So why the rise in injuries? Here, too, the theories are based more in apocrypha than science. Nolan Ryan is among those who have floated the idea that pitchers, with their pitch counts and innings limits and specialized roles, actually aren’t throwing enough. This belief is often steeped in a kind of nostalgic machismo. “When I pitched, you had one mentality: When you started the game, you wanted to finish the game, no matter how long it took you,” the former Red Sox pitcher Luis Tiant has said. (Tiant, it’s worth noting, had his fair share of injuries in his career.) Others blame the injury epidemic on the modern fashion for power over finesse pitching and the riches that now await a kid who can hit the mid- to high-nineties on the radar gun. Young players’ fathers sometimes pay hundreds or even thousands of dollars to a small but growing number of for-profit companies that promise to evaluate videotape of a player and offer insight on how he can change his mechanics to throw hard but still avoid injury. But youth injury rates are as alarming as those for professional players. The American Sports Medicine Institute, a nonprofit research group, has found that five percent of all kids pitching at the age of 12 will have either had some sort of surgery or quit baseball because of a serious arm injury by age 22.
According to Baseball America’s 2013 Prospect Handbook, Brett Marshall is the No. 6 prospect and the No. 2 pitcher in the Yankees system (behind 20-year-old Venezuelan Jose Campos). He “profiles as a durable, sinkerballing No. 4 starter—not the Yankees’ prototype prospect but a useful trade chip,” the handbook reads. It also notes: “He struggled mightily before having Tommy John surgery in 2009.”
Marshall is a Texas kid (baseball scouts have long had a fetish for Texas pitchers, from Ryan to Roger Clemens) who exploded on the scouting scene his junior year in high school. The fact that he had started out as a shortstop made many scouts believe he would be less injury prone because he’d thrown fewer pitches (the “you only have so many bullets in the gun” theory). Marshall lost the last start of his high-school career when he hit a batter in the state semifinals to force in the deciding run. It was his 146th pitch. The Yankees drafted Marshall in the sixth round in 2008. He pitched a total of twenty games (poorly; his ERA was 5.21) before his arm started feeling sore and the Yankees shut him down. He then had Tommy John surgery. He was 19.
Developed by orthopedic surgeon Frank Jobe in the seventies, Tommy John surgery involves taking a tendon from the thigh or forearm and grafting it onto the elbow to, essentially, reconstruct the damaged ligament. Because the procedure has become so common—there are at least 40 Tommy John surgeries a year in MLB and the minors alone—and because a number of high-profile pitchers (from the Cardinals’ Adam Wainwright to former Yankee A. J. Burnett) have not only saved their careers but thrived after undergoing it, the surgery is often thought of as a panacea, if not a rite of passage. Marshall was almost happy to have it. “I saw all these other guys having it, and I knew I was gonna have it someday. I ended up having it earlier in my career rather than late. It really isn’t a big deal.”
In fact, the surgery takes at least a year of recovery and is far from a guaranteed success. The majority of players who undergo the procedure do return eventually, but while some of them claim they come back throwing harder, that’s mostly anecdotal information. While there are pitchers like John Smoltz, who was better after the surgery than before, there are also those like Francisco Liriano, who has never been the same since his operation in 2006.
Marshall was at least humbled enough by the surgery to take it as a teachable moment. “I was like, This is a time I can fix everything,” he says. “I watched tons of video comparing myself to other big leaguers to see what they do right. I knew what I was doing wrong, and I knew I had to fix it. If I didn’t, I was going to have to go through it again.” Now, he says, “I feel like I am healed. I feel like I will be good.”
Chris O’Leary is a St. Louis father who was coaching his 9-year-old son in 2005 when, inspired by his own childhood arm problems, he set out to find the perfect mechanics to keep pitchers healthy. After reviewing hundreds of major leaguers to see what the healthy pitchers were doing differently from the unhealthy ones, he discovered something strange. Many of the pitchers who kept getting hurt—Smoltz, the cursed Mark Prior, Jeremy Bonderman—had a similar motion, something he learned was called “the inverted W.” O’Leary defines the inverted W as “being more than 90 degrees of shoulder abduction with the Pitching Arm Side (PAS) elbow above the level of the shoulders combined with five or more degrees of shoulder horizontal adduction.” But what it really means is that at the midpoint of a pitcher’s motion, his elbows are above the shoulders, making a sort of sideways W. That technique can throw a pitcher’s timing off, which can, in turn, put undue stress on his arm. It was, to O’Leary’s eyes, a recipe for Tommy John surgery.