It's time for another installment of "Common Arm Care" mistakes, and in this go-round, I'm going to be talking about volume management.  This mistake can be summed up in one sentence:

If you keep adding things without taking something else away, you'll eventually wind up with overuse problems.

Effective, there is a "give and take" that is involved with the training of any throwing athlete.  The more throwing these athletes do, the less supplemental training they can incorporate. This can occur in a number of different contexts.

First, on the throwing side, you'll often see pitchers who are always seeking out the latest, greatist throwing programs.  However, they don't "program hop;" they just keep adding.  Before you know it, they're making 300 throws in every session - and throwing seven days a week - because they have to get in their long toss, weighted balls, underweight balls, mound work, and towel drills.  If you told them that practicing their nunchuck skills would help, they'd add that in, too.

Second, you have to be cognizant of the rest of your strength and power training volume.  When your pitch count goes up, you need to pare back on your upper body lifting volume; banging out a bunch of chin-ups isn't going to feel so hot after a 60-pitch outing.  Additionally, your medicine ball work volume needs to go down as the throwing volume goes up.

To give you some frame of reference for this, here's a little excerpt from Marlins closer Steve Cishek's off-season medicine ball programs.  Keep in mind that the total throws equals left-handed throws, plus right-handed throws, plus overhead throws.

October: break from rotation, no aggressive medicine ball or overhead work
November: 156 total throws
December (started throwing mid-December): 138 total throws
January (ramped up throwing): 66 total throws

Once spring training rolls around and he's throwing even more, he'll have even less.  A minor leaguer whose season wraps up a month earlier would actually be able to get an additional month of aggressive medicine ball work in.

Third, pitchers often forget that throwing itself is a huge challenge to the rotator cuff.  So, if your throwing volume goes up as the season approaches, you should be doing less arm care work than you would have done in the off-season.  You can get away with this reduction in arm care work because you've already put in a great off-season to build things up.  Of course, if you throw year-round, then you're already behind the 8-ball when the season starts.

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

Today marks the third and final installment of Eric Schoenberg's series on thoracic mobility drills - and whether or not they're indicated.  In case you missed them, be sure to check out Part 1 and Part 2.

In the final piece of this series, I want to tie things together with a few foundational concepts that we use in the daily management of our athletes and emphasize in our Elite Baseball Mentorships.

Eric C. has written about the concept of relative stiffness on this blog on numerous occasions.  So, feel free to refer back to his articles for more background information.  Relative stiffness or relative flexibility was introduced to me by Shirley Sahrmann and the incredible faculty at Washington University in St. Louis. This is a pillar of their Movement System Impairment model. 

Today, I am going to discuss how relative flexibility impacts the thoracic spine and shed some more light on why T-spine extension work is not always necessary in the baseball athlete.          

Relative flexibility describes the relationship of how the amount of stiffness (or tension) in one area of soft tissue (muscles, ligaments, tendons, etc.) results in compensatory movement at an adjoining joint that is controlled by less stiffness.  This relationship can change (positively or negatively) based on the exercises we choose and the manner in which we perform them.

There are countless examples of relative stiffness in the body.  One of the most common examples that we see involves the lumbar spine.  If the lats are stiffer than the anterior core, then the athlete will be more prone to an extended posture. The athlete will compensate with lumbar extension with overhead activity.  The video that I included in part 2 of this series is a good example:

In this video, Lats, lumbar extensors > (stiffer than) Anterior Core = Lumbar extension tendency.

Note: Clearly, there is a lot more involved (fascia, ligaments, structural issues, motor control, relative position of adjacent joints, etc.) than just this simple math problem, but for the scope of this article, we will leave it at this.  This example is fairly straightforward and I think we are all on the same page here.  We would not program activities that would further encourage lumbar extension and drive the improper recruitment and motor pattern.

