them. We genuinely feel for both of these men as they struggle through the ups and downs of rehab in order to do again the one thing they have always done: throw a baseball at an elite level.

These sad, funny, bawdy, heartbreaking, and inspirational stories are what make this a great baseball book.

But Passan doesn’t just aim to write a great baseball book. He aims to write an important baseball book. And here, he mostly succeeds. No, baseball doesn't have the risks inherent in, say, football. Nobody is dying on the diamond, and kids aren't getting their brains scrambled from overthrowing. But they are coming away damaged.

And sure, you can call arm injuries the "cost of doing business" for major league clubs, but when one quarter of major league pitchers now have a Tommy John surgery scar, and the single greatest predictor of future arm injuries is a past arm injury, that's going to threaten your business model eventually. Worse, when over half of all Tommy John surgeries are on teenagers, there is something very wrong.

We can do better. But getting there will take a reinvention of the way baseball does things on the scale of the Moneyball revolution, and it's unclear if its insular and parochial system is up to the challenge.

I highly recommend The Arm to any baseball fan, but particularly those who are either still playing or have kids getting into the game.

The Arm goes on sale April 5th, 2016