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Authors: Jeff Passan

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Though the fracture in his elbow had healed—the medial epicondyle often breaks in cases of so-called Little League elbow, a malady from which kids usually return to play but find themselves at greater risk for future injury—Ryusei's arm still hurt. Mamizuka pulled up his MRI and clicked at a feverish rate, zooming, panning, explaining. Ryusei's UCL was damaged. Mamizuka couldn't do anything. Unlike some American doctors, he refuses to perform Tommy John surgery on anyone younger than fifteen, and even those cases are infrequent. Just rest, he told Ryusei. This would not be the last boy Mamizuka saw that day whose UCL injury preceded a full set of teeth.

A twelve-year-old needed Tommy John surgery but wouldn't get it. A nine-year-old had an avulsion fracture. An eleven-year-old suffered a broken foot, which Mamizuka worried came from too much running during practice. A nine-year-old, wearing a splint two months after doctors healed his avulsion fracture by inserting a pin into it, was asked by Mamizuka whether he still liked baseball. “Yes,” the boy replied. A fifteen-year-old was diagnosed with OCD. Mamizuka had told him to stop playing at thirteen and let an elbow injury heal. He didn't listen, and the condition turned necrotic. Mamizuka carefully explained to the boy and his mom that doctors would need to transplant bone from the rib or knee to fix the elbow damage.

Every time the door slid open, another heartbreak walked in. I looked at Mamizuka once, in between appointments, and asked if it's like this all the time. “Every week,” he said. One of the nine-year-old boys said he had daily four-hour practices and spent most of his weekend days playing, too. If any more evidence was needed that Japanese baseball had institutionalized injuries, just as its American counterpart had, here it was: the eerie sight of children lining up as though at a buffet to see a man who would say that baseball failed them, not the other way around.

Most came and left with the same advice. Rest your arm. Schedule a follow-up for a few months down the road. And under
no circumstances throw. When a high school–aged kid rolled in, his mom in tow with a Louis Vuitton bag in her hand and Crocs on her feet, Mamizuka asked him to pantomime his delivery. Mamizuka shook his head and stood up. He wanted to teach everyone what he taught his son: throw with less than 100 percent force. “Power is bad,” Mamizuka said. Naturally, his most famous patient, a twenty-year-old named Shohei Otani, threw a pitch in Japan's 2014 All-Star Game clocked at 101 miles per hour, harder than any Japanese-born player ever had thrown. So far, Otani is perfectly healthy. American executives froth at the possibility Otani could soon join the major leagues and foresee a bidding war for his services likely to exceed $200 million.

Because Mamizuka couldn't do anything about stemming velocity, and because so many refused to listen to his criticisms of nagekomi, he focused with older patients on the one thing he could change: mechanics. He demonstrated the proper way to throw a baseball. “
Ichi, ni, san,
” he said. “
Ichi, ni, san.
” One, two, three. One, two, three. Shift the weight through the pelvis. Rotate the trunk to the right. Swing the arm with purpose. It was rhythmic.
Ichi, ni, san
. One, two, three.

If only it were that easy. Mamizuka had minutes to explain what would take months to perfect. This is how it works when a doctor jams twenty patients into an afternoon. No chitchat. In and out, appointments as short as two minutes. For two more hours, kids showed up. Only one left with a clean bill of health from Mamizuka. MRIs, like radar guns, never lied, and child after child showed signs of damage directly related to baseball.

The last, and most vexing, case of the day was a slight twelve-year-old. He had come in months earlier with an epicondyle fracture. It looked better, as did his UCL. He was a sweet kid, his lisp endearing, his self-awareness more so. He didn't understand how he got hurt. He didn't even throw hard. Mamizuka told him it would be OK. That's what kids needed to hear.

He'd said the same to other kids for years. As the doctor for a
national youth team, he did periodic assessments on some of the players. One in particular, the team's closer, intrigued Mamizuka. His name was Shota Tatsuta. Years before Tatsuta made Japan think about its baseball culture, Mamizuka worried what it had done to him already.