In this case, we know that simply “stretching” or foam rolling the lats will not work in isolation. We need to go ahead and “stiffen” the anterior core, while at the same time, downregulating the overuse of the lats.  We often will do this by using exericses that encourage a neutral alignment with overhead activity (i.e. wall slides, back to wall shoulder flexion) as well as limiting the amount of carrying by our sides (e.g. deadlifts, dumbbell lunges, farmer’s walks, etc.) and instead, focusing on options like bottoms-up kettlebell carries, landmine presses, and goblet variations.

In the case of someone that is in too much thoracic extension (or relative thoracic flexion), though, things can get a little more confusing.  The athlete will have increased stiffness of the thoracic extensors vs. flexors: Thoracic Extensors > (stiffer than) Thoracic Flexors = Thoracic extension tendency.

However, we often see the emphasis remain on bench T-spine mobs, quadruped extension/rotations, and side-lying windmill variations? This results in two problems:

1. The athlete will actually become hypermobile (segmentally) and develop a local stability issue. (inverted U-curve)
2. The athlete has difficulty “getting out of extension” due to increased relative stiffness of the thoracic extensors, lats, and scapulothoracic musculature.

This inability to properly flex the spine at ball release can result in a decrease in the required scapular upward rotation and elevation to maintain proper scapulohumeral and glenohumeral joint congruency.  This is a fancy way of saying that if your upper back isn’t positioned correctly, the ball won’t sit flush with the socket. This process can contribute to some of the shoulder and elbow pathologies that we so commonly see in the throwing population.

There is one more point that needs to be addressed to complete this series – and that is the role of the rectus abdominus in thoracic spine mobility.  In this case, the athlete will present in too much thoracic flexion and may appear as though they would benefit from T-spine extension mobility drills.  However, this athlete will not benefit from these exercises unless we appreciate the following point.

When we cue an athlete to limit his extension or “rib flare” we often say “ribs down”.  This seems like a relatively benign cue to help promote a neutral spine and pelvic orientation.  However, we must be sure that the athlete is able to properly recruit external obliques (often with lower level exercises such as back to wall shoulder flexion or a dead bug variation) to help achieve this movement correction.

The reason for this is that increased stiffness of rectus abdominus (dominance) limits ability of T-spine to move out of flexion (or neutral).  Using our relative stiffness example from before, if: Rectus abdominus > (stiffer than) Thoracic Extensors = Thoracic Flexion Tendency.

Therefore, if an athlete is actually is in too much flexion… i.e. sway back (most commonly - posterior tilt and lumbar extension - hanging on rectus as their anti-gravity muscle), he will have a very difficult time getting out of flexion.  This occurs regardless of how many T-spine drills we prescribe.  This is akin to stretching rectus femoris when someone is stuck in a faulty thoracic and lumbopelvic position.

The best approach in our case above is to “allow” t-spine mobility (extension) to occur by decreasing rectus dominance and getting someone out of T-spine flexion.  I am all for cuing the ribs down and establishing alignment, but HOW we get an athlete to do this is of the utmost importance.  The main point here is forcing T-spine extension in the presence of increased relative stiffness of rectus abdominus is not going to give us results.  In other words, weak external obliques will result in rectus overuse and thoracic “immobility” regardless of how many T-spine mobility drills we include in our programs. 

To summarize, this is a very important (and difficult) concept that – like everything else – requires a trained eye and an individualized approach.  If an athlete has too much thoracic and lumbar extension, this can result in scapular depression and downward rotation via, among others things, excessive lat dominance, which leads to a lot of our shoulder and elbow dysfunction.  On the other hand, too little thoracic extension results in scapular anterior tilt and decreased glenohumeral external rotation (“lay back”), also resulting in dysfunction and pathology. 

As a quick review, you want to be able to answer the following questions before prescribing T-Spine extension exercises:

• Is there a lack of T-spine extension (or rotation). If not, then why prescribe T-spine extension mobility drills?
• Where is the extension coming from (upper or lower T-spine, L-spine, C-spine)?
• Is the athlete already at end-range extension and if so, is our attempt to “gain” extension at end-range creating unwanted motion elsewhere? (hypermobility)
• Lastly, if an athlete presents with mal-alignment (too much thoracic extension or thoracic flexion): first, identify it, then determine why this is happening prior to simply prescribing a bunch of mobility exercises.

