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Authors: Jeff Passan

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The perks for Farsad weren't bad, either. On the building's bottom floor, Farsad sells fine Persian art he imports from Iran,
his home country. His office occupies the middle floor; he welcomed me in, guided me to a low-slung couch, offered me a cup of tea, and began telling the stories of the room's assorted amulets—a cardboard cutout of Yu, a gold spray-painted version of his glove, a cowboy hat given to him by Rangers ownership. The museum is on the top floor. Some of the biggest stars in Japan erect similar shrines; at one for Ichiro Suzuki, the hitting star who is likely to be the first Japanese player inducted into the Hall of Fame in Cooperstown, the orthodontic retainer he wore is on display.

Because Farsad was different—a Muslim among Shintos and Buddhists, a foreigner in a place that shuns them—he learned to scoff at tradition. He married Ikuyo, a Japanese woman he met at Eckerd College in Florida, and followed her home in 1982. Four years later, they had a boy—birth name Farid Yu Darvishsefat—whom Farsad promised to raise without strict adherence to Japan's social mores. Darvish threw all the time, nagekomi and otherwise, but he never put Koshien on a pedestal. Even when Darvish pitched Tohoku High to the finals in August 2003, he threw a paltry-for-Koshien 505 pitches over five games and let a sidearming teammate absorb the rest. “He always went to his kantoku saying there are other good pitchers, too,” Farsad said. “Please use them.”

Already an outsider on account of his mixed blood, Darvish did little to ingratiate himself by getting caught smoking a cigarette in a pachinko parlor before his professional debut at eighteen, a grievous sin that earned him a stint in “reeducation.” He later posed half naked in a magazine and knocked up a pop star whom he married and divorced. He was beloved nonetheless, because nobody could deny his greatness. His thriving with the Rangers provided Japan with not just a worthy successor to Daisuke Matsuzaka but a usurper.

The influence of Darvish on the current generation of young Japanese pitchers is apparent. Anraku said he started doing more
weight training to ape Darvish but couldn't fathom baseball without the extreme nagekomi Darvish derided. At the All-Star Game in 2014, Darvish suggested that Major League Baseball consider switching to a six-man rotation, as in Japan's top leagues, to better protect pitchers. Back home, they applauded, framing his proposition as a tacit approval of how Japan handles arms while ignoring Darvish's implicit criticism. He was hardly a spokesman for yakyu.

That was Daisuke Matsuzaka's province. “When I was a little kid,” Anraku said, “my hero was Matsuzaka.” He was everyone's kaibutsu, forever the conqueror, because throwing seventeen innings and 250 pitches harkened back to when men were
men
, when Japanese were
Japanese
. It never troubled Matsuzaka to feed the folklore, either, whether it was his nod-and-wink discussion of a mystery pitch he said he wanted to throw called the gyroball or the interminable throwing sessions through which he further distinguished himself.

In 2004, when he joined the Seibu Lions as pitching coach, Daisuke Araki, the former Koshien hero, marveled at how often his namesake threw. Almost every day, even twenty-four hours before his starts, Matsuzaka would throw 150 pitches, sometimes more. “Daisuke always declined, even if the manager or I would say it's time for a change,” Araki said. “He'd say ‘No, no.'”

The better Matsuzaka got, the more he threw. During spring training a year before he joined the Red Sox, Matsuzaka dug in for ninety minutes one day and threw 333 pitches. Nearly four pitches a minute, never stopping. Like Murata, willing to throw until his arm fell off. Matsuzaka earned his Tommy John scar. Hero at eighteen, dominant at twenty-two, unimpeachable at twenty-six, hurt at thirty, and back in Japan at thirty-four with a few souvenirs: tens of millions of dollars, a World Series ring, and a permanent reminder of the arm's frailties tracing his elbow.

Matsuzaka isn't seen as a cautionary tale in Japan but a triumphant one worthy of emulation. When I asked Anraku about
Matsuzaka and nagekomi, he nodded along in full agreement. “A good arm can't be made without nagekomi, especially for the Japanese players,” Anraku said. “Compared to other countries' players physically, Japanese players are different. We believe that the power is different. That's why the Japanese player needs to practice more and train more. That's why nagekomi is very important to build good muscles and good arms.”