“I checked him at the end of [a tournament],” Mamizuka said. “His UCL is a little bit damaged.”

T
HE NATIONAL SPORT OF AN
educated, industrial society encourages behavior that endangers children's health. This sounds so primitive until one considers football's popularity in the United States. The sanctimony exasperated plenty inside the Japanese baseball establishment, particularly when elite baseball in Japan and the United States is so similar. For Anthony and Nelson Molina, there are Tomohiro Anraku and Masanori Joko. For Riley and Neil Pint, there are Shota and Hirokazu Tatsuta. For the showcase circuit, there is Koshien. For the nonexistent offseason, there is nagekomi. The radar guns are the same. The monetary incentives exist in both places. The only difference is the United States knows its system is defective and Japan is slowly figuring it out.

To show me the progress Japan is making to change its attitude toward pitching, Farsad Darvish invited me to meet someone. Night had fallen. A late-summer rain fell on Kobe. Farsad took the highway about a half hour to Onijus coffee shop in south Osaka. In the parking lot stood a white-whiskered sixty-seven-year-old man with gingham pants, a striped shirt, and a sport coat accented by mother-of-pearl buttons. Farsad introduced him as “kantoku.”

His real name was Asao Yamada, and he was Yu Darvish's middle-school coach. For decades he had coached kids in Habikino, the midsized city outside Osaka where Darvish spent his childhood. Yamada grew up playing baseball himself, often
teaming with another talented young player: Masanori Joko. As both went into coaching—Joko full-time, Yamada part-time—they kept in touch. Neither drank sake. Both enjoyed the sauna. They would talk baseball, their philosophies in lockstep, the sanctity of yakyu nonpareil. Though they hadn't seen each other in a while—Yamada said Joko spent some time in a hospital recently—Yamada sympathized with the American scrutiny his old friend endured because of 772.

At an international youth tournament in Phoenix half a decade earlier, Yamada coached the Japanese national team. Day after day, he ran the same pitchers out to the mound. During a lunch with coaches from other countries, Yamada learned they'd bestowed upon him a nickname. “They called me Crazy Yamada,” he said.

Time passed, and as much as Yamada wanted to blame the cultural divide for his fellow coaches' perspective, he started to ask himself what supported the Japanese way other than its familiarity. When Darvish's elbow blew out, it complicated matters even more. Yamada's generation was supposed to be the protector of yakyu, and suddenly he wasn't sure whether it was something worth protecting.

“It's very important to win,” Yamada said, “but now for me, as I get older, it's very important to see the kids stay healthy.”

Yamada coaches a fourteen-year-old boy named Shinji Oishi who throws left-handed and conjures a mirror image of Darvish at the same age. Yamada's instinct is for Oishi to throw and throw and throw, teach those muscles how to feel on a proper delivery, reach for perfection of form. Then he reminds himself: With something as fallible as the arm, perfection exists only in the minds of the stubborn and anachronistic, a myth unworthy of preservation. He would treat Shinji more like Shota Tatsuta than Darvish.

I left the coffeehouse with a smidgen of hope. If someone like Asao Yamada could grow, surely others could. Maybe even Masanori Joko.

“Who is to change this?” Farsad said. “I suppose only time can.”

T
OMOHIRO ANRAKU SNIFFLED TWICE, SWALLOWED
hard to compose himself, and sneaked a look at the speech he clutched with both hands. At Murata Hall in Matsuyama, more than 750 people showed up to honor a beloved figure in the community. And the kid who wanted to play baseball and sing pop songs was asked to eulogize him.

“Kantoku-san
,” Anraku began, sure to include the formal honorific because Masanori Joko would've expected it. Joko had been sick, like Yamada said, living out his final days with bile-duct cancer before dying September 1, 2014. He was sixty-seven.

