There are no definitive answers in this book. It’s more an exploration of what is and isn’t known about what contributes to pitching arm injuries and successful recovery from Tommy John surgery, an expose of baseball culture and proprietary business interests, and an insider look at some of the people most involved. The case studies/human interest stories of a few pitchers as they go through injury, surgery, rehab, and (attempted) career recovery gave the book its heart, and the hopes and fears of parents of talented children with possible multimillion dollar arms gave it more urgency.

It was a good read for the off-season, to alleviate the boredom of waiting for games to start again, and it will change how I follow my own favorite team and players. Hardcover version, owned.
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I was surprised at how much money MLB spends on pitchers -- $200M contracts for players that have already had Tommy John surgery! With the growth of year-round youth baseball, it is a bit alarming that Tommy-John surgery is growing in the high-school (and even younger set). The chapter on Japanese baseball and it's iron-man cult was interesting too. ( )

In writing this book, Jeff Passan set out to answer two questions: “I sat in laboratories, saw doctors tend to bodies living and dead, went halfway across the globe to a place where the problem is even greater, read medical studies, and scavenged through data, all to answer two vital questions: How did baseball fail the pitching arm, and what can be done to save it?”

He calls attention to an important issue that impacts not only major league pitchers, but children that aspire to become a baseball player, particularly a pitcher: “Elbows are breaking more than ever and younger than ever. And while the rash of Tommy John surgeries that spread across Major League Baseball over the last five years took out some of the game’s finest pitchers, children ages fifteen to nineteen make up a disproportionately high number of patients. Baseball is thus left scrambling to figure out how to keep its million-dollar arms healthy while fixing a feeder system that keeps sending damaged goods to major league teams.”

What he found is that, while data could be used to figure out what could be done about this epidemic in sports injury to help everyone, and in today’s “numbers era” metrics are more readily available than ever before: “Baseball nevertheless has fostered an environment in which all thirty teams treat pitchers’ health as proprietary information instead of banding together to solve the sport’s greatest mystery.”

With today's increasing emphasis on velocity, overuse and excessive maximum-effort throwing are two of the primary culprits. In addition, to exploring the various technical solutions, describing ulnar collateral ligament (UCL aka Tommy John) surgery in vivid detail, and interviewing some of the most celebrated players in the game (such as Sandy Koufax), Passan focuses on the human side of the story by following two major league pitchers, Daniel Hudson and Todd Coffey, to find out how they cope during downtime required during the rehabilitation process.

Some of the interesting highlights of this book include:
- Visiting baseball-obsessed Japan
- Bringing to light to perils involved in kids’ participation in the travel circuit and showcase tournaments
- Investigating the latest technological and scientific developments in the field

I found it well-written and informative. While there are no guaranteed solutions, there are recommendations and steps to be taken to prevent injuries. Baseball fans and anyone interested in the root causes of the rising number of arm injuries will find a wealth of fascinating material in this book. Parents of kids with a passion for baseball will gain insight into how to help keep their arms healthy.
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I like Passan's sentences and paragraphs, and the narrative thread of the rehabs of Daniel Hudson and Todd Coffey was compelling, especially the deeper dive into the emotional component, but the other pieces of the book didn't hang together in a cohesive whole for me. The Jon Lester chapter is a standout in both directions: Being deep inside the negotiations, down to jagermeister spilled on someone's jeans in a late-night session at the winter meetings, was thrilling, but it also felt like a magazine article about that negotiation shoehorned into a book about the arm. The opening chapter, about Todd Coffey's surgery, was a genuine marvel, though. Probably a full star of my rating is for that story. ( )

DNF at 59%. My library loan ran out and I'm not going to bother taking it out again.

It was a very interesting topic, all on Tommy John surgery and how we're screwing with pitcher's arms by making them doing things their arm wasn't meant to do.
My problem was that it repeated itself. And repeated itself. And repeated itself. I found that I lost interest about midway through because it just wasn't saying anything it hadn't said already. I'm not convinced my audiobook didn't get stuck on a loop, to be honest. ( )