Home Posts tagged "Pitching Injuries" (Page 6)

Sports Performance: Study the Majority, and Stop Cherrypicking Exceptions to the Rule

A while back, I Tweeted out the following statistic:  

As can pretty much be expected, this Tweet was met with a thumbs up from frustrated coaches and parents who know a skinny pitcher who could really benefit from weight gain, but still refused to crush calories. That was the 98% of interaction with these numbers.

The other 2% - as can also be expected, after years of social media "exposures" - was people who wanted to disagree. An example:

"Not true. My 6'0 180 pound son throws 93 and threw 90 when he was 5'10 165."

Another:

"So you're encouraging guys to just get fat and they'll throw harder? Why isn't Bartolo the hardest thrower in MLB then?"

In the research world, these exceptions to the rule are called outliers and are nixed from the data set. In the magical world of social media, they are liked, retweeted, celebrated, enshrined, put up on a pedestal - and ultimately almost become the rule. Unfortunately, those who try to replicate the exceptions wind up woefully inferior.

Remember the generation of kids who thought that they could a) abstain from lifting weights and b) go to really up-tempo, cross-body deliveries in hopes of becoming the next Tim Lincecum? With a few exceptions, they become the skinny guys who couldn't throw strikes - or convince anyone to be their catch partners because they were so erratic. And, they really didn't put themselves in great positions to throw hard, in most cases.

Lincecum himself faded as he approached 30 years old, due in part to hip surgery. After a short comeback attempt in 2016, he hasn't pitch in almost 1.5 years and currently sits at 1,682 career innings. Currently, 27 active pitchers have more career innings pitched than that - and only two weigh less than 195 pounds.

This isn't a vilification of Lincecum, either; he recognized he was an outlier and made it work for a successful career that included multiple Cy Youngs and world championships. That's a lot different than the 16-year-old with no track record of success insisting that he can throw 2,000 innings in the big leagues at 140 pounds. That's not backed by demonstrable results or even the slightest bit of logic. Need further proof that you're better off following the masses (pun intended)? 

1. The size of the average MLB player has increased from ~186 to ~210 now (really good analysis here). Not surprisingly, average fastball velocity in MLB has increased dramatically during that same period.

2. Go check out this list of active leaders in innings pitched. Take note of how few are under 200 pounds.

3. Go check out this list of active leaders in Wins Above Replacement (WAR). Take note of how few are under 200 pounds. This guy is eighth on that list (and rapidly climbing). He's 6-3 and 210-215 pounds, but not the "absurdly bulky" many naysayers insist will happen if a 16-year-old kid adds a few hundred calories per day. Max is just big enough to use gravity effectively while remaining athletic.

4. We have loads of studies demonstrating that heavier pitchers throw hard. If you want to pick just a few, use this one and this one. Hopefully, the N=1 Twitter researchers can appreciate that their studies don't have quite as much validity as the peer-reviewed research that is published in the Journal of Biomechanics and Journal of Shoulder and Elbow Surgery.

5. This recent study reported that larger individuals signed professional contracts earlier and made it to the big leagues at a younger age. It also reaffirmed that bigger guys throw harder. Go figure.

6. Go to any powerlifting meet - or simply peruse some records online - and it won't take you long to realize that the heavier guys are the stronger guys. Strength is force. Power is work divided by time. Throwing a baseball is a sport-specific application of power.

Strength is also a foundation for stability: active control of joints. If you lack it, you'll rely more on passive restraints: ligaments, menisci, intervertebral discs, labrum, etc.

If you want to be successful in anything in life - sports, business, education, relationships, you name it - you are better off looking at what has worked for the majority of individuals who have previously been successful.

And, the research, anecdotal evidence, and logic is very much in support of gaining good weight being a wildly effective method for most pitchers to gain velocity, be more successful, and become more durable. You might be the exception to that rule, but chances are that you haven't actually tested the weight gain waters enough to know for sure. Eat up. 

If you're looking to learn more about how we develop pitchers at Cressey Sports Performance, I'd encourage you to check out one of our Summer Collegiate Development Programs. They're available at both our Florida and Massachusetts locations.