Conclusion

This point, along with many others, is a main reason why we chose to develop the Elite Baseball Mentorship program.  As we gather together in these groups, many conventionally accepted ideas and concepts are questioned and explored and the demand for proof (whether it be from research or experience) requires us all to think more critically.  Most importantly, with baseball-related injuries continuing to rise, this allows us to question the status quo of generally accepted baseball-specific protocols.  Ultimately, this collaboration allows us all to advance the bar and develop a better opportunity for our athletes to meet their goals through better health and performance.

Also, if you are interested in more information like this, we would love to see you at one of our Elite Baseball Mentorships. We'll be hosting these events in June, October, and December of 2014. Please click here for more information.

Author’s Note: I would like to thank Michele Ionno, MS, SPT (Wash U Program in Physical Therapy) for his contribution to the 3^rd phase of this blog series.

About the Author

Eric Schoenberg, MSPT, CSCS is co-owner of Momentum Physical Therapy, located in Milford, MA.  He can be reached at eric@momentumpt.com. 

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!

This section is a new addition to the "Best of EricCressey.com" series.  Check out the top 5 baseball articles from the past year:

1. The Truth About CC Sabathia's Weight - I couldn't seem to stop typing this response to a New York Times piece on Sabathia's weight, and the result was a 3,700 word thesis!

2. 7 Ways to Get Strong Outside the Sagittal Plane - These movements are beneficial for anyone, but particularly for baseball players.

3. Regaining Scapular Control: Always Good Intentions, Often Bad Technique - Here's a detailed video on how to train the prone 1-arm trap raise.

4. Improving Thoracic Mobility in Throwers - Check out these great thoracic spine mobility drills we use with our throwers.

5. 21 Reasons You're Not Tim Collins - This was a fun piece to write; I'm glad my readers have a good sense of humor!

I'll be back tomorrow with the last installment of our "Best of 2013" series.

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!

It goes without saying that all rotational sport athletes need adequate thoracic spine (upper body) mobility in order to create appropriate separation as they work to transfer force from the lower extremity to the upper extremity during swings, throws, shots, and changes of direction.  In a throwing population, however, you need to take some special precautions as you work to build it.

One thing we know about pitchers is that their shoulder external rotation improves over the course of a season, and this likely takes place because the ligamentous structures in the front of the shoulder become looser. In this image of a left shoulder, it would be the area labeled "capsular ligaments:"

Effectively, the looser one's anterior capsule is, the more external rotation one will have.  The problem, however, is that if this area becomes too loose, the biceps tendon must pick up the slack as an important anterior stabilizer during external rotation.  Additionally, there are many nerve structures at the anterior shoulder that can be irritated because the humeral head isn't controlled.  This is yet another reason why it's not a good idea to stretch a throwing shoulder into external rotation.  In this video, I go into greater detail:

This knowledge gives rise to two thoughts:

1. If we lack thoracic rotation, our arm will drag during the pitching delivery, as it's a means of creating better separation (albeit in the wrong places).  Guys who have quick arms can often make up for it, but still inevitably irritate the anterior shoulder over time.  So, if your thoracic rotation stinks, you'll need to try to find more external rotation in the wrong places.  Additionally, if we lack thoracic extension, we often substitute lumbar extension (lower back arching) to maintain an upright torso.  These guys wind up with low back pain, oblique strains, and hip issues.

2. We can't just throw any thoracic mobility drill at throwers, particularly in the early off-season, when the anterior shoulder is all stretched out and it may be the path of least resistance.  As an example, the kettlebell arm bar might be a great drill for many folks in the population, but I would never use it with a thrower:

Instead, particularly in the early off-season, we need to pick drills that heavily emphasis thoracic movement independent of humeral (arm) movement. Here's a progression we might use over the course of the off-season:

Off-Season Months 1-2 (and during the in-season phase): Supine Alternating Shoulder Flexion on Doubled Tennis Ball, Thoracic Extension on Roller, Rock-Back Quadruped Extension-Rotation

Off-Season Months 3-4: Side-Lying Windmill, Bent-Over T-Spine Rotation

You'll notice that these options integrate a lot more humeral movement.  In many cases, you can use them earlier in the off-season, but only if they're coached really meticulously to ensure athletes are moving in the right places.

