I talked to Jeff about the book -- which you should buy -- for the Newsletter.
The Arm begins with a prologue that touches on this a bit, but I want to ask you directly: How did you arrive at this idea for a book? Where did you start? Was there a "Eureka!" moment?
You know how around 3 a.m., your mind can drift to the most delightfully creative places...and a second later you realize what seemed so brilliant was actually rather senseless?
Well, it was 3 a.m. in May 2012, and I was feeding my one-month-old a bottle, and I kept thinking about recent conversations I'd had with Alex Anthopoulos and Dan Duquette about how they were handling Noah Syndergaard and Aaron Sanchez [then Blue Jays prospects] and Dylan Bundy. Those thoughts branched into other approaches, and those angles multiplied, and by the time my mind stopped racing it felt like I had enough for a book.
When I woke up the next morning and catalogued the previous evening's thoughts, I realized this wasn't some middle-of-the-night delirium but a legitimate idea.
The Arm spends a lot of time with amateur players in travel-ball leagues, and you make the argument that this is where the problem is beginning. What can be done about youth coaches emphasizing winning a game versus keeping developing arms healthy?
The solution to coaches is parents, and the solution to parents is coaches. Checks and balances at the youth level come down to at least one of the parties being educated. Even then there are appeals to authority and other biases that complicate the matter.
More specifically, what are the solutions to the moral hazard of coaches rewarded for winning rather than sending kids to the next level?
Winning is a hard one to adjudicate. Because every time I have the temerity to suggest winning doesn't matter for 9- and 10- and 11-year-olds, I hear gasps, cries; I am told I'm an un-American heathen. How we devolved to the point where children are going to tournaments and throwing hundreds of pitches in a weekend or three times in two days -- it happens all the time -- is a testament to the commodification of children and how Major League Baseball let its youth space get co-opted by profiteers.
So we need to start emphasizing proper development over winning, particularly at the youngest ages. We need strict pitch counts on arms that simply cannot take the stress and strain of overuse. We need parents and coaches both to understand PitchSmart and to realize Tommy John surgery isn't some sort of sign that your kid has made it. We need them to make health a priority, not a secondary consideration.
For me, the most fascinating story in the book was about what I'll call Tommy John Lite: A new surgery, not yet tested on major leaguers, whose advocate purports to repair UCL tears with half the rehab time. What is the state of this procedure, and when will it make the leap to MLB hurlers?
Dr. Jeffrey Dugas, one of James Andrews' protégés, conceived of the surgery for partially torn ligaments and tested it on the perfect candidate: a high-school kid going into his senior year. Dr. Dugas's procedure -- using a suture tape dipped in collagen that theoretically would stabilize the ligament and promote healing -- worked well enough to allow the patient to pitch into college. Since then, Dr. Dugas has tried the surgery on dozens of kids, and the success rate, last I checked, was 100 percent.
Now, high-school kids in Alabama aren't professionals. They don't throw as hard, and that's what Dr. Dugas doesn't know: whether the ligament -- which because it uses anchors screwed into the bone instead of holes drilled through it brings pitchers back in less than six months -- can withstand the perils of velocity. I hope so. The idea of a pitcher with a partially torn UCL pitching through the end of the regular season, having modified Tommy John at the beginning of October and being ready for Opening Day is, absent us figuring out the arm and how to prevent the injuries in the first place, a pretty phenomenal upgrade in care.
MLB is a penny-wise, pound-foolish industry. Perhaps more to the point, it isn't an industry as much as a loose amalgamation of competitors. What has to happen to get 30 teams to put time and money into a solution that may take a generation to find, and whose benefits will be spread among all teams -- a zero-sum game?
An edict from Major League Baseball that injuries are now the domain of the league. While MLB has taken admirable steps with its injury-tracking system, the 2014 draft study and PitchSmart, it could do so many simple things. A twice-a-year draft combine not only would serve a functional purpose but cut deeply into kids' desire to play year-round competitive ball in order to be seen more often by scouts and decision-makers. Partner with the NCAA to invite college coaches and educate them on the subject of pitcher health, and you create another layer of people less likely to screw up an arm that could be on the cusp of the big leagues. MLB also needs a think tank similar to what the Dodgers built, in which it could conduct experiments with free-agent pitchers who may be on their last chance and looking for nothing more than an opportunity to salvage their careers.
I don't know that MLB focusing more on injuries and teams doing the same are mutually exclusive, of course. Ideally, sure, you'd like the research being done by the party likelier to spread its discoveries among the masses. If baseball were to grow into a research-focused industry, though, and that came about because the league itself was determined to keep up with the Dodgers and Rays and Astros and Indians and other standard-bearers of arm care, a small investment from all teams seems like a cheap price considering how much it could save.
Daniel Hudson, one of your two main protagonists, is pitching out of the Diamondbacks bullpen again. What is Todd Coffey up to?
He's closing for the Long Island Ducks. He has thrown five straight scoreless innings. Sent me a text a couple days ago: "Sat 94-95 tonight." He's convinced he's going to pitch in the big leagues again. And when he's 50 and pitching in a men's league in Rutherfordton, N.C., he's still going to be sure that guys in the major leagues ain't got nothin' on him. I wish I saw life the way Todd Coffey sees baseball.
You've pushed the book very hard to coaches and parents. Four or five years out, when you cover this ground again, what do you want implemented for the care of youth arms?
I want to stop getting DMs from coaches and parents telling me about the awful thing they saw in a regional game where a kid threw 175 pitches.
I want Major League Baseball to run an ad before Game 1 of the World Series with Matt Harvey, Stephen Strasburg, Jose Fernandez and Yu Darvish showing off their elbow scars. One says: "This is not cool." And another: "This is not fun." And then: "This is not supposed to be there." And the last: "Don't let this be your child. Go to pitchsmart.org."
I want the Little League World Series games on TV to stop showing the stupid radar gun like it means a damn thing when it comes to 13-year-olds.
I want Perfect Game to stop being hypocrites.
I want, more than anything, for everyone in baseball to understand it's going to take at least a decade to change the culture, and not go hunting for immediate results. They won't be there. If it starts with the kids on my eight-year-old's team, so it's ten years until they're seniors in high school. Considering that a majority of these surgeries are done on teenagers, perhaps if the coaches and parents recognize how real this problem is, and MLB addresses it in savvy enough fashion, we can allow the coming technology to complement the burgeoning conscientiousness and see the game be better for it.
