Home Posts tagged "Pitching Injuries" (Page 11)

Pitch Count Roundtable: Your Thoughts?

Last week, I contributed on a pitch counts roundtable for ESPN Boston. You can read it HERE.

I'd love to hear your thoughts on the matter in the comments section below, as it is a certainly a heated debate that has come to the forefront in recent years with pitching injuries on the rise.

 

Related Posts

Why Pitchers Shouldn't Do Year-Round Throwing Programs: Part 1 and Part 2
Baseball Showcases: A Great Way to Waste Money and Get Injured
7 Weeks to 7 Pounds of Lean Mass and 7 Miles Per Hour

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Baseball Strength and Conditioning: What to Do With an Extra Day Between Pitching Starts

Q: I read your series, A New Model for Training Between Starts, and love the ideas you introduced.  Since eliminating distance running between outings, I've noticed a big difference in how I feel and how I pitch.  I did have one question about the weekly rotations you outlined in Part 2.  What happens if I have an extra day between starts due to erratic scheduling or just a rain out? A: This is a great question - and one I have received several times - so I'm glad I'm finally getting around to answering it here on the blog! I usually look for guys to do a "bridge" training session.  Basically, these sessions are all about leaving the gym feeling refreshed; you work, but not so hard that you're exhausted.

In the typical in-season baseball strength and conditioning program we use with professional pitchers on a five-day rotation, here's how we'd schedule it: Day 0: pitch Day 1: challenging lower body lift, push-up variation (light), horizontal pulling (light), cuff work Day 2: movement training only Day 3: Single-leg work, challenging upper body lift (less vertical pulling in-season), cuff work Day 4: low-intensity dynamic flexibility circuits only Day 5: next pitching outing However, if the next outing isn't until Day 6, we will integrate one of two options: The first option would be to simply split the Day 3 training session into two shorter sessions: one upper, one lower.  These sessions might only be 10-12 sets in all. Then, Day 5 would be the low-intensity dynamic flexibility circuits.

The second option would be to keep the strength training component as-is, but perform some medicine ball circuits on Day 4, then use Day 5 for the low-intensity dynamic flexibility circuits. Both options keep you training hard without interfering with the subsequent pitching outing.  Particularly in professional baseball, there are more days off early in the season, so it's important to be able to roll with the punches like this. At the college and high school levels, the 7-day rotation is usually implemented.  If a pitcher starts on Day 0, I like to see him strength training on Day 1, Day 3, and Day 5, with Day 5 being a lower-intensity lift (Days 2 and 4 are movement training, and Day 6 is low-intensity dynamic flexibility).  If there is an extra day on the end, we simply treat our Day 5 lift like we did the Day 3 option in the 5-day template from above; it can either be split into upper and lower body sessions, or we can do it as-is, and add medicine ball circuits on Day 6, taking Day 7 for dynamic flexibility before starting again on Day 8.

That said, as in my experience, guys rarely get that extra day in high school and college; they're more likely to have their starts pushed up.  In this case, we just drop the Day 5 lift. Getting training sessions in between starts is incredibly important, but that doesn't mean that one must be rigid in the scheduling of these sessions.  In fact, one must be very flexible in tinkering with that scheduling on a week-to-week basis to make sure that guys are getting in their lifts, but not at the expense of their performance on the mound. Hopefully this blog provided some strategies you can employ when weather or scheduling throws you a curveball! 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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Increasing Pitching Velocity: What Stride Length Means and How to Improve It – Part 1

Ask almost any pitcher, and he'd tell you that he'd love to increase his stride length on the mound in hopes of increasing pitching velocity.  And, this is certainly an association that has been verified by both anecdotal and research evidence for years.  Look back to the best pitchers of former generations, and they figured this out even without the benefit of radar guns.

On the anecdotal side of things, hitters often comment on how pitches "get on them faster" with a guy who strides further down the mound.  This is a no brainer: a pitcher who releases the ball closer to the plate has a competitive advantage.  That's perceived pitching velocity.  However, what about actual velocity - meaning what the radar gun says? The truth is that it's somewhat tricky to prove specifically that a longer stride directly equates to better actual velocity, as it really depends on how the pitcher gets to that point.  You see, a pitcher can effectively delay his weight shift to create better "separation;" in fact, keeping the head behind the hips longer correlates highly with pitching velocity.  This separation is the name of the game - and he'd throw harder.

