Home Posts tagged "Pitching Injuries"

CSP Elite Baseball Development Podcast: Tommy John Timelines with Stan Conte

We’re excited to welcome physical therapist Stan Conte to this week’s podcast for a detailed discussion of expectations surrounding Tommy John surgery. Stan is not only an experienced clinician, but also a prolific researcher in the baseball sports medicine world. With the prevalence of ulnar collateral ligament injuries in today's game, this podcast is a must-listen.

A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 20-pack of Athletic Greens travel packets with your first order.

Show Outline

  • How Stan’s career in professional baseball has evolved from the clinical setting into more research based work
  • How Stan was a part of the group that began the Health and Injury Tracking System (HITS), the first injury surveillance system in Major League Baseball
  • How the disabled list had long been utilized as more of a roster management tool than an injury prevention system
  • Why DL data is still nonetheless relied upon when analyzing medical history in pro baseball
  • What studies Stan has been a part of regarding Tommy John surgery, and how this research is shaping the way players are managed
  • How the increase in pitching velocity throughout the game of baseball has redefined the pressure put on prospects and led to throwing injuries in younger arms
  • Why no one really knows how long it takes a UCL graft to mature and what conclusions Stan has drawn from research and working alongside rehabilitating athletes
  • When the best time to begin throwing after Tommy John surgery is
  • Why having pain when throwing during Tommy John rehab is not normal and what protocols players can look to when setbacks arise
  • When flat grounds, bullpens, and simulated games should fit into a return from TJ throwing program
  • When Stan recommends the reincorporation of off speed pitchers in return to throwing programs
  • What the true success rate of UCL reconstruction surgery is
  • What common Tommy John perceptions are actually myths
  • Why the number of Tommy John revisions is rising and how long post-op are the majority of these revision surgeries occurring
  • What the difference is between UCL repair and UCL reconstruction, and when each is an option for patients
  • Despite the high success rate for pitchers with TJ surgery, why catchers see the lowest success rate from Tommy John
  • Where Stan would like to see more research done in the baseball performance industry
  • You can follow Stan on Twitter at @StanConte.

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!

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Arm Care: Why Are We Still Talking About “Down and Back?”

Today's guest post comes from Eric Schoenberg, the physical therapist at Cressey Sports Performance - Florida and a great resource to the entire CSP team. Enjoy! -EC

To get right to the heart of what I'm covering today, I think it's best that we start with a video:

So, as you can infer, the reason we're still talking about "down and back" is because we need to! Athletes are coming into the gym every week after multiple surgeries or drops in performance with postures and movement patterns that are faulty and easily correctible.

Obviously, the down and back concept is not the only reason for this, but the idea of driving our scapulae into maximal adduction (retraction), downward rotation, and depression is certainly something that we can control and improve upon.

To set the record straight, the only time an athlete should receive this cue is when their arms are by their side (Deadlifts, farmer’s walks, heavy dumbbell holds for lower body lifts). Once the humerus starts to move away from the side more than 20-30 degrees, the scapula needs to start moving in the appropriate direction to keep ball on socket congruency and reduce mechanical stress to the neighboring soft tissue structures (labrum, rotator cuff, neurovascular structures).

On the performance side of things, the “down and back” posture (scapular adduction, downward rotation, and depression) limit the ability to get the hand out in front or overhead. This has obvious implications in overhead athletes.


 In the case of throwers, the difference in extension at ball release can vary by 3-4 inches depending on the position of the scapula. (as you can see in the comparison pics above and the video below).

When we don’t get full extension at ball release, any variety of downstream stresses can occur (aggressive elbow extension, lack of full pronation through the baseball) that result in increased injury risk and decreased performance.

As mentioned in the introduction video, we are bringing bad cues to good programming and it continues to result in faulty movement and injury. Even worse is when this “down and back” cue is brought into the rehabilitation setting and athletes that have already had surgery continue to experience symptoms similar to their pre-surgery presentation.

In conclusion, let’s continue to look at our cues and consider where the arm is in relation to the body when we decide to cue down and back. When the arms are by the side, then go ahead and cue the scaps down and back. However, when the arm is abducted to the side, overhead, layed back into ER, or out in front at ball release, we need to cue a degree of upward rotation and elevation to make sure the joint is aligned for success.

About the Author

Eric Schoenberg is a Physical Therapist and Strength Coach and the Owner of Diamond Physical Therapy located inside Cressey Sports Performance – Florida. Eric’s approach is to help athletes move more efficiently to reduce injury and improve performance. You can follow him on Twitter and Instagram at @csp_physicaltherapy, or email him at eric@diamondphystherapy.com.

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CSP Elite Baseball Development Podcast: March 2020 Q&A with Eric Cressey

For this week's podcast, in lieu of a guest, I'm going to do a Q&A on a collection of baseball training questions that were submitted by listeners.

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 10% off on your order.

