Home Posts tagged "Baseball Sports Medicine"

Exercise of the Week: Supported Elbow CARs

The benefits of controlled articular rotations (CARs) are now well known in the strength and conditioning and rehabilitation realms, thanks to Functional Range Conditioning teachings. One way in which we've evolved this approach is by taking a closer look at the position at which we perform our elbow CARs. Historically, they've been performed with the arms at the sides, like this:

However, I think there's a lot more benefit to be gained by performing them with the upper arms supported at 90 degrees of flexion, particularly in an overhead athlete population.

Here's why:

1. With more shoulder flexion, we are able to lengthen the long head of the triceps over both joints it crosses (elbow and shoulder). In the seated position, the long head of the triceps is actually shortened as a shoulder extensor.

2. In throwing athletes, you'll commonly observe Bennett's lesions, areas of increased calcification along the posterior glenoid rim. For most athletes, they're incidental findings in asymptomatic shoulders, but in some cases, they can get too big and cause rotator cuff pathology (I relate it to a speed bump that the cuff has to go over). While the true cause of Bennett's lesions has been debated in the sports medicine world, many are of the belief that it results from traction stress from the long head of the triceps (LHOT) tendon. The tendon attaches on the supraglenoid tubercle (which is on the inferior aspect of the glenoid) and extends up to the labrum and joint capsule. LHOT also eccentrically prevents excessive elbow flexion during the cocking phase of throwing (think of it being heavily lengthened in a shorter catcher-like arm action).

So, whether you believe it's related to Bennett's lesions or not, there's a strong anatomical basis for us to say that the long head of the triceps is an extremely important - but heavily underappreciated - muscle for overhead athletes. I've seen a lot of throwers over the years who've benefited tremendously from manual therapy on the triceps - and this mobility drill is a useful proactive initiative that'll help the cause as well.

3. At positions of 90 degrees of shoulder flexion or more, we get greater serratus anterior recruitment to drive the rotational component of scapular upward rotation - but also a reduction in latissimus dorsi tone that can restrict it. This is particularly important in athletic populations that tend to carry a lot of extensor tone and live in scapular depression and/or downward rotation. It also gives these folks a break from competing against gravity, so it can actually reduce protective tension of the upper traps.

4. Building on this last point, serratus anterior also works to preserve the convex-concave relationship between the scapula and rib cage, which is particularly important to address in the aforementioned athletes who may have acquired flat (extended) thoracic spines over years of extension/rotation. These athletes crave reaching, rounding, and rotating.

You can add this to a warm-up, use it as a filler, or plug it into a cooldown. Take your time with each rep, and be sure to drive not only full elbow flexion/extension, but also pronation/supination of the forearm.

If you're looking to learn a bit more about long head of the triceps, I'd encourage you to check out my Sturdy Shoulder Solutions course, as I delve into it quite a bit as part of my upper extremity functional anatomy module.

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CSP Elite Baseball Development Podcast: AJ Ramos

We're excited to welcome Colorado Rockies relief pitcher AJ Ramos to the latest podcast. As an athlete who has come back from both a Tommy John and a shoulder surgery, AJ has many insights to share on the rehab process to contribute to our sports medicine series.

A special thanks to this show's sponsor, Marc Pro. Head to www.MarcPro.com and enter the coupon code CRESSEY at checkout to receive an exclusive discount on your order.

You can follow AJ on Twitter at @TheAJRamos and Instagram at @TheAJRamos.

Sponsor Reminder

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Podcast Feedback

If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.

And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.

Thank you for your continued support!

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

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The Best of 2019: Baseball Articles

With baseball athletes being the largest segment of the Cressey Sports Performance athletic clientele, it seems only fitting to devote a "Best of 2019" feature to the top baseball posts from last year. Check them out:

1. Vertical Shin and the Pitching Delivery - Vertical shin can be a powerful coaching point in the weight room, but it also has applications to putting pitchers in the right position to be successful on the mound. Check out this article to learn more.