When Joko started cancer treatment in the fall of 2013, he didn't tell anyone on his team. Joko's final months were blackened by scandal. Before a spring game in 2014, one of Joko's sophomores had insisted a freshman put a dead bug in his mouth or drink kerosene. The boy chose the bug. A month later, a group of sophomores made freshmen fight one another, encouraging them to punch harder and throwing rubber balls at the underclassmen. The Japan High School Baseball Federation, calling the behavior a “deep-rooted problem,” suspended Saibi from competing in any games, including Koshien, for a year. Joko went to the hospital a week later and never left.

The mourners wept at the smiling picture of Joko in better days and the three jerseys and the purple flowers and the advice of Joko they remembered, like taking little moments and connecting them to survive in bigger moments. Kantoku was right: This is what real pain felt like. This is what true loss felt like. Nothing—not even 772 pitches—could prepare him for this. “You always considered my condition first, putting your own matters aside,” Anraku said. “Even when you were not feeling well, you didn't show that to us. Instead, you always faced us with full force.
Speak when spoken to, greet well, pay attention, be considerate, be thoughtful. Those were the words you always valued from your belief that students shall grow up not only as great baseball players but also great people in an adult society.”

Anraku had set three goals with Joko: win Koshien, throw a fastball 160 kilometers per hour (99 miles per hour), and become the first overall pick in the draft. “I wasn't able to make the first two promises,” Anraku said, “but I still keep my challenge to make our third promise.”

Seven weeks later, with the number two overall pick in the 2014 Nippon Professional Baseball draft, the Tohoku Rakuten Golden Eagles chose Tomohiro Anraku. In the first round, all twelve teams name the one player they covet most. If more than one team chooses the same player, a lottery determines where he goes. Four teams selected Kohei Arihara, a pitcher from Japan's baseball factory, Waseda University. Despite Anraku's elbow issues and velocity dip, Rakuten and the Yakult Swallows both wanted him.

While Anraku prepared for a press conference in his traditional
gakuran
school uniform, Shota Tatsuta went home to watch the draft on TV. He wasn't going to be a first-round pick; he didn't throw hard enough. He probably wouldn't be a second- or third-rounder, either. And at that juncture, he feared teams wouldn't want him because of his baseball beliefs. He watched with his father, and when the Hokkaido Nippon Ham Fighters chose Tatsuta with the eighth pick of the sixth round, they started to cry. He'd made it. They'd made it. The plan worked. Maybe Shota did have some UCL damage, like Mamizuka said, but it had presented with no symptoms for long enough that he could convince one team, which is all he needed.

“There's no right answer,” Shota said. “There are many younger kids who hurt their throwing arm, but at the same time there are so many kids who don't get injured no matter how many pitches they throw. It depends on the individual. There's no right answer.”

In Masanori Joko's mind, the right answer was Tomohiro Anraku. He willingly embodied the tradition upheld by generations of Japanese baseball players and unwittingly became the face of a debate that spanned the world. On the day Joko was laid to rest, Anraku's face was again the focus as the entire Saibi baseball team gathered outside the hall. The players wore their uniforms, head to toe, and they were clean, just as Joko would have expected before practice. The hearse started to pull away. Joko's children doffed their caps. They said good-bye to their kantoku and the style that went with him, the former gone forever, the latter not far behind.

CHAPTER 12
Changeup

O
N THE FIRST NIGHT OF
a visit back to his parents' Virginia house in the fall of 2013, Daniel Hudson glanced around the kitchen, saw the bottle of Barefoot Sweet Red Blend, and knew he needed to make a run to the ABC store. One perk of being injured for two years was the chance to try new things, and Hudson and Sara had discovered the joys of good wine, which had the added benefit, of course, of blunting the drudgery of rehab.

When Hudson left for the store, Sara retreated to the bathroom, and set out to eliminate one reason for her nausea that morning. She'd taken pregnancy tests before, and they all turned out the same: one line, many disappointments. As she held the stick this time, she held her breath, too. When a second pink line crept across the surface, she couldn't move. It was five p.m. on November 19, 2013. “You never forget that moment,” Sara said, “when your heart stops after you've been trying for two years.”

