My Tommy John Experience: Kyle Boddy, Part 1

This week I tried something different. Instead of speaking with a recipient of Tommy John surgery, I had the opportunity to talk with Kyle Boddy of Driveline Baseball. The idea was that I would get a trainers’ perspective on the recovery process, and it was phenomenal. I learned a lot about what goes on behind the scenes, as well as some of the most advanced ideas of the industry. I sincerely hope learn as much as I did about an organization with the goal of being at the forefront of rehabbing athletes, as well as predicting and preventing injury. We’re going to break this interview into three parts, so be sure to check them all out.

If you have had Tommy John surgery and would like to participate in this series, feel free to email me at shawnbrody9@gmail.com, or DM me on Twitter (@ShawnBrody) to let me know.

Shawn Brody: Can you explain what Driveline baseball is and does, for those who might not know?

Kyle Boddy: The quick elevator pitch is that our company aims to be the sabermetrics of player development. The (slightly) longer part is that we’re trying to quantify skill acquisition. How do people get better? What is the mechanism behind it, and how can we develop that process to make our pitchers and hitters better? Whether they’re rehabbing, healthy, or developing velocity/spin; whatever it may be. We want to do it using sports science. We want to do it using a methodical, logical, data intensive way.

SB: How many athletes recovering from Tommy John have you rehabbed at your facility?

KB: Two that we’ve done full-intensive rehab with. We’ve done a lot of return to throwing, but the big ones were Troy [Rallings] and Herbie [Good]. Herbie was the first one we did, he had a modified version of Tommy John. Troy was the first one where we had a very specific process that we knew we’d use for the future.

SB: So, with Troy’s recovery specifically, I loved the article you wrote because it addresses the interval throwing program. I remember seeing that I had to throw 50 percent, then 75 percent, then 90 percent. For someone who has always been terrible at throwing a certain percentage of their strength, that terrified me. I always thought that if I did that wrong, it would hurt me more. What you did with Troy, you created a program fitted to him personally — to his development. How were you able to design a completely different program fitted to a specific player?

KB: With Troy, we wanted to take a measurable way. The Mariners were in here and we were actually just talking about that with them. The most frustrating thing, like you said, is that you don’t know if you’re making progress. You’re getting good at this rehab process, but you don’t know if you’re getting good at actually healing your elbow. There’s no quantifiable test. You’re just doing all this time-based throwing, interval-based throwing. You’re doing whatever is on a sheet and reporting whether you do or don’t feel sore, and if it is or isn’t working for you. And that’s frustrating.

That’s what we wanted to set out. What that was going to look like wasn’t clear at the beginning, but we knew that we wanted to have a very data-driven approach where the athlete is given measurable results. For example, we’d say, “these are the metrics we want you to hit today, this is what want you to do tomorrow, and in three weeks we want you to be here. If we’re here, then we can move everything up.”

It was loosely based on time, but really it was just in three to four week blocks where it was like, “this is what we’re tackling. If we’re ahead of schedule, we nailed it. If we don’t, then we push it back.” That’s how we designed it.

SB: One of the metrics you used was called Rate of Perceived Effort, can you talk about what that?

Driveline Baseball

KB: So, in the weight room, it is a very valid technique. It’s great for strength development, especially power development. You want to operate within certain RPE’s. Anywhere between 50-80 RPE is a good period to be developing power. Absolute strength is above that, and absolute speed is below that. That is where we wanted to be with Troy, especially because he needed to put on weight at the beginning so we did a hypertrophy program and then a power program. On the throwing side, RPE is known as being a poor indicator of actual stress because athletes don’t know what 80 percent is. They’ve never tested it.

If you throw 90 mph and then you throw at 80 percent, your velocity is going to be all over the place. For any 10 people, they’ll throw a different velocity when you tell them 80 percent. There’s also this great paper that indicates 80 percent effort of throwing produces something like 92 percent of joint kinetics. Even though your velocity is lower, you’re actually just much more inefficient in throwing. So, are you really at 80 percent? That’s a huge mismatch.

As a result, what we see a lot with the interval throwing program (the normal ones) is that players are just overworked. Their volume is too high. Their intensity is probably too high, but the volume is definitely too high for the intensity. So right around month seven through nine these guys have big regression, especially once they start throwing off the mound. They’ve just accumulated way too much fatigue. Ligamentization, in a really bad case, can go backwards. And there’s always forearm issues, as you no-doubt have experienced. We did really well at staying away from that with Troy. It went about as good as possible, we only had to make like two deviations from the plan.