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Arm Injuries, Sports Science, and Player Development

Earlier this week, I hopped on The Motus Global show with Will Carroll, and we covered a ton of ground in the 40 minutes we chatted. From arm injuries, to sports science, to player development, there's a lot of good stuff in this podcast. You can check it out at the links below:

Overcast: https://overcast.fm/+JRLCkbN08

or

iTunes: https://itunes.apple.com/us/podcast/the-motus-show/id1245348721?mt=2

Enjoy!

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Random Thoughts on Sports Performance Training – Installment 29

I didn't get in a May installment of this series, but the good news is that it gave me two months to gather my thoughts for a big June! Here goes...

1. Athleticism is doesn't have to be max effort if you have a strength and power "reserve."

Cressey Sports Performance athlete Logan Morrison is currently second in Major League Baseball in homeruns. I came across this video of #22 on Twitter and it immediately got me thinking:

Hitting bombs in the big leagues - particularly on 95mph sinkers - is really challenging, but that looked absurdly easy. He put some force into the ground, got himself in a good position to succeed, and athleticism "happened."

The only reason this is possible is that he's developed a strength and power "reserve." LoMo is strong - and more importantly, he's a powerful dude. When he throws a medicine ball, in many cases, the entire gym stops and watches because it sounds like he's going to knock the wall down. When you've got a foundation of strength and know how to use it quickly, this kind of easy athleticism happens. It does not, however, happen if you're a) weak or b) strong and not powerful. I'd call LoMo a nice blend on the absolute strength-to-speed continuum.

2. If you're struggling to feel external rotation exercises in the right place, try this quick and easy fix.

One of the reason some throwers struggle to "keep the biceps" quiet during external rotation drills is that they start too close to the end-range for external rotation. A quick strategy to improve this is to simply build a little success in a more internally rotated position. This video goes into more depth:

3. Be cautiously optimistic with new surgical advances.

On a pretty regular basis, we hear about remarkable sports medicine breakthroughs that will revolutionize the way we prevent and treat both acute and chronic diseases and injuries/conditions. Unfortunately, they usually don't live up to the hype. Most of the time, we're talking about a "miracle" supplement or drug, but sometimes, we have to ponder the benefits of a new surgical procedure.

In the mid 1990s, the thermal capsulorrhaphy procedure was introduced to attempt to treat shoulder instability. It gained some momentum in the few years that followed, but the outcomes didn't match the hype in spite of the fact that the initial theory seemed decent (heat can shorten capsular tissues, which would theoretically increase shoulder stability). Failure rates were just too high.

Conversely, in 1974, Dr. Frank Jobe revolutionized the way elbow pain was treated in baseball pitchers - and saved a lot of careers - when he performed the first successful ulnar collateral ligament reconstruction (better known as Tommy John Surgery). More than 1/4 of MLB pitchers have had Tommy John, so you could say that this procedure revolutionized sports medicine even though it's taken decades to fine-tune it.

More recently, a new surgery - the UCL repair with internal brace -  has been gaining some steam as an alternative to Tommy John surgery. The initial results have been very promising, particularly in situations where the patient is a good match (depending on age, activity level, and location and extent of the UCL tear). I've actually seen two of these surgeries in the past week myself. One pitcher (Seth Maness) was able to successfully return to the Major Leagues after having it - but we still have a long way to go to determine if it might someday dramatically reduce the number of Tommy John surgeries that take place. Why? 

Right now, we only have statistics on a limited number of these cases, and they're usually in the high school and college realms. All that is reported on is return to previous level of competition (e.g., varsity baseball). We don't know whether a kid that has it at age 16 is still thriving with a healthy elbow at age 22 during his senior year of college.

Additionally, Seth Maness has really been an 88-90mph pitcher throughout his MLB career. We don't know if this same level of success will be seen with 95-100mph flamethrowers. 

Dr. Jeffrey Dugas has become known as "the guy" when it comes to these procedures, and I loved the fact that he reiterated "cautious optimism" in his webinar at the American Sports Medicine Institute Injuries in Baseball course earlier this year. If this gets rolled out too quickly and in the wrong populations, the failure rate could be significantly higher and give an otherwise effective surgery a bad name.  I think it's important for all of us to stay on top of sports medicine research to make sure we don't miss out on these advancements, but also so that we know to be informed consumers so that we don't jump behind new innovations without having all the information we need.