I heard this over and over, players and coaches attributing dubious practices to nationality. While it is true the average Japanese male is smaller than the average American, Anraku was a leviathan compared with his teammates. The closest thing to a medical study that has compared Japanese and Americans physiologically focused on clogged heart arteries. If the Japanese arm really
is
different, like the legs of the Kalenjin tribe of elite runners in Kenya, that's one thing, but from everything doctors in the United States have seen, their arms are practically the same. “Maybe the joint is a little looser, but it's really no different,” said Dr. James Andrews, who performed Tommy John surgery on at least three Japanese pitchers, none more important than the most recent.

Toward the end of the 2014 season, Yu Darvish's elbow started hurting. The MRI showed standard damage, ordinary enough that an insurance company sold the Rangers a policy on the elbow in case of injury. Darvish made it through a typical offseason throwing program in good health and came into spring training feeling strong. One inning into his first start, Darvish tore his UCL. As much as Farsad tried to protect him, as much as he tried to protect himself, Darvish was just like Matsuzaka and the other Japanese players who sought professional glory in the major leagues and wound up scarred.

It reminded me of a conversation with Masanori Joko, the sage of Saibi High School. He was just as curious about American culture as I was about Japanese.

“What is it about America,” Joko said, “that makes Japanese pitchers get hurt when they go there?”

He wondered about the American ball and the five-man rotation and the lack of nagekomi and dietary changes and the dirt on the mound and everything except the endless throwing sessions Joko long ago convinced himself weren't just right but necessary.

F
OR HIS SIXTY-SEVENTH BIRTHDAY, MASANORI
Joko received a gift from his players. In the middle of a large piece of poster board, one of the kids drew a perfect rendering of the most famous outfield fence in Japan. Joko knew it well, though in case anyone else needed help identifying it, two words were looped in English cursive: “Koushien Stadiam.” The drawing sat on a table in Joko's office behind a pair of gloves marked “95” and “85,” for the ninety-fifth Summer Koshien and eighty-fifth Spring Koshien.

For thirty-three years he'd done this—coach baseball, spread yakyu, sprinkle some of what TV commentators called “Joko Magic”—all because owning a drugstore in his prior life bored him. He left the business he had built to coach his first team, Uwajima Higashi High, which made Koshien in his fifth year and won the spring tournament two years later. Other coaches wore excruciating looks during the high-stakes games. Joko grinned, like he knew something the rest of them didn't. He earned a nickname for it: “Smiling Joko.” It was an odd dichotomy, his insistence on enjoyment amid the practice of a century-old style that frowned upon it. From January 3 to December 29, his teams practiced or played every day. The dankest summer afternoons, the most blustery winter days—neither weather nor physical condition nor any excuse, however legitimate, interrupted Joko's lessons. His children swung and threw and ran. They hopped onto rowing machines, yelling on every pull-back to show Joko their dedication, as if two thousand daily meters wasn't evidence enough. Wearing a Saibi jersey compelled a boy to forever seek Joko's approval.

“When my father is not here,” Tomohiro Anraku said, “Jokosan is my father.”

Koichi Anraku works for a paper company in Tokushima, about a two-and-a-half-hour drive from Saibi, so he entrusted Joko with that role and, by extension, Anraku's arm. With no think tanks advocating pitch limits and only a handful of youth leagues with hard-and-fast usage rules, the coach in Japan serves as gatekeeper. And in a society where age equals status, and winning Koshien magnifies credibility exponentially, Joko's word was bulletproof.

“Everybody listens to the manager,” said Kenshi Sakayama, Anraku's doctor. “Culturally, Japan has a relationship between manager and players that managers are not forcing them to do it. But if the manager has to argue, then the only answer from the player is: ‘Yes, I am OK.'”

Joko ceded on just one matter with Anraku, and even that was begrudging. He could not understand why Anraku iced his arm after starts. Starting in elementary school, Anraku mummified himself in ice to stem the swelling. This did not compute with Joko; he worried ice halted blood circulation and didn't promote healing. In June 2013, he found a powerful ally: the
American Journal of Sports Medicine
published a study that questioned the efficacy of ice, noting that while it reduced inflammation, it also slowed healing.