SB: In that article, you also talked about how the window of adaptation for an athlete post-surgery is almost always wasted in a normal interval throwing program. With your recovery throwing program, how were you able to use it effectively?

KB: To me, that is the biggest crime of the normal interval throwing program. If you’ve had Tommy John surgery there’s obviously a very large luck and variance component to it, but there were probably some mechanical factors that contributed to the inefficiency. So this is now a time where you have six months of throwing, nine months of throwing, to really make some changes. And that opportunity is wasted— considerably.

Driveline Baseball

People are using baseballs to throw and, from what we know about motor learning from other throwing sports and baseball, that is one of the worst ways to make a change. Using overload/underload implements is shown to be very effective. Constraint throwing is very effective. Internal narrow band of focus is very effective. Those are the types of things that we do.

Just being able to provide the best methods to provide those mechanical changes we thought was really important. In Troy’s case, we felt good about his mechanical pattern. There wasn’t a lot of changes that needed to be made. He was just massively overused. As a freshman in college he had some elbow issues, like a partially torn UCL, but he rehabbed it and he was fine. His senior year he was the closer for the team, and at the time of his injury he had logged the second-most innings on the staff. He was being used really irresponsibly. He was being used like four innings on Saturday, then throwing again on Sunday. And he can’t throw during the week because his arm is cashed.

So there’s two things there. He was being overused on the weekends, and then he didn’t throw between weekends because he was overworked. Because he doesn’t throw, he doesn’t build up any fatigue resistance, he’s not refining his skills, his arm strength is going backward. It’s all a cyclical issue. In my opinion, that’s the largest single contributing factor for why Troy got hurt, and so we didn’t feel that we needed to remap his mechanics significantly. There were a few changes that he wanted to make that I think made him a little bit more effective. Not injury prevention-wise, but pitch type-wise he wanted to make a few changes and I thought it worked out pretty good.

SB: Anthony Brady said last week that, “pitching is just shitty,” in talking about how he got hurt. What have you found, through your research, is a big factor or the reason why people eventually have UCL reconstruction surgery?

KB: Unfortunately, as far as I can tell, the biggest factor is variance and luck. That sucks to hear, because people want a single defining reason. But tissue load is so variable across populations, it’s just really tough to say what the issue is. The biggest contributing factor, in my opinion, is loss of forearm strength and forearm proprioception. Basically, motor recruitment ability of the forearm, of the muscles that surround the UCL.

There is some interesting evidence that supports that view in research, peer-reviewed research. A lot of Dr. Jimmy Buffi’s research on computed muscle control seems to indicate that’s a big factor to mitigate net-Valgus stress. But again, we don’t know for sure. We just have some research that kind of points in that direction.

So that would be my biggest thing. Lack of fitness, fitness going backwards, people just not taking care of their body, or people being overcome by the season and not taking care of their body.

Driveline Baseabll

SB: Is the ability to prevent such a steep decline in-season a big contributing factor?

KB: Yeah. You’re almost just trying to stave it off, right? For us, the model that we like to follow is Dr. Tim Gabbett’s chronic vs. acute load, where we want people to basically have a high chronic load going into the season. So they’ve tolerated a ton of volume from a very slow build, and then they go from that to they hit Spring Training, or right after Spring Training. The load starts to decrease significantly or shift to the competitive events — you know, pitching in games. From then on it is a free-fall to the bottom.

So we’re just trying to figure out how to throw that person a parachute or a rope. How to do our best job to mitigate that loss of ability, proprioception. That loss of feeling that keeps your elbow protected. That’s our job, and that’s honestly all of baseball’s job. Most of professional baseball sees it that way, we see it that way, too. We just take a different tact. We think that pro-ball generally doesn’t build up enough volume going into the season, and then they try to mitigate these problems throughout the season. And, at that point, you’re playing catch-up.