We use these exercises right after our foam rolling and positional breathing drills during the warm-up, and before anything we'd do to directly work on scapular stabilization and rotator cuff strength/timing.  Hopefully, this article gives you a little feel for not just some of the exercises we may use, but also the way we'd program them throughout the competitive season.

If you'd like to learn more about how we manage throwers, be sure to register for one of our Elite Baseball Mentorships.  The next one will take place June 14-16 in Hudson, MA.

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!

Today marks the third installment of this series on trunk position at foot strike during the pitching delivery.  In case you missed them, be sure to check out Part 1 and Part 2.  In those installments, we outlined the problem of early and excessive lumbar (lower back) extension, and how to address it with drill work.  In today's final installment, we'll introduce some drills we like to use with our athletes to teach them about proper positioning and build stability within those positions.

At the end of the day, there are a few things that can contribute to a pitcher drifting into excessive extension from the time he begins his leg kick all the way through when his front foot strike.  Obviously, the foremost concern is what cues the athlete has been given that may be leading him in this direction.  Once those have been cleaned up, though, we have to look to see how physically prepared an individual is to get to the right positions. I think the first question you have to ask in this case is, "Where does the posture start?"  If an athlete looks like this at rest, he's going to at least look like this dynamically - and this heavily extended posture is going to be much more exaggerated.

With that in mind, step 1 is to educate athletes on what acceptable resting posture is.  In this case, we need the athlete to learn to bring the pelvis and rib cage closer together, most notably through some posterior pelvic tilt.  Once that has been established, here are some of my favorite warm-up drills for athletes with this heavily extended posture. You'll notice that exhaling fully and learning to get the ribs to come down are key components of these drills.

In addition to these low-level core stability exercises, we'll progress to some balance drills, especially in the early off-season.  Effectively, we're teaching athletes to resist extension and rotation in single-leg stance.  Yes, it's static balance training, but I firmly believe these drills have carryover to bigger and better things at higher speeds. And, you're certainly not going to overtrain on them, so you've got nothing to lose.

With all these exercises out of the way, it takes a lot more high level core stability for this posture to carry over to the high level throw.  You need to improve both anterior core control (your ability to resist excessive extension/arching) and rotary stability (your ability to resist excessive rotation at the lower back).  I've outlined loads of options on these front, but here are two to get the ball rolling for those who aren't up to speed on my writings just yet:

And, remember that the different types of core stability never work in isolation - especially during the basebal throw.  Check out this video for more details:

The core stability you build must, however, be accompanied by a strong lower half.  Candidly, I don't think having a huge squat is necessary.  Athletes seem to get much better carryover from deadlift variations, in my experience - likely due to the fact that the deadlift does such a tremendous job of teaching good hip hinging.  We see so many athletes who drift (LHPs toward 1st base, and RHPs toward 3rd base) early in the leg kick and subsequent movement toward home plate in part because they can't hip hinge at all.  Once you've gotten that hip hinge back (in part with the toe touch video from above), you have to strength train in that pattern to get it to stick.  For the most detailed deadlift technique video tutorial out there, check out my free one here.

Additionally, single-leg strength is insanely important, and there are lots of ways to attack it. 

I think it's equally important to be able to build and maintain strength outside the sagittal plane, especially when it comes to carrying that good hip hinge over to movements when a pitcher is starting to "ride his hip" down the mound.  With that said, definitely check out an article I wrote previously, 7 Ways to Get Strong Outside the Sagittal Plane.

Once you've established hip and shoulder mobility, core stability, and lower half strength, you can really start to make the most of your medicine ball training.  As you can see, I think Tim Collins is a great example from which young throwers can learn a lot, as he has built up a lot of these qualities to make the most of a smaller frame in order to consistently throw in the mid 90s.  That said, I couldn't ask for a better demonstrator for our medicine ball drills for a few reasons.

