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| Q: I've developed some issues with my right shoulder due mostly to pitching in baseball. I've had an MRI done recently and I've been working with an ART specialist as well. So here's the email I just received from my chiropractor:
I just got your MRI results in, it shows tendonitis of the supraspinatus tendon and a small "hot spot" on the anterior/superior aspect of the glenoid labrum, which might represent a small tear. The radiologist has recommended an arthrogram, which is an MRI with contrast injected directly into the joint capsule instead of intravenously.
You have two options: We could try some more ART and more laser treatments. If your pain decreased after one treatment, than I think it would definitely help. Option two is referral to an orthopedist. He would in turn probably refer you for 4-6 weeks of physical therapy. In any event, the possibility of a major labral tear is slim as a large tear should have been visible on the MRI.
Based on the MRI results what do you recommend as far as the options he layed out for me? The ART has helped some but it is still very painful to throw hard. I have no clue what to do and I'm afraid of getting in over my head with medical bills and still having a hurt shoulder.
A: Congratulations! You have the same MRI that every pitcher I've ever seen has ever had!
I can pretty much tell you that your labrum is frayed regardless of whether or not you get the MRI. According to the research, the main difference between those in pain and those not in pain is internal rotation ROM.
Get the PT - and bring this list with you:
1. Scapular stability
2. Thoracic spine range of motion
3. Glenohumeral (ball-and-socket joint) range of motion
4. Overall soft tissue quality (especially posterior capsule)
5. Rotator cuff strength
6. Cervical spine function
7. Mobility of the opposite hip
8. Mobility of the opposite ankle.
9. Core stability/force transfer
10. Breathing patterns
Tell them that you want to address each of these 10 factors (in this order) in your rehab.
In particular, tell them to check internal rotation ROM, and even print this out for them, if need be: http://www.jaaos.org/cgi/content/full/14/5/265/JA0008404FIG9
Click here to purchase the most comprehensive shoulder resource available today: Optimal Shoulder Performance - From Rehabilitation to High Performance. |
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| Q: There have been a few quadriceps pulls in MLB this year. Have you seen these before in baseball players? What gives?
A: This is why I love baseball; it's probably one of the most at-risk sports you'll ever see (particularly in pitchers). Here's a little excerpt from a slide in a recent presentation I gave on training for overhead athletes:
-Very Long Competitive Season
>200 games as a pro?
>100 College/HS?
-Unilateral Dominance/Handedness Patterns
Asymmetry is a big predictor of injury
Switch hitters – but no “switch throwers!”
-The best pitchers – with a few exceptions – are the tallest ones. The longer the spine, the tougher it is to stabilize.
-Short off-season + Long in-season w/daily games = tough to build/maintain strength, power, flexibility, and optimal soft tissue quality
Specific to the quad pulls, I'd add to this list that baseball guys rarely hit top speed; all of their sprint work is done in acceleration, where the quads are dominant. Factor in that they spend a lot of time sitting on airplanes/buses, and it's no surprise that they'd get tight anteriorly. It's why it's so important to really hammer on hip mobility in any population that sits a lot.
The stop and go nature of the sport also dictates that strains would be common, whether they are groins, hip flexors, hamstrings, or quads (likely rectus femoris, which is a hip flexor that can get overactive, particularly alongside poor psoas function).
So, all that said, before anyone jumps to conclusions and tries to criticize some strength coach, it's important to consider:
a) the certain amount of happenstance that occurs with any baseball player due to the nature of the game and the season
b) what that athlete does on his own in the off-season
In terms of "b," I’ve seen some pretty bad stuff, unfortunately. For many guys, it becomes a leg extensions and curls off-season if they're on their own - or they do nothing.
I'd like to think that our success in working with baseball guys is not just in the fact that we've made the programming good, but also in the fact that we've changed the culture a bit in our guys: they appreciate what lifting is doing for them and look forward to getting after it in the gym.
Sign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches used by Cressey Performance Pitchers after they Throw!
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| We opened Cressey Performance on July 17, 2007. Amidst all the lifting, jumping, sprinting med-ball-stomping, and blaring of loud music, we neglected to actually make a website - until now.
www.CresseyPerformance.com
Enjoy.
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| In Newsletter 95, I wrote about how pathologies often don’t become symptomatic until inefficiencies get to be too bad. Here is a perfect example of a guy who has basically learned how to work around a pathology to remain competitive at a high level.
New Twist Keeps Dickey’s Career Afloat
You can bet that he’s got a lot of efficiency working in his favor.
Thanks, Paul Vajdic, for passing this along! |
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Click the link below to view an hour-long interview I did on the Audrey Hall Show alongside Rich Gedman (former Red Sox catcher and current manager of the Worcester Tornadoes) and Bunky Smith (head coach of Framingham's American Legion Team) on the topic of youth baseball training.
http://link.brightcove.com/services/link/bcpid1137806189/bclid1408993191/bctid1424672868?src=rss |
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| Many of you are going to hate me for what I’m about to say. I don’t let my overhead throwing athletes overhead press or bench press with a straight bar.
There. I said it. Call me all the names you’d like but ask yourself this:
“Am I cursing Eric’s name because I think that the cost-to-benefit ratio of overhead pressing and straight bar bench pressing justifies their use, or is it because I feel naked without these options? I have to bench press. I can’t start an upper body day with any other exercise.”
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