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Jeff Passan's Inverted W Tweet

In May 2015, a paper was published that described the results of a 2010 study of the Inverted W. Jeff Passan tweeted the following in response...

The problem is that Jeff Passan's tweet about the Inverted W and Tommy John surgery is at best incomplete and, in my opinion, deceptive. As I said in 2010...

What the not so durable guys do is they take their elbows back but they also take them up. Now, that's actually painful to do, but it's not that bad in and of itself. The problem is that when you take the elbows back and up, you can end up with a Timing problem.

...the truth about the relationship between the Inverted W and Tommy John surgery is a bit more subtle.

It's the Timing, Jeff Passan

For years, and since at least 2007, I have made it clear that I believe that the Inverted W does not directly cause injuries; the position itself isn't the root cause of the problems that pitchers who make the Inverted W so often experience. Rather, I believe the Timing problem that the Inverted W can create is the root cause of the problems that pitchers like Mark Prior and Anthony Reyes experienced.

As a result, a more accurate tweet would have been...

The Inverted W directly causing Tommy John surgery is a myth; the real culprit is Timing. As Chris O'Leary has been saying since 2007.

But what we're stuck with is...

In my experience, tweets like Jeff Passan's only serve to further cloud an already muddy issue and benefit those who would deny there's a link between the Inverted W and injuries by making it easier for them to sell, or blow off, the Inverted W and the other problematic arm actions -- including the Inverted L, which is currently eating away at the arm of Jose Fernandez -- when talking to concerned but unsuspecting parents and ballplayers.

I'm honestly surprised Jeff Passan would imply that the core claim is that the root cause of pitcher injury problems is the Inverted W, and not the Timing problems that positions like the Inverted W so often create, given that I told him as much in person in August of 2013 and then pointed him to a number of articles of mine that said the same thing.

Jeff interviewed me in person for his book on the day that, coincidentally, Matt Harvey's elbow blew up. As a result, we talked about my experience with him, my view of Matt Harvey's pitching mechanics and his problems, how I never saw an Inverted W in Matt's arm action and told his father as much, and how I had previously expressed concerns about Matt's timing before his elbow injury.

I did so precisely to make the point that the Inverted W isn't the only -- or even the main -- thing people should be focusing on.

Hell, back in 2010, in the Stephen Strasburg and Inverted W Interview (MP3) that led to the Douoguih 2010 sudy, I very explicitly, and on multiple occasions, made the case that the problem was the Timing problem positions like the Inverted W tends to create, not the position itself.

What the not so durable guys do is they take their elbows back but they also take them up. Now, that's actually painful to do, but it's not that bad in and of itself. The problem is that when you take the elbows back and up, you can end up with a Timing problem.

So I'd be VERY surprised if Jeff Passan, who said he and his assistants/interns were going to read everything I'd written about the subject, had missed that interview.

Maybe Jeff Passan was going to ask me more about this topic during a subsequent interview -- the most recent interview request coming in the days following Jose Fernandez's shoulder injury -- all of which I quickly agreed to and none of which he actually conducted?

I could see how, in two years, Jeff Passan could forget what I said when interviewing me. But he did record my comments.

I'd have been fine if Jeff Passan tweeted...

The Inverted W DIRECTLY causing Tommy John surgery is a myth.

...because I've been trying to make that point -- to shift the conversation from positions like the Inverted W to the concept of Timing -- starting in 2007...

In Frame 28, Mark Prior is at a position that I call the Inverted W (or simply The M). Notice how his PAS elbow is both above and behind his shoulders and his PAS forearm is hanging down nearly vertically beneath it.
This position isn't damaging in and of itself.
However, by coming to this position, Mark Prior is ensuring that his pitching arm will not be in the proper position at the moment his shoulders start to turn.
As with pitchers with other timing problems like rushing, because his pitching arm is so late, he will dramatically increase the stress on both his elbow and shoulder.

...and here in 2008 where I said...

The problem with the Inverted W is that it can (and I mean can and not always does) create a timing problem (aka rushing) and cause the arm to be late.

...or when Tom Verducci, who liked my explanation so much that he copied it, pretty much verbatim, in one of his 2011 pieces on Stephen Strasburg...