By the time Hudson returned, Sara was catatonic with joy.
“What's wrong?” he said. She showed him the test. Hudson hadn't given up hope for a baby; a few weeks earlier they had scheduled an appointment to talk with a doctor about in vitro fertilization and other potential remedies. His speechlessness awoke Sara from her trance. She jumped up and down. He couldn't remember the last time he smiled like this.

“A lot of news we've gotten recently has been just bad,” Hudson said. “This is the first good thing.”

Now it made sense why Hudson reacted as well as he did to the Diamondbacks taking him off the roster two weeks later: for the first time in his life, something beyond himself was driving his baseball career. When Hudson shot up between his junior and senior years of high school and his fastball ticked up from 87 to 93, he felt a certain power on the mound, an impregnability that nothing in life could match. He burned for the competition.

Something changed in Hudson after Sara took the pregnancy test—and five more, just to make sure the previous ones weren't lying. His choice was clearer: sit around and feel sorry for himself or become proactive about his faltering career and try to understand how the arm works, why it works that way, and what he could do to make it work for him and his wife and baby. It wasn't that Hudson became more outwardly positive; he was simply reminded of the world outside this bubble he created for himself, one with buckets of rice and hours of sculpting scapulas and Jobes and the godforsaken treadmill he'd worn out as much as it did him. Baseball does a great job of convincing players that's what life is until life proves otherwise.

The baby was due July 21, 2014, just about the date of its father's projected return to baseball after what would be thirteen grueling months of recovery. His own due date depended on his health, of course. The Diamondbacks had built in multiple-week breaks to give Hudson's arm a breather. At the sign of even the tiniest bit of soreness, Hudson shut down his throwing program for a few days.

Hudson's protocol was essentially a slightly more cautious version of the typical twelve-month post–Tommy John surgery plan. In mid-January, back at the Diamondbacks' spring-training complex in Scottsdale, Hudson was throwing for about ten minutes at a time, starting at sixty feet and backing up to ninety. On the other end of the throws was Brad Arnsberg, still the rehab coordinator, still the consummate bullshitter.

“I love war, the old wars,” Arnie said to me during his catch with Hudson. “Anything from World War I, World War II, the Korean War, Vietnam. I've read a lot of the Navy SEAL books. I think if I could do it all over again and didn't choose baseball, I always had a big affection for the military and a great respect for it. I'm not saying I could've. Those guys are built out of a different cloth.”

Throw. Pop.

“I always had great work habits and pushed my body to the limit,” Arnie said. “I did things not a whole lot of other guys did. I might've given it a try. But to say I could've gone through the training. I don't know. It's the mentally tough guys. The ones who can handle the ups and downs. It reminds me a lot of playing baseball. Knock on wood, there's been no setbacks. Every day he's gone with me, it's not like he has a couple steps forward. But he's either treaded water or gained steam. No setbacks.”

Throw. Pop.

“And knock on a big piece of wood,” Arnie said. “I hate to jinx something like that.”

“Couple more,” Hudson called out, and after precisely two throws, he rejoined Arnsberg for a pat on the back. “Solid, man,” Arnie said.

Hudson proceeded inside to the Diamondbacks' weight room, a massive structure with thirty-foot-tall ceilings and futuristic equipment, and opted for something basic: standing in front of a mirror and cutting short full throws of two-pound medicine balls. Then he loaded a four-ounce baseball into a sock and threw
it, making sure to hold on to the sock. He did the same sock drill with a six-ounce ball. All the while, he paid particular attention to his hand in relation to the rest of his arm, slowing himself down when it felt wrong.

As the greatest change in his life beckoned, so did the transformation of his career. After years of protest, Hudson was ready to overhaul the most fundamental thing about himself: how he threw a baseball.