Show Outline

  • How bullpen arms can arrange their lifting schedule to optimize their performance and feel prepared for each outing
  • How hitters can mitigate the stressors placed on the lead shoulder of their swing
  • What recent history and research says about bicep tenodesis and recovery and what baseball players should be aware of when considering this procedure
  • What high school coaches can do to best prepare their pitchers for week one of spring season

Sponsor Reminder

This episode is brought to you by Marc Pro, a cutting-edge EMS device that uses patented technology to create non-fatiguing muscle activation. Muscle activation with Marc Pro facilitates each stage of the body’s natural recovery process- similar to active recovery, but without the extra effort and muscle fatigue. Athletes can use it for as long as they need to ensure a more full and quick recovery in between training or games. With its portability and ease of use, players can use Marc Pro while traveling between games or while relaxing at home. Players and trainers from every MLB team - including over 200 pro pitchers - use Marc Pro. Put Marc Pro to the test for yourself with their new "Try Before you Buy" program, and use promo code CRESSEY at checkout at www.MarcPro.com for 10% off on your order.

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: Aaron Barrett

We're excited to welcome Washington Nationals relief pitcher Aaron Barrett to this week's podcast. Aaron is one of the most impressive comeback stories you'll ever hear. A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 20-pack of Athletic Greens travel packets with your first order.

Show Outline

  • What major injuries and setbacks Aaron experienced that removed him from competitive baseball from 2014 to 2018
  • What the medical priorities and overall rehab process were for recovering from this freak injury
  • How Aaron managed his psychology as he endured a major setback
  • How he incorporated and began to increase his hand speed as he progressed throw his rehab throwing program
  • When in Aaron’s rehab protocols he felt more consistent and confident as he began throwing in professional baseball games once again
  • What recovery modalities Aaron utilizes to help his arm bounce back
  • How Aaron modified his routine after enduring these setbacks
  • How Aaron remained process oriented and focused on his goals for the long haul of a four-year rehab period
  • What lessons has Aaron learned after experiencing the workload of being a reliever in a major league bullpen
  • How Aaron manages his throwing volume and intensity in-season
  • What Aaron’s gameday routine is
  • What the characteristics of coaches and rehab professionals that have been the most impactful on his career
  • What Aaron’s next step is for his career as he transitions from this incredible recovery from injury to being a consistent performer for the Washington Nationals

You can follow Aaron on Twitter at @AaronBarrett30 and on Instagram at @AaronBarrett30.

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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Strength and Conditioning Stuff You Should Read: 9/12/19

I hope you're hadving a great week. Here's a little recommended reading and listening to keep it rolling.

Complete Coach Certification - Mike Robertson launched this excellent continuing education resource for trainers last week. I just finished working my way through it and it was outstanding.

Models of Skills are Important - Lee Taft interviewed Dan Pfaff for this podcast, and it was absolutely outstanding.

Shoulder Assessment and Treatment with Eric Cressey - Speaking of podcasts, I was a guest on the Squat University Podcast recently. I talked a lot of shoulders with the host, physical therapist Aaron Horschig.

An Alternate Approach to Summer Ball: The Rise of Private Facility Training - This article from Aaron Fitt at D1Baseball.com highlights how many athletes are taking non-traditional approaches to summer development for baseball. Aaron shadowed a training session with Duke pitcher Bryce Jarvis at Cressey Sports Performance.

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The overhead view in a pitching delivery can enable you to see certain things that can’t be appreciated from other perspectives. Foremost among these is the ability to differentiate between thoracic rotation (upper back motion) and horizontal abduction (shoulder motion). 👇 In this image taken just prior to stride foot contact, @gerritcole45’s pelvis has already rotated counterclockwise toward the plate while his torso is still rotating clockwise. This is the hip-shoulder separation throwers seek for generating big time velocity. 🔥 However, when a thrower lacks thoracic rotation - or gives up thoracic rotation too early (usually by chasing arm speed too early in the delivery) - he’ll often resort to creating excessive horizontal abduction (arm back) to find the pre-stretch he wants to generate the velocity he covets. This is not only an ineffective velocity strategy, but it also can increase anterior shoulder and medial elbow stress - all while leading to arm side misses, accidental cutters, and backup breaking balls. 🤦‍♂️ Over the past few years, I’ve heard of a few pitchers being advised to work to increase the horizontal abduction in their deliveries. I don’t think you can make this recommendation without the overhead view, and even then, it’s likely taking a distal (arm) solution to a proximal (trunk and timing) problem. 🤔 I covered hip-shoulder separation in the pitching delivery in great detail in a free presentation I gave away earlier this year when we launched our podcast. You can still get it at the link in my bio.👊👍 . #Repost @astrosbaseball @get_repost_easily #repost_easily ****** Like H-Town in the summertime 💯

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Why the Overhead Angle Matters in the Pitching Delivery

The overhead view in a pitching delivery can enable you to see certain things that can’t be appreciated from other perspectives. Foremost among these is the ability to differentiate between thoracic rotation (upper back motion) and horizontal abduction (shoulder motion).