The problem is the timing associated with that move, not the move itself.

In terms of the problem with the Inverted W, what that means is that, in the picture below of Anthony Reyes, the biggest problem isn't the height of his elbows.

Anthony Reyes and the Inverted W

Anthony Reyes's Inverted W

Rather, and as I state in my analysis of Anthony Reyes' pitching mechanics, the biggest problem is that Anthony Reyes' elbows are up, and his forearms are pointing downward, at the moment his front foot is planting and his shoulders are stating to rotate. That will cause his pitching arm to externally rotate (flip over backwards) with more force than his body can handle.

Of course, Tom Verducci summarizes the problem in a remarkably similar manner...

Many people have frozen that (Inverted W) moment of his delivery and assigned it as the point of risk. That's not entirely true.
The problem is the timing associated with that move, not the move itself.
When Strasburg gets his elbows above his shoulders and the baseball is below or about even with his right shoulder, his stride foot is hitting the ground.

Finally, as a result of what I suspected was a lie that Jeff Passan told me, and after confirming that it was a lie, Dr. Douoguih told me the following...

I told him that our data showed an increased injury rate requiring surgery in pitchers who exhibited the inverted W, it just didn't reach statistical significance. Because it did not reach statistical significance I can't make the claim that the inverted W increases injury risk.

My hunch is that it does.

I appreciate your pioneering efforts and would never try to discredit your work in a malicious fashion like that. I know we don't really know each other that well but I do hope that you don't get too down on yourself because people want to shoot down your effort to shed light on a complex subject.

It usually means that you're on to something.

Who are you going to believe? The doctor who conducted the study or a writer with an agenda to push and a severe case of confirmation bias?

Is the Inverted W Dangerous or Not?

As for Jeff Passan's tweet...

"Fear-mongered" is a pretty balls-y, if not libelous, statement, since in contemporary usage it usually goes along with or implies deception. At a minimum, the perjorative implication isn't appropriate given that the Douoguih study found that Timing problems do increase the risk of injuries, which is why Dr. Douoguih called me and asked me to come to Washington D.C. to help present and discuss the study.

In terms of whether my statements about the Inverted W are in truth "conjecture not backed by science," again, the study backs up what I've been saying about Timing since 2007.

Again, I discussed the relevance of Timing in my 2010 interview about Stephen Strasburg and the Inverted W that inspired the study of the Inverted W and Timing in question.

What the not so durable guys do is they take their elbows back but they also take them up. Now, that's actually painful to do, but it's not that bad in and of itself. The problem is that when you take the elbows back and up, you can end up with a Timing problem.

Why do you think they studied both the Inverted W and Timing?

Because I said in my writings and in that interview that both are relevant.

As to whether the Inverted W causes injury problems at a higher rate than other arm actions, the answer is this.

We still don't know.

The problem is the Douoguih study of the Inverted W compared it to every other arm action -- good and bad -- combined. While the Inverted W did cause a higher rate of injuries than every other arm action combined, that difference wasn't statistically significant. Lumping together all the other arm actions into one heap leaves that part of the study too confounded to be of much value.

In truth, the Douoguih study says nothing definitive about whether the Inverted W is more or less dangerous than the other arm actions -- if it creates Timing problems at a higher rate than other arm actions -- due to that confounding. To answer that question, you'd have to more finely divide up the different types of arm actions.

I will say that on my page about The Science Behind The Epidemic, I am collecting all of the evidence that I can find, and it is at least suggestive that the Inverted W -- because it promotes prolonged Internal Rotation -- is in fact problematic.

The Epidemic
The EpidemicAs a result of the recent discussion about the baseball pitcher injury epidemic, I have put together a webbook called The Epidemic that gives my view of what is happening, why, and what coaches, parents, and physicians can do about it.

 

Where to go from here

The theory that the Inverted W is problematic is controversial. As a result, I have addressed some of the objections to it in my...

Recently, a number of studies have been completed that are relevant to the topics of the Inverted W in particular and Timing problems in general, and I discuss them in my piece on The Science Behind The Epidemic.

If you are interested in helping to fund this project, I have put together a page for crowdfunding partners.

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