B
OREDOM SNUCK UP ON TODD
Coffey in interesting ways. During the early stages of his recovery, he took perverse pleasure in getting booted from the youth-league softball games of his daughters, Hannah and Haley, for arguing with the umpires. That got old after the fourth or so ejection, so he moved on to something with the promise of far greater rewards: Dumpster diving.

Over his baseball career, Coffey had made around $7 million. After his second Tommy John surgery, he tightened his budget and started impersonating someone a lot more strapped for cash than he was. He traded original, in-box Nintendo cartridges to earn small profits. He hit swap meets and thrift stores in search of bargains. Coffey even jumped into a trash bin to snatch a particularly lucrative supermarket flyer to use in his latest round of extreme couponing.

“I can't believe I did that,” Coffey said. “Actually, yes I can. Hey, it's free money.”

Extreme couponing is the art of stacking discount on top of discount and leaving a store with large and often unnecessary amounts of stuff for a pittance. During one such trip, Coffey and Jennifer got $160 worth of hair-care products, toothpaste, and granola bars for thirteen bucks. Another session yielded more than one hundred bottles of Powerade for free. When he wasn't preparing for his next showcase, Coffey scoured the Internet for the best coupons.

“I really need to pitch,” he said.

With every week that passed, he achieved a new level of delirium. Coffey wanted another showcase at the end of April. Then he injured his knee when emphasizing lower-half mechanics and trying to get an extra mile per hour from his legs. “I'm there,” he said. “I am so close. But I've got to be smart about it. What's an extra week right now? Nothing.”

He was approaching the two-year anniversary of his surgery date, a year longer than he wanted, even longer than Dr. ElAttrache anticipated, and Coffey still couldn't stay healthy. Minor though they were in the grand scheme, every twinge and tweak put him further from where he was supposed to be. On May 2, 2014, a former closer named Joel Hanrahan signed for a guaranteed $1 million with the Detroit Tigers less than a year removed from his Tommy John. Coffey was incredulous. Hanrahan's fastball sat around 90 and topped out at 93 in his showcase. Coffey's fastball was parked at 92 before the leg flared up.

He couldn't wait any longer for his second showcase. “Especially after seeing Hanrahan get what he got,” Coffey said. He booked a flight to Phoenix for May 4 and gave himself ten days to get used to the mound at Physiotherapy Associates, rid himself of the bad memories from the last showcase, and prepare to win a job. On Coffey's fourth day there, former big league catcher Lou Marson, also rehabbing an injury, caught his bullpen session. “I finally get some big league feedback,” Coffey said. “He said, ‘If I was you, I'd do my showcase. You hit all your spots. The ball was heavy and hard. I wouldn't want to face you.'”

Coffey set the showcase for May 14. Another performance like the first one and his career was over. This frightened him; Coffey didn't spend much time thinking about his future after baseball, because baseball still dominated his present. He had neither the patience nor the desire to coach. Front-office and scouting work sounded fun, as did the agent side of the game, but only a privileged few get to stay in baseball, leaving the rest to explore alternative interests. One business idea stuck with Coffey.

“A legit go-kart track,” he said. “Take Dave and Buster's, and add electric go-karts inside. Add alcohol to it, too. I'd do it somewhere in the Midwest. You're freezing. You're always cold. Everything has to be indoors. When people go out in the Midwest, they want to be out two to three hours. Adult go-karts, kid go-karts, food. One-stop shop. With the alcohol, everyone purchases everything on a card. If you've had too much to drink, they'll know and you won't be allowed to race.”

Before he entered the semidrunk go-karting business, Coffey needed to prove to himself this return to pitching wasn't some flight of fancy. He said it himself nearly two years earlier: he didn't want to be the guy whose lack of self-awareness left him hanging on long past his time. He was certain he wasn't. Someone would see what he saw. They always did. When that happened, he would pitch his way back into the major leagues. Once there, he'd finally get to do something ten years in the making.