Speaking of the ASMI Injuries in Baseball Course, it's on sale for $100 off through this Sunday, June 24, at midnight. I've enjoyed going through this collection of webinars, and I'm sure you will, too. You can check it out HERE.

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Are Pitching Mechanics Really That Repeatable?

The 2011 Major League Baseball Draft class was pretty ridiculous. As I recall, it was ranked as the deepest draft since 1986, and the top 20 picks alone produced established big leaguers like Gerrit Cole, Trevor Bauer, Dylan Bundy, Anthony Rendon, Archie Bradley, Francisco Lindor, Javy Baez, George Springer, Jose Fernandez, Sonny Gray, Matt Barnes, and Tyler Anderson. Even just looking a few picks later, you see names like Joe Panik, Jackie Bradley, Jr., Michael Fulmer, and Trevor Story – and these are really only the tip of the iceberg. Mookie Betts was a 5th rounder, Blake Treinen was a 7th rounder, Kyle Hendricks was an 8th rounder, Travis Shaw was a 9th rounder, Cody Allen was a 23rd rounder, and Kevin Pillar was a 32nd rounder.

Interestingly, Massachusetts was ranked as the #5 state in country that year, so Cressey Sports Performance was right in the thick of things. As a result, the spring of 2011 was a big lesson for me in managing highly touted prospects – and it set the stage for our draft classes to grow with each passing year thereafter.

Foremost among these prospects was CSP athlete Tyler Beede, who was committed to Vanderbilt and ultimately wound up turning down a large signing bonus from the Toronto Blue Jays as the 21st overall pick. Three years and a Vanderbilt national championship later, he was a first round pick again, and has since made his MLB debut with the San Francisco Giants.

This isn’t an article about that draft class, though; it’s about a lesson I learned during the spring of 2011 that applies to every single pitcher on the planet, regardless of age and ability level – and whether they were even close to being drafted in 2011 (or any year).

Ask any Northeast scout, and they’ll tell you that evaluating any New England prospect is incredibly challenging. Talent is very spread out, so it’s difficult for scouts to even geographically get to all the prospects they want to see. Additionally, it’s hard to consistently see good pitchers match up with good hitters to see how they compete on higher stages. Northeast players are also far more likely to be multi-sport athletes than prospects in other parts of the country, so you’re evaluating athleticism and “projectability” more than just baseball competencies.

Moreover, because of weather restrictions, the season can be very short, so a starting pitcher might only have 7-8 starts prior to the draft. Also on the weather front, pitchers peak later as the temperatures warm up. The first 3-4 games of the season are usually played in 40-something-degree weather, and rain (or snow!) might actually push games back a day or two last-minute, throwing off both the players’ and scouts’ schedules.

Getting back to Tyler, he started his season well, pitching at 91-94mph for the first several starts. Typically, the lines were complete games with 14-18 strikeouts, 0-1 walk, and no earned runs. To give you a frame of reference, between his junior and senior years, Ty went 14-1 with a 0.80 ERA with 189 strikeouts in 96.1 innings – pretty much what you’d “expect” from a eventual first-rounder.

Roughly five weeks into the season, Ty had a Wednesday outing on the road. It was early May and probably about 50 degrees. I was a few minutes late getting to the game, and actually arrived right as he was hitting in the top of the 1st. The parking lot was out past center field, and as I was walking in, Ty drilled a ball to the gap and legged out a triple. A batter or two later, the inning ending and he went right out to the mound.

As I settled in on the left field line, I saw a crew of people get out of the car and all set up not far to my left. Like everyone else at the field that day, I quickly recognized one of them as Theo Epstein, who was still with the Red Sox at the time. He seemed to have so many Red Sox scouts with him that I actually joked to my wife that they must have borrowed the magical car from Coolio’s “Fantastic Voyage” video to get them all to the park. They fit in nicely with the 40 scouts and front office guys who were standing behind the plate.

As I recall, that day, Ty threw six innings, struck out 12, and gave up no runs and no walks, with just two hits. One was a double on a ground ball that hit the first base bag, and the other was an infield single. He pitched at 89-90mph most of the game. I might have seen one 91mph fastball. Ty still absolutely dominated overmatched hitters and showed what many people called the best high school changeup in the country, but it was a pretty “blah” outing by his standards. The team won, and we even joked around post-game with Ty and his teammates.