Or, that same pitcher could simply jump out - letting his body weight leak forward prematurely - and completely rob himself of separation and, in turn, velocity.  So, that's the first asterisk to keep in mind: it's not just where you stride, but also how you stride there. Additionally, in that second scenario, this modification may cause a pitcher to shift his weight forward excessively and wind up landing too much on his toes.  While the point on the foot at which the weight should be centered is certainly a point of debate among pitching coaches, it's safe to say that they all agree that you shouldn't be tip-toeing down the mound! Lastly, even if the weight shift is delayed perfectly, a pitcher still has to time up the rest of his delivery - when the ball comes out of the glove, how high the leg kick is, etc - to match up with it in "slightly" new mechanics.  These adjustments can take time, so the velocity improvements with a long stride may not come right away because other factors are influenced. Of course, keep in mind that not every hard thrower has a huge stride.  Justin Verlander doesn't get too far down the mound, but he's still done okay for himself!  Verlander seems to make up the difference with a ridiculously quick arm, great downward plane at ball release, and outstanding hip rotation power.  There's no sense screwing with someone who is a reigning Cy Young and MVP - and has two career no-hitters under his belt.  However, YOU have to find what works best for YOU.

So, without even getting to my list, you can say that mechanical proficiency is the #1 factor that influences whether a long stride will improve your pitching velocity.  Dial in what needs to be dialed in, and it could work wonders for you - if your body is prepared.

To that end, in part 2 of this series, I'll outline five physical factors that will help you improve your stride length and increase pitching velocity.

Interested in learning more about the throwing shoulder? Check out Optimal Shoulder Performance: From Rehabilitation to High Performance!

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Baseball Injuries: What to Expect in the Next Few Months

With football season now officially over, loads of sports fans are now turning their attention to the fact that pitchers and catchers "reported" this week, signifying the start of spring training and a new Major League Baseball season.  Truth be told, most college programs will have already started their seasons - and many high school programs will be playing official games - before the big leaguers start having regular season contests.

Unfortunately, with the start of a new season comes injuries...and lots of them. In fact, according to researchers who examined MLB injury statistics from 2002 through 2008, professional baseball players are 10.6 times more likely to get injured in April than they are in September.  In other words, they are far more likely to get hurt because they haven't prepared adequately for specificity than because they've had too much specificity.

Think about that for a second.  By the time September rolls around, most MLB players have logged 150 games between spring training and regular season play.  On a regular basis, they've fouled balls off their feet, gotten hit by pitches, made 100 slides, attempted dozens of diving catches, and sprinted full-tilt when they aren't warmed-up thoroughly after standing around doing nothing for a few innings.  Pitchers have logged hundreds of innings, in some cases, and catchers are sick of squatting for hours on end.  Yet, guys are dropping like flies in April, when they're supposed to be the most fresh.

Huh?

There are four legitimate reasons that this is happening.

First, rosters expand in September, so teams can easily keep a guy with a minor injury on the roster without putting him on the disabled list, which would make him "officially" hurt.  However, this doesn't explain why August injury rates are still dramatically higher than April's.

Second, the weather is colder - which means it's tougher for guys to stay warm and loose during early season games.  This doesn't explain the high injury rates we see in spring training, though, as all games take place in Arizona and Florida.

Third, guys may be ramped up too quickly.  Too many swings or throws in a short period of time may be the problem - but this really isn't something that can be changed, as guys need to become game ready, getting their timing, coordination, and mechanics down cold while they've got proper coaching at hand.

Fourth (and this is the main message of this article), guys simply aren't preparing correctly in the off-season with their baseball strength and conditioning programs.  They may not be showing up with the right mobility and stability in the right places, or they may simply be waiting too long to start throwing, hitting, or sprinting.  This happens all the time at the high school, college, and professional levels.

In the high school ranks, kids may be winter sports athletes, and not pick up a ball until a week or two before tryouts.  Or, they may have just lifted weights all winter, but not done enough sprinting or mobility work.

In the college ranks, some athletes will skip throwing and hitting altogether over winter break - and then wind up with issues when they return to campus and ramp up quickly to prepare for the start of the season.