First, he always throws the ball with intent; there are no half-speed reps. If you want to develop power, you have to try to be powerful in each throw during training.  Second, his direction is outstanding.  You never see him drift forward as he builds energy to apply with aggressive hip rotation. Third, he's got a great hip shift, which is necessary to get the most out of his posterior chain.

As a follow-up to that video, CP coach Greg Robins has a great tutorial here to teach you how to get "in and out" of your hip on rotational medicine ball exercises:

As you can see, there are a lot of different factors that contribute to an athletes being in excessive extension - but also allowing that extension to carry over to their pitching mechanics to the point that trunk position will be out of whack at foot strike.  Additionally, these exercises should demonstrate to you that athletes who land in a very extended position - but still have success and don't want to change things - will need to take special precautions in terms of physical preparation to make sure that their bodies don't break down over time with this delivery style.

This wraps up our series on understanding trunk position at foot strike during the pitching delivery; we appreciate you following along for all three articles!I If you'd like to learn more about how we manage throwers, be sure to register for one of our Elite Baseball Mentorships.  The next one will take place December 8-10.

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!

If you've read just about any of my writing, you likely know that I'm a big fan of various forms of soft tissue work. Obviously, there's foam rolling for our more "diffuse" work, but a lot of people also use a baseball, tennis ball, or lacrosse ball to get a bit more "focal."  While this can definitely be helpful, there are a few precautions you want to take.  Check out this video to learn more:

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!

I talk a lot about how there's a difference between simply "training baseball players" and actually training baseball players with a genuine appreciation of the unique demands they encounter - as well as their bodies' responses to those demands.  Today's post will be a great example of how you can't just throw every throwing arm into a generic program.

One of the adaptations you'll commonly see in throwers is an acquired valgus carrying angle at the elbow.  For the laymen in the crowd, take note of how the throwing arm (in this case, the right arm, which is to the left side of the picture) has a "sharper" angle: 

This is an adaptation to the incredible valgus stress during the lay-back portion of throwing.

While the research on the subject isn't really out there, it's widely believed that a sharper valgus carrying angle predisposes throwers to elbow injuries, particularly ulnar collateral ligament (UCL) tears.  My good friend Mike Reinold actually has a lot of very good unpublished data on the topic, too. In my eyes, this verifies that we need need to treat throwers like this with extra care in light of this increased susceptibility to injury. 

From my perspective, I think it means more time off from throwing each off-season in order to regain passive stability, as the UCL is already stretched out more than in the normal pitcher.  Additionally, it may take longer for these athletes to regain good soft tissue quality, as the musculature at the medial elbow is likely working harder to make up for this loss of passive stability and the increased range-of-motion demands.  Another key point is that this valgus carrying angle may increase the likelihood of ulnar nerve hypermobility (snapping back and forth over the medial epicondyle during flexion/extension) or ulnar neuritis (irritation of the nerve from excessive stretch). If this nerve only has a limited number of flexion/extension cycles before it really gets irritated, then we need to use each throw wisely to put off the possibility of needing an ulnar nerve transposition surgery to set it where it needs to be.

Additionally, I think it means less aggressive throwing programs, particularly with respect to extreme long toss.  I think long toss has a ton of merit for a lot of throwers, but one concern with it is that it does increase valgus stress slightly as compared to throwing on a line at shorter distances.  With that in mind, these folks might respond better to other throwing initiatives, or simply less long toss than they otherwise might do.

From a training standpoint, we need to work to gain more active external rotation to ensure that more of the range-of-motion is occuring is at the shoulder than the elbow.  This should not be confused with simply stretching the shoulder into external rotation, which does much more harm than good in 99% of cases.  Rather, we need to educate athletes on how to get to lay-back without compensation. I like supine external rotation - an exercise I learned from physical therapist Eric Schoenberg - as a starting point.

