Q: I just saw your post about Strasberg and pitching injuries.  This may be hopelessly naive, but – do “submarine” throwers face the same perils?  I’m old enough to remember Kent Telkulve, so it made me think.  It seems as though I see a fair number of throws from SS and 3B positions that appear somewhat submarine-like in motion, so the technique wouldn’t be completely unknown. Thoughts?

A: In short, the answer would be “yes,” they do face the same perils.

If you actually slow things down and example joint angles, you’ll see that the shoulder and elbow positioning most of these guys get to is very similar to what you see in more overhand throwers.  The difference is in how much lateral trunk tilt they have; the more trunk tilt, the lower the release point.

The primary difference you’ll see is that sidearm/submarine throwers will typically break down at the elbow a lot more than the shoulder.  Aguinaldo and Chambers found that sidearm throwers had significantly higher elbow valgus torques than overhand throwers. It’s not surprising, given that they do tend to lead with the elbow a bit more.

Position players who throw more sidearm can largely get away with it because a) they don’t have anywhere near the volume of throwing in a single outing or a season that pitchers do, and b) they aren’t throwing off a mound.  We know that just stepping up onto the elevated mound dramatically increases arm stress.

So, what are the practical applications of knowing the demands are, for the most part, very similar?

First, spend a considerable amount more time focusing on core stability and working to iron out excessive right-left asymmetries that arise secondary to all the lateral trunk tilt.  In other words, worry as much about the spine as you do about the arm.

Second, I’d put an even greater emphasis on soft tissue work at the medial elbow – particularly on the common flexor tendon (the muscles that join to create this tendon protect the ulnar collateral ligament from excessive valgus stress).

Third, as is usually the case, use these guys as relievers to keep their throwing volume lower while still maximizing their utility.

Other than that, manage them as if you would any other pitcher – which should always be a tremendously individualized process, anyway!

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