Finally, in the professional ranks, many players simply wait too long to start baseball activities.  You can lift all the weights you want, throw medicine balls, sprint, take yoga classes, and participate in any of a number of other general training modalities, but nothing prepares you for being in baseball cleats and hitting, throwing, taking ground balls, or shagging fly balls for hours on end - and doing so every day of the week.  It's why I encourage our professional baseball crew to always get started on these things well in advance.  Guys might start playing catch as early as Thanksgiving, start hitting off a tee in early December, and start working on defensive drills when January rolls around.  And, we'll do movement training - sprinting, change of direction drills, ploys - throughout the off-season.  We don't add everything at once; instead, we gradually introduce a more and more baseball-specific stimulus as the off-season progresses so that nobody gets surprised when they show up to spring training; it should feel like a breeze.

So, with anywhere from a few weeks to a few months of your off-season remaining, make sure you're not just getting bogged down in the weight room.  Keep in mind that you lift weights to stay healthy on the field and improve performance, not just for the sake of lifting weights.  Look for more and more specificity in your programming with increased participation in baseball activities - but not so much that it becomes a "too much, too soon" scenario.  And, keep an eye out for the media reporting on loads of hamstrings, hip flexor, adductor, and oblique strains in the months to come, as it's a sign of the season!

Related Posts

Oblique Strains in Baseball: A 2011 Update
Hip Injuries in Baseball

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Pitching Injuries: It’s Not Just What You’re Doing; It’s What You’ve Already Done

A while back, this article on pitching injuries became the single-most popular piece in EricCressey.com history:

Your Arm hurts?  Thank Your Little League, Fall Ball, and AAU Coaches

In that feature, I made the following statement:

We can do all the strength training, mobility work, and soft tissue treatments in the world and it won’t matter if they’re overused – because I’m just not smart enough to have figured out how to go back in time and change history. Worried about whether they’re throwing curveballs, or if their mechanics are perfect?  It won’t matter if they’ve already accumulated too many innings.

While athletes might be playing with fire each time they throw, the pain presentation pattern is different.  You burn your hand, and you know instantly.  Pitching injuries take time to come about. Maybe you do microscopic damage to your ulnar collateral ligament each time you throw – and then come back and pitch again before it’s had time to fully regenerate.  Or, maybe you ignore the shoulder internal rotation deficit and scapular dyskinesis you’ve got and it gets worse and worse for years – until you’re finally on the surgeon’s table for a labral and/or rotator cuff repair.  These issues might be managed conservatively if painful during the teenage years (or go undetected if no pain is present) – but once a kid hits age 18 or 19, it seems to automatically become “socially acceptable” to do an elbow or shoulder surgery.

Sure enough, just yesterday, reader Paul Vajdic sent me this article from the Shreveport Times. The author interviews world-renowned orthopedic surgeon Dr. James Andrews about the crazy increase in the number of Tommy John surgeries he'd performed over the past decade.

A comment he made really jumped out at me, in light of my point from above:

""I had a kid come in, a 15-year-old from Boca Raton, (Fla.), who tore his ligament completely in two,' Andrews said. 'The interesting thing is when I X-rayed his elbow with good magnification, he has a little calcification right where the ligament attaches to the bone. We're seeing more of that now. He actually got hurt with a minor pull of the ligament when he was 10, 11, 12 years of age. That little calcification gets bigger and, initially, it won't look like anything but a sore elbow. As that matures, it becomes more prominent. It turns into an English pea-size bone piece and pulls part of the ligament off when they're young.'"

In other words, it takes repeated bouts of microtrauma over the course of many years to bring an athlete to threshold - even if they have little to no symptoms along the way.  Injury prevention starts at the youngest ages; otherwise, you're just playing from behind the 8-ball when you start training high school and college players.

In addition to walking away with the perspective that young kids need to be strictly managed with their pitch counts, I hope this makes you appreciate the value of strength and conditioning programs at young ages, too.  For more information, check out my post, The Truth About Strength Training for Kids.

We can't prevent them all, but I do think that initiatives like the IYCA High School Strength Coach Certification in conjunction with pitch count implementation and coaching education are a step in the right direction.

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“The Physics of Pitching” Review

I just wanted to quickly mention that a book to which I contributed will be out shortly. The Physics of Pitching will be released on June 6 and can be pre-ordered at Amazon.