Within a day or two, I had gotten a few texts from scouts. Paraphrasing, they ran the gamut:

“What’s wrong with Beede?”

“Is Beede hurt?”

“Has Beede lost his fire and gotten too comfortable?”

My response was pretty simple: “He’s fine. He’s also 17 years old.”

That Sunday, Ty was in for an in-season lift at the facility. I can distinctly remember our conversation about how – as unfair as it might seem – he would always be held to a different standard than just about everyone else. Expectations of consistency would always be unreasonable, so it was always important to focus on the process and not the outcome. Even Cy Young award winners don’t have their best stuff every time out, but you can’t deviate from the plan for every little hiccup. The secret was to never get too up, and never get too down.

It was in that moment that I think I truly realized that Ty would someday be a big leaguer. Absolutely nothing I said to him came out of left field; he got it.

The next time out, he was back to his old self. A week or two later, in his last start before the draft, he was 93-96mph. He even walked to lead off the game - and then stole 2nd and 3rd as dozens of scouts gasped in terror that a kid with millions of dollars on the line would risk injury. What they didn't seem to realize is that this was all part of being process-driven (competing hard to help the team win) instead of outcome-driven (impressing scouts and getting drafted). Go figure: he led his team to an undefeated season and league championship.

[bctt tweet="Expecting a teenager to consistently perform at a high level each and every week is unrealistic."]

Every geographic climate is different. Every mound is different. Hitting in a week when you’ve had four exams and are sleep deprived won’t be nearly as easy as it is during vacation week. And having the general manager of your favorite MLB team show up to watch you pitch might even impact your performance a bit.

Teenage athletes are still developing physically, emotionally, neurologically, and socially. It’s why I absolutely abhor mock drafts that shuffle players up and down from week to week based on results and – in many cases – feedback from folks who don’t have the knowledge of physiological and psychological variability to even make valid estimations in this regard. 

And, don’t even get me started on companies that are ranking eighth graders ahead of their peers just because puberty kicked in early and their parents are misinformed enough to shuttle them around to showcases all across the country when they should be preparing their bodies for what’s ahead – and enjoying their childhood. 

This entire experience and the countless erratic performances we see from players of all levels - from high school kids who walk the bases loaded to big leaguers who develop "the yips" - has given me a lot of time to think about just how unrealistic some coaches, parents, and fans are in demanding incredible consistency in performance from throwers. If one of the best high school arms in one of the best draft classes in history had up-and-down performances, you can be sure these struggles are going to extend 100-fold to less prepared pitchers.

To further illustrate this point, I did a little digging last week. As I type this, the three hardest throwers in MLB in 2017 have been Aroldis Chapman, Joe Kelly, and Trevor Rosenthal. Modern technology like Trackman can give us a lot more information than just velocity, though. Pitching release point (extension) is one such piece of information that fits in nicely with this discussion. According to a quick look at Statcast reports on the 50 hardest pitches in baseball this year, here is the variance in extension for those three:

Chapman (20 pitches): 6.5 to 7.2 feet

Kelly (9 pitches): 5.7 to 6.5 feet

Rosenthal (4 pitches); 5.5 to 5.9 feet

With a larger sample size - particularly for Kelly and Rosenthal - we'd likely see even bigger gaps. That said, it's important to recognize that a lot of factors can play into this variability. One MLB front office friend of mine commented to me, "There are a lot of park to park variances, so we have to calibrate raw data." Additionally, pitches may be different from the stretch and wind-up, weather factors may impact extension, and accumulated fatigue plays into it as well. And, extension will be different for different pitches - although that likely doesn't factor in here because we're comparing apples (fastballs) with apples (fastballs). The point isn't that any of this data is absolutely, 100% perfectly accurate. Rather, the message that any way you slice it, the three hardest throwers on the planet - some of the guys who theoretically put themselves in the best possible positions to throw the crap out of a baseball - actually deviate a little bit from their "norm" on a very regular basis. "Repeatable" mechanics aren't perfectly repeatable.