Once we've been successful working with gravity, we'll progress this drills to prone to work against gravity, and then add in various holds at end-ranges of motion to strengthen athletes in external rotation closer to end-range.  Here's an example you can try at home:

In terms of contraindications, I can't say that it changes much as compared to what we avoid - back squats, Olympic lifts, etc. - with the rest of our throwers.  However, I think the fallout could be even more dramatic; just imagine these elbows catching a snatch overhead in the off-season after 200+ innings of wear and tear.

This picture also teaches us that one can simply be born with a more significant valgus carrying angle, but throwing during the adolescent and teenage years would make it more extreme.

Beyond training implications, for the reasons I noted above, it's also extremely important to take care of tissue quality at the common flexor tendon and pronator teres. I like a combination of instrument-assisted soft tissue mobilization and hands-on work like Active Release.

I hope this post brings to light an additional assessment and follow-up training principles you can use to give your throwers the quality training and (p)rehabilitation they need. If you're looking for more insights on training throwers, I'd highly recommend you check out our Elite Baseball Mentorships; the next course takes place on December 8-10.

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!

There may not be more perplexing phenomenon in the baseball world than a pitcher with a case of the yips.  For those of you who aren't "down with the lingo," this term refers to an extended period of time when a pitcher simply can't throw the ball where he wants to throw it.  And, the yips can certainly extend to position players, as there are countless instances of catchers mysteriously struggling to throw the ball back to the pitcher, and infielders who can't make clean throws to first base - in spite of years of doing these things successfully. Perhaps the two most noteworthy cases of the past few decades were Rick Ankiel and Chuck Knoblauch, who were both forced to change positions because they couldn't overcome the issue.

Clearly there is a heavy psychological component to this issue - and that's a big part of how the yips have historically been managed.  Whether it's visiting with sports psychologists or chatting with pitching coaches, the powers that be aim to modify the thoughts that go through the pitcher's head prior to throwing.  And, there's certainly nothing wrong with that approach, as it's clearly part of the problem.  However, in today's article, I want to view the yips through a bit of a different paradigm.

One thing that nobody ever seems to mention is that the yips don't happen in high school players. Why?  It's because the frame of reference is different.  You see, high school kids don't throw enough strikes normally for us to even perceive when something is out of whack.  I've spoken with a ton of professional pitchers and they universally agree that they weren't able to repeat their mechanics consistently until they were in the 18-20 age range.  Until that point, their bodies were changing dramatically and they hadn't had sufficient throws under their belt to master the pattern and consistently repeat it.  Plus, they were pitching off different mounds each time out, and the quality of the mound can have a dramatic impact on one's delivery.  With these factors in mind, I think we can all agree that the yips are a problem confined to the college and professional ranks.  If a high school kid or pop star is missing wildly, we just chalk it up to poor skill or inexperience.

Drawing parallels in other sports proves to be difficult, though.  Among athletes who need to accurately project an object from a consistent release point, you just don't see the yips outside of baseball players.  Quarterbacks don't get it, and I've never seen a track and field thrower accidentally fire an implement into a terrified crowd.  Olympic archers and biathlon competitors don't miss targets by large margins, and I've never heard of a tennis player whose career ended from double faulting over and over again.  Certainly, if all these issues were purely psychological, we would have found cases of the yips across other sporting disciplines, right?  There simply have to be examples of other professional athletes' minds being so jumbled that tens of thousands of reps worth of motor control and precision would be seemingly wiped clean from the slate, right? 

Nope. It doesn't seem to work that way. So what is so unique about pitching, then? 

Stress and adaptation to that stress.

You see, throwing a baseball is the single fastest motion in all of sports - and that means serious stress on not just the arm, but also the rest of the body.  Additionally, the Major League Baseball season is among the longest in professional sports - lasting from mid-February to some point in October (depending on post-season play) - and eight months is plenty of time for things to go in the wrong direction as players may get more and more detrained.