Len Solesky, a local pitching instructor who works with quite a few of our athletes, co-wrote the book with James Cain. The Physics of Pitching also features contributions from orthopedic surgeon Dr. Scott Silverberg, physical therapist Rob Ackerly, former MLB pitcher Rusty Meacham, and some schmuck named "Cressey." My chapter is, of course, focused on strength and conditioning for baseball. This is an excellent read for parents and kids alike. It won't appeal quite as much to higher level players and coaches, but if you're looking to learn the basics of pitching and become a better teacher (or student), it'll help you to do so. I especially like the fact that the guys went to great lengths to focus on the mental side of pitching.  In all, it's 192 pages with loads of photographs and an accompanying instructional DVD...not too shabby for a resource that only costs $16.49.  Check it out HERE. 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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Stuff You Should Read: 3/7/11

For this week's list of recommended reading: Final Phase Fat Loss: An Interview with John Romaniello - I did this interview with John Romaniello just over one year ago, but the information is still very applicable.  And, given that John is just "re-launching" his product with new additions and a big price discount (starting next Monday at midnight), the timing is very good.  For more information, check out Final Phase Fat Loss. Band Work After Pitching? - With the baseball season about to get going, I thought this would be a good time to reincarnate this post I wrote a while back. Act Small to Grow Big - When I read this article by Pat Rigsby, I immediately sent it to my business partners, Pete and Tony.  While I think we are doing a lot of things correctly in this regard, it seemed like a good reminder.  If you're a fitness professional reading this blog, I'd call it a must-read for you. Sign-up Today for our FREE Newsletter and receive a deadlift technique tutorial!
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Lose Fat, Gain Muscle, Get Strong, and Laugh a Little – Installment 2

Time to learn and laugh - and hopefully lose fat and gain muscle in the process. 1. Here's a great study that shows that scapular dyskinesis in swimmers is magnified as training duration increases.  I think that we all assume that you either have a scapular dyskinesis or you don't - but the truth is that you may not have it at rest, but it can kick in with activity as you fatigue.  This is often why pitchers' mechanics change (e.g., elbow drops) as they get tired later in an outing.

It's a perfect example of how managing a pitcher - building up throwing volumes, charting pitch counts, and preparing the body - is much more important in terms of long term health than simply teaching pitching mechanics.  A pitcher might have great mechanics in a 15-30 pitch bullpen, but that can change dramatically if he is asked to extend his pitch count. 2. I woke up this morning to an email from two CP pro guys, Matt Kramer (Red Sox) and Chad Rodgers (Braves), and it included this video thank you/tribute from the off-season.  Not a bad supplemental skill set for a couple of guys who throw 95mph!

3. My wife and I have been doing more and more cooking from Dave Ruel's Anabolic Cooking.  He's got a ton of great (and healthy) recipes in this cookbook that have been a nice change of pace for us, as we seemed to have gotten in a rut when things got busy and we just kept preparing what was quick, easy, and familiar.  I'll write up a thorough review of the product sometime soon, but for now, you can find out more information HERE.

4. On Monday, my wife and I returned from four days in Iceland.  It was an awesome trip; people there are so hospitable and we were treated fantastically.  I could go on and on about our experiences there, but a travel guide could tell you much more than I ever could - so I'll just make an interesting observation...

On average, Icelandic folks live two years longer than those in the U.S.  This is in a country that a) gets far less vitamin D due to minimal sunlight and b) has very few resources when it comes to growing fruits and vegetables because almost the entire country is lava fields.  What do they have that we don't? Portion control at meal time.

Speaking of meal time, I ate whale blubber, rotten shark, and ram's testicle.  Not surprisingly, none of them were very good.

5. I saw this advertisement with Mick Jagger on it in a clothing store at a Reykjavik mall and just had to snap a picture.  Apparently, Jagger has 20-inch biceps in Iceland.

This was definitely one of the better Photoshop jobs that I've seen.  They really made it believable.  The only thing missing from the picture is the purple unicorn that Mick rode to the show.

6. My buddy John Romaniello was on Good Morning America the other day.  I was hoping he'd talk about the time that we ate moose meat sloppy joes together, but instead he talked about fat loss.  I think the sloppy joe story would have come out better, but his appearance still went pretty well.  Check him out.