Looking further, check out the 2017 Pitch/Fx fastball velocity ranges for these three guys, as per Fangraphs:

Chapman: 95.4-102.1 mph

Kelly: 96.0-102.0 mph

Rosenthal: 95.5-101.7 mph

(we can bank on these "interpretations" of pitches being accurate, as nobody is ripping off 95-96 mph sliders or changeups)

What do these numbers this tell us? Even in the hardest throwers on the planet, there are actually considerably larger variations in pitch-to-pitch mechanics and performance than most folks realize. Every year, the media becomes convinced that a few dozen pitchers in MLB have "lost it"- and invariably, they all figure it out at some point and it all evens out over the course of a season. Remember a few years ago when everyone told us that Justin Verlander was washed up? Yep, he wasn't.

If we were to extend my aforementioned three-pitcher "study" out even further - particularly to a collection of minor league pitchers who haven't had success on par with these three - I'd be willing to bet that we'd see even more considerable variation. And, it'd be huge if we looked at college pitchers, and massive in high school guys (and younger). 

Anyone who has spent time reviewing data from Motus sleeve measurements can attest to this. Even as the accuracy of the readings has improved dramatically and the sleeves have become an incredibly useful tool, the variability from pitch-to-pitch has remained intriguingly high. You'll see different ranges of motion and joint stresses for two of the same pitch thrown 30 seconds apart. 

Where does all this leave us? Well, above all else, I think we can at least appreciate that even in a very specific closed-loop (predictable) action like pitching, there is still at least subtle variance - and this variance becomes even more dramatic as you go from the professional down to the amateur ranks. Sorry, Dad, but your 11-year-old doesn't have "pristine mechanics;" he is just less inconsistent - and likely more physically prepared - than his peers.

Expanding the discussion to higher levels, a thought process that has recently surged among those "in the know" on social media is that velocity and "stuff" are probably even more important than consistently outstanding command (which would theoretically relate to optimally repeating mechanics). This highlight reel of CSP athlete Max Scherzer during his 20-strikeout game last year shows just how many times he missed his spots.

I'm not saying that command isn't important; professional pitchers definitely miss spots a lot less than amateur ones. I'm just saying that all these factors fluctuate more than we appreciate and it's part of that discussion. Interestingly, command is the one of these three factors most impacted by outside factors: umpire interpretation, catcher's receiving, sweaty palms, pretty girls in the stands, and whether Mom is yelling "super job, kiddo!" from the stands.

Expecting teenagers to consistently repeat their mechanics at a high level - particularly during a period of time when their bodies (and brains) are constantly changing - is absolutely absurd. Far more important is preparing their bodies for all the chaos that sports throws at them. This is done with exposure to a wide variety of athletic endeavors in the youth levels, comprehensive strength and conditioning and arm care, and a broad spectrum of throwing challenges (not just mound work!).

That doesn't mean that it will work to just throw a bunch of poop on the wall to see what sticks. This has become a larger issue of late, as countless kids have assumed "throwing with intent" to be "just try to throw hard."

Very simply, here is the most important message I can deliver to any young pitcher:

[bctt tweet="Every throw is a chance to get better or worse."]

Treat every throw like you're playing catch with a Cy Young award winner and want to leave a favorable impression in terms of your attention to detail. Don't give up any throws. Even as a teenager - and regardless of who his throwing partner was - Tyler Beede tuned out the world every time he picked up a ball. He was always working on improving or refining something. It's almost like he understood that inconsistency could always sneak up on a pitcher in the blink of an eye, and he wanted to stay ahead of it. Ty didn't become a two-time first rounder or #1 organization prospect by accident. 

Really, more importantly, the take-home message is to be patient with young athletes and pitching success. Practice consistently and train to handle all everything the sport might throw at them. Still, though, remember that some of the best in the world struggle to consistently repeat their mechanics, so you can probably cut that 17-year-old some slack when he throws a 97 mph fastball to the backstop in an All-American game. And, your 11-year-olds can still have post-game ice cream even if they walk seven batters in three innings of work. Being consistent with anything in athletics is challenging, but if you focus on processes instead of outcomes, you'll never be disappointed.

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Strength and Conditioning Stuff You Should Read: 5/22/17

I hope you all had a great weekend. I turned 36 on Saturday, and it was a pretty mellow, unremarkable birthday - which is exactly what I wanted! Here's a little recommended reading/listening/viewing for you to kick off the week:

Lat Injuries in Major League Baseball - Here's an article from Lindsay Berra on an injury on the rise in MLB. I chipped in some info on the function of the lats in throwing.  

