Home Posts tagged "UCL Repair with Internal Brace"

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!

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!

Name
Email
Read more

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.

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

Name
Email
Read more
Page
LEARN HOW TO DEADLIFT
  • Avoid the most common deadlifting mistakes
  • 9 - minute instructional video
  • 3 part follow up series