You’re putting a guy on the Disabled List, and he’s almost always going to go back on for a more serious injury. People think it’s because, “Oh he’s hurt, so he is prone to being hurt.” That’s true, it is the biggest signal. If they’re going on the DL for something, that means there is probably some recurring issue underneath causing that. It’s combated by the fact that, once they put you on the DL, there’s no high-intensity training. Your volume goes way down, they make sure all the symptoms subside, and then you on-ramp. You start throwing again, and then they put you in games when your symptoms subside where you can throw at 100 percent of velocity.

But that doesn’t indicate readiness. That just means that you can compete at that level today. That doesn’t mean you can compete at that level for eight weeks, 12 weeks, 16 weeks, or even two weeks. That’s the biggest difference that we have with almost every professional team. We think a very high chronic load in the offseason is protective of injury throughout the season.

SB: What are some of the biggest things pitchers can do to protect their arms, specifically their forearms?

KB: The best thing that they can do is probably that high protective load. A lot of research coming out in parallel exercise science fields shows that low-velocity, high-load is one of the best ways to build up tissue capacity. That’s known for rehabilitating hamstring tears, Achilles’ tendon tears, ACL grafts — it’s true about pretty much everything. We think that it’s probably applicable to elbows, too, because it’s essentially the same joint as the knee. So, we’re trying to build up those muscles and that proprioception in a very slow way before we go to the high-velocity way.

To us, that’s throwing one- to two-pound balls, heavy overload implements, wrist weights at very low speeds, relatively, but still with very high joint kinetics. So, you’re getting that high joint kinetic protective stress, and a ton of joint compression. That generates stimulus in your body that responds to it, and then you slowly switch from that mode. You gradually move to a more high-velocity, lower-weight implement, which culminates into baseball.

People that start with a baseball to begin with and then build up load there, I actually think that if you were to design a throwing to maximally injure pitchers, that is what you would do. You would start with baseballs and three- to four-ounce balls. That would be the best way you could hurt a guy (laughter). If I wanted to design a program to specifically injure someone, that’s what I would do. And, honestly, that is what basically all professional baseball does.

Their programs are designed specifically to have people have issues at the beginning of the year. There’s no shortage of articles on FanGraphs or The Hardball Times that show DL-day spike massively in March or April, or that there’s so many UCL or Tommy John injuries that happen in Spring Training. It happens all the time.

SB: Weighted balls are kind of Driveline’s thing. It’s one of the things you guys are known for in the baseball community. Why do you think that there is still pushback from Major League teams, and the public in general?

KB: It’s interesting because we’ll go into Major League teams, we work with the Los Angeles Dodgers, and we’ll get pushback from a lot of the coaches my age (I’m 33). They think it’s stupid, not useful, or whatever. That’s the people we get pushback from, people who are 20- to 40-years old. But then you see people who have been in the game for 30-40 years, people that pitched in the 70’s and 80’s, and they almost always say the same stuff.

They’re just like, “yeah man, in the 70’s and 80’s people were using weighted balls everywhere. I played with Nolan Ryan, he threw an iron ball, a football. These Latin pitchers that came up, Freddy Garcia, they always used overload, but they didn’t call them weighted balls. They just had heavy balls.” And that’s really interesting.

Then there was this wave that culminated with the pitch count-era of baseball. Where 100 pitches was the max, we’re going to denigrate people from overusing. Dusty Baker ruined Mark Prior and Kerry Wood, and whatever if that’s true or not. He certainly pitched them too much. But then people started thinking that we have to protect arms, and a lot of the training moved in that direction, too.

Driveline Baseball

If pitch counts are good, then throwing less is good. Protecting arms is good, and lifting weights is good. Reducing as much throwing as we can is good, because throwing is stressful and it hurts the body so we need to do less of it. At the end of the day, though, every fifth day you’re throwing 90 to 110 pitches as hard as possible. I don’t care how much reduction of throwing you’re going to do, that fifth day you’re going to throw as hard as you can because that’s your job.

It’s good-natured, but it makes no sense.

So the 90’s and early 2000’s was that pitch count, let’s reduce injuries type thing, and it was completely ineffective. In my opinion, and I’m ever the optimist, a lot of baseball is moving in... We’re really fortunate, I’ve got to be honest. A lot of people say Driveline exists because of hard work, work ethic, etc., and that’s true. But there’s a lot of luck involved. If this had happened 20-years ago, I don’t think I have anywhere close to the amount of success. The explosion of sites like FanGraphs, The Hardball Times. The acceptance of sabermetrics by guys like Pete Palmer, Bill James, David Appelman, Dave Cameron, Travis Sawchik, and all the new writers. The embrace of those ideas has been a parallel revolution for player development.