EC on The Fit Clique Podcast - I hopped on Chris Doherty's podcast last week, and you can check it out on YouTube:

Business Bench Pressing with Pete Dupuis - Speaking of podcast, my business partner, Pete, shared some great business tips for fitness professionals on The Fitcast a few weeks ago.

How Harmful Are Processed Foods? - The Examine.com crew has been on a roll with great content lately; here's another example.

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Video: Active vs. Passive Hip Extension

Here's a video I just filmed that talked about how important appropriate hip extension is to the pitching delivery. While the video is addressed more to pitchers, the general lessons are applicable to all athletes whose sports involve hip extension (particularly if it's hip extension past neutral). Check it out:

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Strength and Conditioning Stuff You Should Read: 5/3/17

After surviving last week's sale, I took a quick blog hiatus to get my feet underneath me. I'll have some new content posted later in the week, but in the meantime, here's with some recommended reading.

Pitching Injuries: Should Lat Strains Even Be Happening? - In light of Noah Syndergaard's lat injury this week, this article of mine from last year got a lot of traffic (and I received lots of emails and social media outreach). This one's a whopper, so have a cup of coffee ready to help get you through it.

The Hardest Topic to Write About: Program Design - My old friend Tony Gentilcore did an excellent job tackling a complex topic. I'd highly recommend you give this a thorough read to appreciate just how daunting a task it is to write about program design.

The Stop & Give Me 20 Podcast - I hopped on a 20-minute podcast interview with Anthony Renna a few weeks ago, and you can listen to it here. I really enjoyed it because it wasn't the same 10 questions that ever podcast interviewer seems to ask!

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Strength and Conditioning Stuff You Should Read: 2/15/17

It's been an exciting and busy week, thanks to the launch of the new Minimus 20v6 Cressey Trainer coinciding with the last week of the Major League Baseball off-season.

IMG_7256

I'm happy to report that the shoes have sold really well - to the point that we're already sold out in several sizes. With that in mind, there are still some options for you to get them:

1. If you're looking for international shipping, Eastbay.com is your best bet. They should be making the shoe available on their site either today (Wednesday) or tomorrow.

2. If you're in the U.S. and your size is already sold out HERE at New Balance's website, Eastbay.com is also your best bet.

3. If you're in Canada and your size is already sold out HERE at New Balance's Canadian site, you can try SportChek.ca or Eastbay.com.

Now that all that is out of the way, let's get to this week's content!

Meet the First Performance Coach to Get His Own Signature Training Shoe - This article at Stack.com takes a look at the design process behind the new Minimus 20v6 Cressey Training sneaker.

As Spring Training Begins, Pitchers Enter Tommy John Danger Zone - Along with Alan Jaeger and Mike Reinold, I was interviewed for this USA Today article on the spike in injuries seen during spring training each year. 

Power Development for Powerlifters - This is an excellent post from Cressey Sports Performance coach Tony Bonvechio. I wish I'd had it back in the early 2000s to help my bar speed along, as it took me a few years to figure out that getting faster was a key to getting stronger for me.

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The Best of 2016: 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 2016" feature to the top baseball posts from last year. Check them out:

1. Preventing Baseball Injuries: Actions Speak Louder Than Words

This was my first post of 2016, and it turned out to be one of my most impactful. A cool follow-up note on this: one of the suggestions I had to reduce pitching injuries was to push the high school season back in warm weather states, and here in Florida, they actually moved it back two weeks for 2017. I doubt my writing had anything to do with it, but it's nice to see things moving in a positive direction. 

2. Should Lat Strains Even Be Happening?

The lat strain is becoming far more prevalent in higher levels of baseball as pitchers throw with more and more velocity. In this lengthy article, I discuss mechanisms of injury, diagnostic challenges, prevention strategies, and longer-term prognoses.

Latissimus_dorsi

3. 6 Saturday Shoulder Strategies

I wrote this as a "brain dump" in about 30 minutes on a Saturday morning, and it turned out to be a hit with the baseball audience.

4. Looking Closer at Pitching Injuries: An Interview with Jeff Passan

I interviewed Jeff Passan around the time of the launch of his popular book, The Arm, and we covered in more specific detail some of the areas he touched on in the book.

y648

5. Specificity, Delayed Transmutation, and Long-Term Baseball Development

This was actually a video blog more than an article, but it was still very popular - but didn't quite crack the top 5 videos of the year because it's more baseball specific.