2. Baseball Athleticism: It's Probably Not What You Think It Is - Not all "great athletes" make great baseball players, and not all great baseball players are what you'd call "great athletes." I did a little deeper on this topic in this article.

3. Should You Chase Shoulder External Rotation - And If So, How? - I often get questions on how pitchers can increase shoulder external rotation for throwing. The answer really depends on a few things, so here's a video to walk you through them.

4. Pitchers vs. Swimmers - I evaluated a baseball pitcher and swimmer on the same day in August. The markedly different assessment findings served as a great reminder that not all overhead athletes are created equal – both in terms of the demands of their sports and the way they adapt to those demands.

5. Coil in the Pitching Delivery: Friend or Foe? - Recently, I came across a picture of Nationals pitcher Patrick Corbin at the top of the leg lift in his delivery, and it got me to thinking about how the transverse plane can be your biggest ally or enemy in the pitching delivery.

We've got one last "Best of 2019" list running tomorrow, so stay tuned for the closer!

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CSP Elite Baseball Development Podcast: Understanding the Throwing Elbow with Dr. Chris Ahmad

We're excited to welcome Dr. Chris Ahmad, team doctor for the New York Yankees, to this week's podcast. Dr. Ahmad goes into great detail on the throwing elbow with respect to anatomy, diagnostic challenges, surgical complexities, non-operative strategies, and biological interventions. He also touches on important lessons for players, parents, and coaches who want to avoid youth baseball injuries.

A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 10-pack of Athletic Greens travel packets with your first order.

Show Outline

  • What makes the anatomy and function of the elbow so complex, specifically in throwing athletes
  • What the biggest mistakes are both surgically and diagnostically with respect to the elbow
  • Why injuries of the elbow aren’t as binary as partial and full tears and how professionals can better evaluate and understand the health of elbows in throwing populations
  • How UCL calcification and injury at a young age impacts the health of baseball players as they grow and advance in their career
  • What makes a Tommy John surgery successful from a surgical perspective
  • How Tommy John surgery has evolved since it was first performed in 1974
  • What the clinical implications are for Dr. Ahmad to perform an ulnar nerve transposition during UCL reconstruction surgery
  • What variables surgeons must consider when deciding where to take a tendon graft from for UCL reconstruction
  • How Dr. Ahmad manipulates grafts to ensure an elbow is strong and sturdy for his patients post-surgery
  • What key things Ahmad discusses with his patients as they begin their road to recovery post-surgery
  • What key benchmarks Dr. Ahmad looks for patients to progress to through the Tommy John rehab process
  • Why there isn’t a true standard timeline for athletes to return to performing in games after UCL reconstruction
  • Why Dr. Ahmad is an advocate for biological interventions such as PRP injections and the use of stem cells to manage elbow injuries, and what benefits these methodologies offer beyond throwing injuries
  • Where the future of biological treatments is headed, and what the drawbacks and dangers of using these powerful methods can be
  • Where Dr. Ahmad sees the need for more research to be done in the prevention, reconstruction, rehabilitation, and recovery of arm injuries
  • Why Dr. Ahmad has worked to create a registry with Major League Baseball to collect data on injured professional ball players and how this resource will be used to find answers to questions in the field without setting up a formal study

You can follow Dr. Ahmad on Twitter at @DrChrisAhmad and on Instagram at @DrChrisAhmad. And, you can learn more about him at www.DrAhmadSportsMedicine.com. Definitely check out his books:

Baseball Sports Medicine

Skill

Understanding Tommy John Surgery

Sponsor Reminder

This episode is brought to you by Athletic Greens. It’s an all-in-one superfood supplement with 75 whole-food sourced ingredients designed to support your body’s nutrition needs across 5 critical areas of health: 1) energy, 2) immunity, 3) gut health, 4) hormonal support, and 5) healthy aging. Head to www.AthleticGreens.com/cressey and claim my special offer today - 20 FREE travel packs (valued at $79) - with your first purchase. I use this product daily myself and highly recommend it to our athletes as well. I'd encourage you to give it a shot, too - especially with this great offer.

Podcast Feedback

If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.

And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.

Thank you for your continued support!

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

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