If that was wrong—if Americans spent nearly four decades listening to doctors' and trainers' orders to treat inflammation with the famous RICE acronym: rest, ice, compression, and elevation—Joko wondered what else was faulty. Professional players in the United States blew out their elbows at record rates in recent years, and they wanted to call
him
the abuser?

“It's the final game of the Koshien tournament,” Joko said. “That's two high schools out of four thousand–something. It's a very honorable thing to be in the final game of that tournament. I can't even put it in words. As a pitcher, it can be a pretty memorable and honorable thing for them. As long as he said he wants to pitch, I want to send him to the mound.”

Heading into the 2014 Summer Koshien, Joko wanted to summon his kaibutsu one final time. If that meant 772 pitches or 800 or 949, one more than Yuki Saito's record, Joko would allow Anraku to choose, knowing what the answer would be. Saibi's defeat in the regional tournament made it moot.

“Everybody was sort of relieved that he lost,” Sakayama said.

It's cruel to think it's that way, winning and arm health the two ends of yakyu's imbalanced scale. Backward though it may be, the truth is that getting injured may have been the best thing that happened to Tomohiro Anraku. It saved him from even worse.

T
HE FIRST PATIENT ARRIVED A
little before two p.m. The waiting room around him at Mito Kyodo Hospital bustled with noise and activity. He was nervous until the blue door to one of the offices that ringed the room slid open. Dr. Naotaka Mamizuka greeted him with a smile and welcomed him in. Two afternoons a week, Mamizuka takes time off from his work as a spinal surgeon to treat baseball players with hurt arms. Wearing a head-to-toe Adidas getup instead of a lab coat, the athletic-looking Mamizuka projected an aura more coach than doctor. Children from everywhere in Japan travel to see Mamizuka. They are as young as eight. Nearly every one is injured.

For the next four hours, I watched a parade of kids come through the sliding door into a twelve-by-ten-foot hospital room and reveal the true story of yakyu today. The bones in the first patient's arm were not yet fully formed, and the UCL yanked a piece of bone off the inside knob of his elbow, similar to the injury Braedyn Woborny suffered. Mamizuka diagnosed it as an avulsion fracture of the medial epicondyle and said this wasn't the first time. The boy likely broke his elbow once before, did not allow proper healing, and fractured it again. He was ten years old. And his story mirrored that of almost all the nineteen other patients Mamizuka saw that afternoon, a typical Friday other than it
happened to be one day before Summer Koshien was set to begin.

“I say to parents: This is not good,” Mamizuka said. “Bad training. Bad pitching. Bad coaching.”

Millions of Japanese boys play baseball, and studies show the youngest are hurt far more frequently than kids in the United States. During a regional tournament in July 2011, an orthopedist named Tetsuya Matsuura surveyed every participant, ages ten to twelve. While Matsuura was looking for cases of a bone injury called osteochondritis dissecans (OCD), he found something far more interesting: of the more than one thousand players with no signs of OCD, 43.4 percent still reported elbow pain, according to his article in the
Orthopaedic Journal of Sports Medicine
. Another study of youth players in Yamagata, Japan, found that two-thirds of the sixty-three-pitcher sample suffered elbow injuries. By contrast, in a ten-year-long study conducted by Glenn Fleisig at the American Sports Medicine Institute, 25.5 percent of American children in the same age group copped to elbow pain.

Mamizuka once visited ASMI in Birmingham, Alabama, and returned to Mito wishing his life's work of fixing Japanese baseball wasn't the solitary windmill-tilting it's always been. In a few years he turns fifty, and he hopes that his added gravitas will make the baseball power structure start listening to him. For now, a small, dedicated bunch reads his book,
The Baseball Medicine
, and feasts on the Facebook posts in which he politely dismantles Japanese baseball's willful institutional ignorance. In the meantime, he serves as one of a handful of doctors who treat arm injuries. Because the demand for his time is so great, a standard Mamizuka appointment consists of him perusing an MRI—every kid gets one because they cost only $70 at Mito Kyodo, compared with around $1,000 in the United States—and delivering a quick diagnosis before it's another patient's turn.

“Next!” Mamizuka said after the first boy left, and the blue door slid open and in walked Ryusei, an eleven-year-old. His name means “shooting star” in Japanese.

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