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3 Tips for Improving Shoulder Health and Performance

Today's guest post comes from my good friend and Elite Baseball Mentorships colleague, Eric Schoenberg. Enjoy! -EC

It is well documented that shoulder pain/injury is a primary reason for lost time in the gym and on the baseball field. Often times, the culprit is not poor exercise selection, but instead poor exercise execution. Most high level performers are going to do the work that we ask them to do, the issue is whether they are practicing getting better or practicing getting worse.

The following three tips will be useful for any strength coach or physical therapist to help ensure optimal function of the shoulder.

1. Understand and Appreciate Relative Stiffness.

There are several examples of relative stiffness around the shoulder that can result in faulty movement, pain and/or decreased performance.

A primary culprit occurs when the relative stiffness of the deltoid is greater than the rotator cuff. The result of this will be superior translation of the humeral head.

55-deltoid-pull

This can lead to undersurface rotator cuff tears, biceps tendon irritation, cyst formation, inferior glenohumeral ligament tears, or humeral head abnormalities – all of which are common to throwers.

Consider this when attempting to strengthen the cuff. Check to see if the humerus is in extension, as demonstrated in this photo. This faulty "elbow behind the body" pattern will lead to over-recruitment of the posterior deltoid:

humeralextension

You also want to cue the athlete away from excessive horizontal abduction, as demonstrated in the next photo. Prone external rotation with no support results in increased use of deltoid to support the arm against gravity:

proneer1

Here it is corrected with support:

proneercorrected

More times than not, we see athletes doing the correct exercise with the wrong execution and getting poor results. We want to avoid allowing an athlete to practice getting better at moving incorrectly.

2. Stop rowing so much, especially if your rowing technique is incorrect!

Rowing variations are generally the safest and easiest upper body exercises to program. However, even though a row is usually pain free, it can sometimes lead to patterns that result in injury down the road.

For example: If the rhomboids and lats are too stiff, you will see limited upward rotation of the scapula. Regardless of how much you strengthen the serratus anterior and lower trapezius, these smaller muscles will never match the force production of the lats and rhomboids.

With this in mind, the best “fix” is to increase stiffness and muscle performance of serratus and lower trapezius while simultaneously decreasing the stiffness and use of the lats/rhomboids.

This can be done by modifying the way we row. In this great video, EC discusses how to correct the row and ensure the scapula is moving properly on the ribcage with both phases of the rowing pattern.

In addition, we should program pressing or reaching exercises such as landmines, kettlebell presses, overhead carry variations.

3. Don’t let good lower body days double as “bad” upper body days.

We sometimes see athletes come in complaining about an increase in symptoms following lower body days. They will report something like “I don’t know what I did to my shoulder; I lifted lower body yesterday.” 

By now we know that a common cause of shoulder pain is the scapula being too depressed and downwardly rotated.

ScapularDownwardRotation-300x225-2

If an athlete performed deadlifts, back squats, or any lower body exercise where the weight was held by their sides (DB reverse lunges, step ups, RDLs, Bulgarian split squats, etc.), chances are they were feeding the pattern of depression and downward rotation.

Taking this a step further, we commonly see these exercises resulting in postures and stabilization strategies that present with increased lumbar lordosis and anterior pelvic tilt. When this goes uncorrected, scapular alignment suffers. Here’s a look at a reverse lunge with excessive hip extension, lumbar extension, and anterior pelvic tilt:

revlunge

Remember, there is no “corrective’ in the world that will counteract the stress of carrying 120-pound DBs by your side while training on a lower body day. This does not mean that you shouldn’t program it; instead, it means that we should just be aware of the consequences.

The solution to this is to consider alternate loading strategies (such as a Safety Squat Bar, KB Goblet set-up, or weight vests) that will allow the shoulder girdle to be freed up and positioned more optimally.  If we pair this with consistent attention to proper alignment and movement strategies, we can use lower body days as another opportunity to enhance shoulder function.

About the Author

Eric Schoenberg (@PTMomentum) is a physical therapist and strength coach located in Milford, MA where he is co-owner of Momentum Physical Therapy. Eric is addicted to baseball and plays a part in the Elite Baseball Mentorship Seminars at Cressey Sports Performance. He can be reached at eric@momentumpt.com.

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