Rotator cuff strength drops over the course of the season. Scapular upward rotation diminishes.  Tissue quality gets "gunkier" with each throwing session. Some players lose hip, shoulder, and elbow range of motion. Others acquire more ligamentous laxity and become increasingly unstable. Body weight may drop, and lower body strength and core stability fall off.  And when these issues collectively build, elbows, shoulders, lower backs, and any of a number of other areas may even become symptomatic. 

To be clear, what I'm saying is that guys don't magically forget how to throw strikes after tens of thousands of reps.  Rather, their bodies often let them down and don't enable them to physically get to the positions needed to repeat the mechanics to which they've grown accustomed.  They're like the teenagers who are growing into their bodies all over again.

If you need further proof, check out this great study from Kibler et al. Researchers noted that in the tennis serve, a 20% decrease in kinetic energy from the hip and trunk means the shoulder must generate 34% more velocity to get same force to the racket. It's safe to assume that the stress of pitching in this context is even higher because arm speed must be greater.  If you're 10-15 pounds lighter and have lost a bunch of your lower body strength, how can we know if your issues are purely psychological and not physical? In attempting to maintain velocity and compete, you have to compensate in any of a number of ways - and that's how physical problems quickly become mechanical and psychological ones.

As another example, it's not uncommon to see pitchers get hurt when they've been quickly transitioned from relieving to starting roles without adequate time to build up their pitch counts.  And, I wouldn't be surprised if the incidence of the yips is much higher among those who don't get hurt.  When you throw fatigue in the mix, altered mechanics (whether they appreciate it or not) are the only way guys can continue to try to compete.  This is one reason why it's so important to bring guys along slowly and methodically with this transition.

When we see a guy who is struggling with his command or velocity, the first thing we ask is, "Is he hurt?"  Yet, when he responds "No," nobody ever asks if he feels fatigued or weak.  So, maybe it's a paradigm that needs to shift?  I can remember chatting with a major league pitcher a while back roughly 2/3 of the way through his season.  He told me he'd had outings when he had absolutely no idea where the ball was going, and had actually developed a new pitch by accident because his mechanics were so off. Not surprisingly, the evaluation I then performed revealed a lot of things he needed to address physically - and he was clearly fatigued.  Nobody had even touched them, though, because his velocity, command, and numbers were good. This is like refusing to change the oil and tires on your car proactively because it seems to be running fine. Maybe the yips are just the equivalent of breaking down on the side of the road after ignoring those routine service appointments?

With all these factors in mind, I think it's safe to say that there is a definite role for physical shortcomings and both acute and chronic fatigue in the development of the yips.  It just may not be easily "diagnosed" because a) symptoms may be absent and b) many athletes aren't assessed appropriately when they're doing well, so there isn't a standard against which to compare.

Here is where I think so many players have struggled to overcome the problem.  They think that throwing more to "re-master" their mechanics is the way to fix the problem.  In throwing more, two things happen:

1. If each throw isn't right on the money mechanically, they're simply re-engraining those problems.

2. With each passing throw, they're imposing more fatigue - especially when those throws are off the mound (and if you want to re-master your mechanics, you want this level of true specificity).

Conversely, my first suggestion to athletes with the yips is always to simply take the ball out of their hands for 7-10 days.  I think it's important not only because it's a chance to acutely avoid reaffirming bad habits, but more because it's a chance to temporarily remove fatigue so that one can build up strength and stability in the right places, improve tissue quality, and normalize body weight. When that happens, "muscle memory" can kick in. 

Imagine driving your car after someone has adjusted all the mirrors, moved the seat up, lowered the steering wheel, messed with the alignment, and changed all the pre-set radio stations. It feels brutally awkward in spite of the fact that it's the same car you've had for years, and you might even be a danger on the road.  This is what pitchers often feel and look like at the end of a long season if they haven't been managed correctly on the physical side.  If you fix all these issues with the car, it goes back to feeling normal; you don't just forget all those years of safe and "natural" driving.  You wouldn't just call your driver's education instructor for a pep talk and then hop back into the funky new version of your car, would you?  The only differences are that you can easily recognize everything that's out of whack with a car, and a quick tune-up at the mechanic only takes a few minutes. Conversely, it's hard to self-assess physically, very few people truly understand how pitchers should move, and physical adaptation takes time.