We’re still 20-30 years behind Sabermetrics, but it put the idea in people’s heads that the those who have been in baseball forever may not actually be the people that ultimately know a lot about baseball, or are poised to take over the game. With that idea alone, it opened doors for us. Even though they were the very smallest of openings, it gave the idea that maybe some outsiders may change player development forever.

I think that there’s a significant wave embracing what we do. That would be reflected in the contracts we have signed with professional baseball teams, the amount of professional athletes that we see, the fact that our products have been selling extremely well over the last year, and the fact that colleges adopt our program at a higher rate than ever.

The number one (Oregon State) and number two (North Carolina) teams, going into the regionals, use our stuff. Vanderbilt, one of the most well-known colleges for churning out elite pitchers, has been using our stuff for a long period of time. These college teams are increasingly having analytic people on their staff. People that parse play-by-play data, Statcast data, analyze breaking ball type, spin rate, pitch sequencing, etc. It’s changing the game from that level. Baseball has almost always changed from the middle out. For us, our strategy was to target the colleges.

Can we do right by the colleges, because those players go on to play pro-ball and pressure their coaches to use the same stuff they used in college. Kids and parents look up to the colleges, for amateur baseball, and ask what they are doing. That’s how it changes. Trying to change people in pro-ball, their mind directly, is a fruitless endeavor. They’re pitched ideas every single day.

It’s a logistics problem. People looking on the outside in, and this used to be me, say player development is a great opportunity to make people better; to develop players. That would be true, except that the department is just misnamed. Player development is actually just logistics. The best person to handle the director of player development role is the VP of logistics of UPS. It is just putting people in A-ball, high-A, Double-A at the correct time. Coordinating food vendors, plane flights, busses, trainers, hiring staff, etc.

That’s actually what all goes into the minor leagues. Not, ‘how do we teach people to throw harder, hit the ball harder, teach them launch angle’. All that stuff is not even secondary, we’re talking tertiary concerns, so that’s why stuff never gets done. That’s how baseball is now, and I don’t know if it will always be that way, but that just is how it is.

SB: When you rehab Tommy John pitchers, and I know you said you’ve only done two, what is the thing you are most cognizant of?

KB: Psychology, honestly. It sounds like a cliché answer, but as someone who has gone through it I’m sure you understand how important it is that we manage their mental state, as best we can. By that, I mean, we’re not trying to do mental skills coaching; we’re not a psychologist; we don’t have a shrink. What we think works best is giving them data, giving them a plan, that says, ‘this is what we’re going to do. The probability of success is very high if we do this plan like we want to. Here’s exactly the markers we want to do’, and you get a specific plan going out.

I’m not sure what your rehab was like, but a lot of it is, ‘I’m going to go to PT today. I’m going to pull bands, they’re going to do some manual therapy on me, then they’ll bill me for my 15 minutes because they have to churn a lot of insurance people through’. And they don’t give you any actionable feedback, because there isn’t any. Because they don’t have any.

They’re just going off a sheet that they downloaded. You might not be, but I think people would be shocked to find out that most rehabilitation programs for Tommy John surgery and throwing programs are purchased from a physical therapist who sells rehabilitation programs online as part of his practice. People pay for membership to the site, download these supposedly good programs, print them out, and say that we can trust it because they come from professionals.

These people that are giving the programs have never validated it. They have never done any first-party research, first-party experimentation. They’ve never collected information with EMG sensors, grip testing, or motion capture. They’re just going off the word of someone who sold them a program, and that is probably what over 90 percent of the people who have Tommy John follow. Even in professional baseball. It’s pretty shocking.

SB: Do you feel that most Tommy John recovery programs are flawed because they don’t allow for that individualized wiggle room?

KB: Yeah. That’s ultimately why they’re flawed, but they exist because people don’t know any better. No one is willing to do the hard work of testing new things — no one is going to get fired for buying IBM. That’s just the gold standard, right? No one is going to be fired for buying the gold standard out there. So, if you do anything different, it’s going to be weird. But we’re doing our athletes a huge disservice, because we’ve known for a long time that these programs are no good.

Part 2 | Part 3