In this image taken just prior to stride foot contact, Gerrit Cole's pelvis has already rotated counterclockwise toward the plate while his torso is still rotating clockwise. This is the hip-shoulder separation throwers seek for generating big time velocity.

However, when a thrower lacks thoracic rotation - or gives up thoracic rotation too early (usually by chasing arm speed too early in the delivery) - he’ll often resort to creating excessive horizontal abduction (arm back) to find the pre-stretch he wants to generate the velocity he covets. This is not only an ineffective velocity strategy, but it also can increase anterior shoulder and medial elbow stress - all while leading to arm side misses, accidental cutters, and backup breaking balls.

Over the past few years, I’ve heard of a few pitchers being advised to work to increase the horizontal abduction in their deliveries. I don’t think you can make this recommendation without the overhead view, and even then, it’s likely taking a distal (arm) solution to a proximal (trunk and timing) problem.

I covered hip-shoulder separation in the pitching delivery in great detail in a free presentation I gave away earlier this year when we launched our podcast. You can still get it by subscribing below:

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Elite Baseball Development Podcast: Monitoring Arm Stress and Workload with Ben Hansen

We're excited to welcome Ben Hansen, the Vice President of Biomechanics and Innovation at Motus Global, to this week's podcast. In lieu of a sponsor this week, we've just got a final reminder that this week is the last chance to get the early bird discount on this year's fall seminar at CSP-MA. It takes place September 21-22; you can learn more HERE.

Show Outline

  • What led Ben to pursue a career in biomechanics and wearable technology
  • How Motus Global strives to impact the game of baseball and how their model for developing healthy arms has shifted over the years
  • What peer reviewed research says about the significance of joint torques and how we should interpret these metrics for predicting the risk of injury in baseball players
  • What acute and chronic workloads are, and how managing these variables can allow coaches to keep their athletes healthy and high performing
  • Why pitchers should have individualized throwing programs to account for the diverse variables that impact a player’s health
  • How truly different catch play, flat ground, bullpen, pre-game, and in-game throws are, and how coaches can more accurately account for the stress they impose on pitchers throughout a season
  • How rest should be incorporated into a baseball players year and why short breaks during a season of heavy throwing may be doing more harm than good for throwers
  • What ballplayers should consider when deciding between continuing to throw into the next season or shutting down to rest
  • What role mechanics plays in the health of a throwing arm and how common mechanical tendencies, like the Tommy John Twist and the Inverted W, influence arm stress
  • How fatigue is more predictive of injury than mechanics
  • Why building a durable work capacity is more important for staying healthy than mastering mechanics
  • How reliable using perceived effort is when creating and executing a throwing program
  • Why professionals need to rewrite the return to throwing program for common injuries in baseball
  • Where more research is needed to further understand how to manage baseball arms

You can follow Ben on Twitter at @BenHansen9 and on Instagram at @MotusGlobal.

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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Elite Baseball Development Podcast with Scott Oberg

We're excited to welcome Colorado Rockies relief pitcher Scott Oberg to the podcast. A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 20-pack of Athletic Greens travel packets with your first order.

Show Outline

  • What Scott’s college recruiting process was like as a late-blooming pitcher from the Northeast and why he chose to attend the University of Connecticut
  • How Scott persevered to overcome multiple injuries/conditions over his college baseball career
  • How Scott advanced quickly through the ranks of pro ball
  • How Scott’s journey through adversity has molded his mindset and what his advice is to young players looking to remain resilient through obstacles in their baseball career
  • Why Scott favored a two-seam fastball in college and how reintroducing a four-seam fastball back into his repertoire improved his game in pro ball
  • How becoming more self-aware and instilling confidence improved Scott’s command and transformed him from a fringe big leaguer to a mainstay in a big league bullpen
  • How controlling the count and competing from 0-0 makes pitching easier and allows pitchers to play the games within the game of baseball
  • How Scott developed a relationship with Texas Rangers minor league pitcher Tyler Phillips and what lessons Scott passes on to the aspiring big leaguer in their offseason training.

You can follow Scott on Instagram at @scottoberg45.

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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Strength and Conditioning Stuff You Should Read: 4/26/19

Today, I've got a little recommended reading and listening to wrap up your week! Before I get to it, though, just a quick reminder that the early-bird registration deadline for my June 2 shoulder course in St. Louis is quickly approaching. You can learn more HERE.

Just a Coach in the Strength and Conditioning Profession - Jim Ferris is an accomplished coach whose social media posts are always super entertaining. He's got a great sense of humor and a lot of experience, so it's awesome to see him publishing articles now.

Strength Training for the Softball Athlete - I joined the National Fastpitch Coaches Association podcast to talk about strength and conditioning in the softball world. It covers a wide range of topics, though, ranging from long-term athletic development to specific injury prevention.

How to Show You're Passionate in a Job Interview - On the surface, this has nothing to do with strength and conditioning. However, just about everyone who interviews for a S&C position invariably falls back on leveraging their passion to make their case. If you're going to use that approach, keep these strategies from the Harvard Business Review in mind.

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