“Every rookie who comes up, I tell him before his first outing, do your warm-ups and do a three-sixty,” he said. “Look around the stadium. You'll never get the chance to do it again. You have only one debut. You deserve to be selfish. Take your ten seconds and get back to work.”

Coffey hadn't done that on April 19, 2005. It was a Tuesday. After seven years clawing through the minor leagues, not listening to the teammates who laughed at him or the scouts who ignored him or the people who told him to lose weight, he joined the Reds in Cincinnati. His manager, Dave Miley, called on him to start the sixth inning against Derrek Lee, the best hitter in the National League that season. Coffey was too young to treasure the moment, too frightened to do anything but throw sinkers and hope for ground balls. After Lee welcomed him to the major leagues by whacking a single, Michael Barrett continued the hospitality with a home run, and so began the run he refused to let end.

He had to make it back, if only so he could have that feeling
once more. His arm new, his career reborn, these two years worth something.

“I'm gonna run in from the bullpen,” Coffey said. “I'm gonna do my three-sixty, and I'm gonna take my ten seconds. Maybe even more.”

T
HE ARM IS NOT JUST
the arm. It is, as the anthropologist Neil Roach said, “everything from the feet to the fingers.” The St. Louis Cardinals were one of the few teams that understood this. A few years ago, they hired Paul Davis, a former college baseball player and coach working toward his doctorate in leadership studies. Davis spent years trying to wrap his head around the mysteries of the arm. He struck up a friendship with Brent Strom, the Buzz Aldrin of Tommy John surgery. Strom, then the Cardinals' minor league pitching coordinator, recommended Davis to the organization.

In 2012, they hired Davis and two years later gave him his dream job and a most unique title: coordinator of pitching analytics. The Cardinals wanted Davis to apply his knowledge to the twin problems of keeping their pitchers healthy and steering clear of ones susceptible to injury. He read more than 150 academic papers from around the world that covered every aspect of the throwing motion. He used himself as a guinea pig to test what he learned, a fifty-year-old man trying to re-create the motions of someone half his age.

Davis studied video of four pitchers in the Cardinals organization—starters Shelby Miller and Joe Kelly, relievers Trevor Rosenthal and Mitchell Boggs—and focused on a single measurement: the position of the back ankle during a pitch. Davis subscribed to the theory of triple extension—the ankle, knee, and hip extending were critical to an efficient pitching motion. Everything started with the foot. He paused the video, zoomed in, and studied the ankle's dorsiflexion, or how far it extended.
Rosenthal had the best ankle mobility of the group. He's the only one of the four still with St. Louis.

“If you start incorrectly, it's just going to be a snowball,” Davis said. “You'll see guys who come to a set and their first move they get their pelvis in a bad position, which is reflected in their ankle, and the very first movement they make, they're screwed. I can say that's a bad delivery and he's got bad arm action, and the analytics guys will tell me that I can't say when he's going to break. And they're right. What I can say is this guy has a riskier delivery. It's like insurance. If you're in a flood zone, there's more risk there.”

While Daniel Hudson preferred not to turn himself into a laboratory experiment, he refused to play innocent bystander again. If others wanted to stare at Hudson's ankles, they could. Ken Crenshaw, the Diamondbacks' trainer, instead devised a program for Hudson to shorten his arm swing behind his body and get his hand on top of the ball, so he could pull down on it rather than fling it off the sides of his fingers. Essentially, it was what Brad Arnsberg wanted to do the first time around.

“I've been thinking about it,” Hudson said. “A surgery that has an eighty to eighty-five percent success rate, where guys get back to their previous level or better, didn't work for me. So am I going to just do it again the same way or try something different? Once I had surgery again, I'm like, ‘I gotta fix something. Something's gotta change if I really want to pitch for ten, twelve, fifteen more years. I've got to figure something out to stay healthy.' I basically had to reteach myself how to throw.”

BOOK: The Arm
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