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Stuff You’ll LOVE to Read: Valentine’s Day Edition

Sappy title, huh?  Well, the truth is that people around the world will spend loads of money on flowers that will die in the next week - so we'll carry that theme forward with today's list of recommended reading.  Check these out: White Sox, Brewers Lead Injury Prevention Parade - A big thanks goes out to Mike Stare, DPT for sending this article my way.  It's always good to see quantifiable evidence of just how bad injuries in major league baseball have gotten.  One really important thing to consider is that man games (and money) lost to injuries doesn't always paint a true picture of how effective a team's medical staff is.  Teams with good medical staffs are more likely to sign better players in spite of pre-existing injuries (the 2009 Red Sox signed John Smoltz, Billy Wagner, and Brad Penny when they were all coming off surgery, for instance), so they'll understandably have higher rates in spite of the fact that they're doing a lot of things really well.  Muddy waters, indeed. Smith Machine Salaries - Speaking of wasteful spending, this post is about two years old and is very, very sad, but true.  I'm sure it's even worse nowadays. Baseball Showcases: A Great Way to Waste Money and Get Injured - This is timely on a number of fronts, as there are loads of showcases going on right now.  Many of the participants are kids who haven't even picked up a baseball since last August, yet they're throwing full speed in front of radar guns.  Sad. Happy Valentine's Day, everyone; try not to think about all the money you spent on flowers! Sign-up Today for our FREE Newsletter and receive a detailed deadlift technique tutorial!
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Long Toss: Don’t Skip Steps in Your Throwing Program

My good buddy Alan Jaeger has gone to great lengths to bring long tossing to the baseball world.  I discussed why I really like it and what some of the most common long toss mistakes are in two recent posts:

Making the Case for Long Toss in a Throwing Program
The Top 4 Long Toss Mistakes

However, one thing I didn't discuss in those previous blogs was the status quo - which is essentially that long toss distances should not exceed 90-120 feet.  These seemingly arbitrary numbers are actually based on some research discussing where a pitcher's release point changes and the throwing motion becomes less and less like what we see on the mound.  Alan looked further into the origins of the "120 foot rule," and informed me that these programs began in the late 1980s/early 1990s and were based on "post-surgery experience" of a few rehabilitation specialists.

Yes, we're basing modern performance-based throwing programs for healthy pitchers on 20+ year-old return-to-throwing programs that were created for injured pitchers.  It seems ridiculous to even consider this; it's like only recommending body weight glute bridges to a football player looking to improve his pro agility time because you used them with a football player who had knee or low back pain.  It might be part of the equation, but it doesn't improve performance or protect against all injuries.  Let's look further at how this applies to a throwing context, though.

A huge chunk of pitching injuries - including all those that fall under the internal impingement spectrum (SLAP tears, undersurface cuff tears, and bicipital tendinosis), medial elbow pain (ulnar nerve irritation/hypermobility, ulnar collateral ligament tears, and flexor/pronator strains), and even lateral compressive stress (younger pitchers, usually) occur during the extreme cocking phase of throwing.  That looks like this:

It's in this position were you get the peel back mechanism and posterior-superior impingement on the glenoid by the supra- and infraspinatus.  And, it's where you get crazy valgus stress (the equivalent of 40 pounds pulling down on the hand) at the elbow - which not only stresses the medial structures with tensile force, but also creates lateral compressive forces.

In other words, if guys are hurt, this is the most common spot in their delivery that they will typically hurt.

So, logically, the rehabilitation specialists try to keep them away from full ROM to make the surgical/rehab outcomes success - and you simply won't get full range of motion (ROM) playing catch at 60-120 feet.

Effectively, you can probably look at the "progression" like this:

Step 1: 60-120 ft: Low ROM, Low Stress
Step 2: 120+ ft: Medium ROM, Medium Stress
Step 3: 240+ ft: High ROM, Medium Stress
Step 4: Mound Work: High ROM, High Stress

In other words, in the typical throwing program - from high school all the way up to the professional ranks - pitchers skip steps 2 and 3.  To me, this is like using jump rope to prepare for full speed sprinting.  The ROM and ground reaction forces (stress) just don't come close to the "end" activity.

Only problem?  Not everyone is rehabbing.  We're actually trying to get guys better.

Long Toss.  Far.  You'll thank me later.

Want to learn more? Check out Alan's DVD, Thrive on Throwing, to learn more.  He's made it available to my readers at 25% off through this link.

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