This isn't a knock on sports psychologists or pitching coaches, as they are absolutely, positively a huge part of the process with getting a pitcher with the yips back on track.  However, it'd be extremely ignorant to overlook the pronounced physical adaptations and detraining that often take place with pitchers - and how this might interfere with one's ability to repeat mechanics that until that point had become second nature.

Wrap-up

A lot of you will read this article and think that it doesn't apply to you.  And, while you may not have experienced the yips yourself or in one of the players you coach, my hope is that this article effectively served as a call for you to establish baseline evaluations of movement quality.  If there isn't a thorough preliminary assessment against which to compare when things go south, you're really just guessing about how much is physical, psychological, and mechanical. If you're not assessing, you're assuming - and if assuming worked, this wouldn't be a problem that had shaved years off a lot of careers.

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!

Today, I'm going to tackle one of my biggest pet peeves in the baseball world: people saying that throwing builds arm "strength."  Sorry, but it doesn't. 

What I'm going to write below might seem like wordplay, but truthfully, it's a very important differentiation to make.  If young athletes believe that throwing builds arm strength, they'll quickly convince themselves that year-round throwing is safe and acceptable, when it's actually one of the worst things they can do for long-term health and development. Here's what you need to know:

1. Throwing builds arm speed - which is power.  Power is heavily reliant on muscular strength.  If you can't apply much force, you can't apply much force quickly.

2. Throwing also builds muscular endurance in the arm.  Muscular endurance, too, is heavily reliant on muscular strength. If you don't have strength you can't have strength endurance.

If you enhance muscular strength, power and endurance will generally improve.  That's been shown time and time again in the research, both in throwers and other athletic situations.  However, if you train power and endurance, strength almost never goes up.  Otherwise, we'd see loads of athletes stronger at the end of seasons than they were at the beginning. In reality, if you check rotator cuff strength and scapular stabilizer proficiency at season's end, it's generally much lower.  As physical therapist Mike Reinold describes it, managing arm strength during the season is a "controlled fall."

This underscores the importance of using the off-season (including a period with no throwing whatsoever) to improve rotator cuff strength and optimize scapular control.  Simultaneously, athletes gain passive stability at the shoulder as the acquired anterior instability (secondary to increased external rotation from throwing) reduces.

Now, we need more research to see if it's the case, but I think that one of the hidden benefits of throwing weighted baseball is that doing so essentially helps us blur the line between arm strength and speed, as I outlined in this presentation a while back:

Of course, it depends heavily on the volume, frequency, load, and type of weighted ball drills utilized, as well as the time of year at which they're utilized.  However, as I mentioned, it is somewhat of a noteworthy exception to the rule of throwing a 5oz baseball.  Weighted balls surely still take a toll on arm strength over the course of time, but that might be a "slower fall."

Regardless, when you're talking about a throwing program, feel free to say that you're building "arm speed" or "arm endurance," but let's all appreciate that you definitely aren't building "arm strength." 

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!

This week's list of recommended strength and conditioning reading (and listening) will have a heavy baseball focus.  Check out these websites:

Elite Baseball Mentorships - We've run two of these, and the feedback has been fantastic.  With that in mind, today is the early-bird registration deadline for the August 18-20 Phase 2 (no prerequisites required). We'd love to see you there!

Talking Shoulders and Elbows with Eric Cressey - This is the audio of a podcast I did for the Blue Jays Plus Podcast.  We discuss baseball injuries, player development, and a host of other topics. I come on the show at the 34-minute mark, in case you want to fast-forward to it.

The Surgery that Changed Baseball Forever - With the upcoming induction of Dr. Frank Jobe (who thought up and did the first Tommy John surgery) to the Baseball Hall of Fame, Will Carroll wrote this outstanding four-part article for Bleacher Report.  Here are the links to check out each of the articles: Part 1, Part 2, Part 3, and Part 4.

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!