This was written by rockinfire on ASMI forums, it's too good not to post on multiple sites so..
This post is directed at all parents of HS pitchers: Yesterday I saw the "upteenth" pitcher with elbow pain that has these issues: 1. Has poor flexibility in his hips/legs 2. Has fair core strength 3. Has fair - poor balance 4. Poor scapula (shoulder blade) stabilization/strength 5. Decreased shoulder/rotator cuff strength 6. Decreased hip strength 7. Loss of internal rotation range of motion on his throwing side 8. History of pain and problems for the past 2 years while playing travel baseball and high school baseball 9. Does NO rotator cuff strengthening in his conditioning/strength training 10. Does NO rotation strengthening 11. Does not take at least 2-3 months away from baseball per year 12. Displays decreased spinal extension.
I see these characteristics over and over and over again. These kids will go from shoulder pain to elbow pain back and forth, back and forth. Good kids that are getting poor advice, supervision, etc In my opinion, here is why all of these issues (there are more, this is what is in the forefront of my thoughts this morning) are problematic: Item #1 is a problem because if you have loss of flexibility in your lower extremities it translates increased forces to the arm #2 Core strength is vital in athletic endeavors and is the base of strength/endurance #3 Balance is important for both the stance leg (R leg for R hand pitcher) and the plant/lead leg to decrease energy expenditure, control location, and decrease chance for injury to the throwing arm #4 Scapula stability is important to provide a stable base for the throwing shoulder and elbow #5 Loss of strength here leads to increased loads on the shoulder and elbow which comprises the integrity of the structures of the joint leading to breakdown/injury #6 The hips are the power generator for pitching. Loss of strength/endurance here is going to cause problems up the kinetic chain. #7 The more they gain external rotation, they lose internal rotation as a season progresses. In medical terms it is called GIRD and it has been proven to cause breakdown as well. Google anything from Kevin Wilk and Dr James Andrews and you can read all about GIRD. #8, #11 Ask Dr Andrews about this as well and he'll tell you all about the countless surgeries he has done on kids from overuse #9, #10 This young man has the same problem most HS pitchers have. Their "strength coach" is usually a football coach that has no clue what to give a baseball player. Find someone that understands the sport-specific needs of your child's sport and get them on a regular program that provides specific strength for their chosen sport(s). #12 If you can't extend (back-bend) through your spine, you can't reach back into external rotation as easily so you are going to evetually strain the elbow and/or shoulder leading to injury.
These a just a few things I regurlarly see in the clinic. The sad thing is that most, if not all, are entirely preventable. There are more issues such as kids having no idea how many pitches they throw in a particular night, weekend, week, etc. that will probably be brought up as a reply to this post that will be helpful to you as well. Bottom line: Your son should NOT be throwing if he is complaining of elbow or shoulder joint pain. He needs to take several months off a year from throwing. He needs to be on a regular baseball flexibility/strength and conditioning routine that includes varied intensity depending on whether he is "in seaon/out of season". Just my opinion from what I see over and over that sure seems to be preventable
Posts: 299 | Location: Green Cove Springs Fl. | Registered: October 30, 2007
Great stuff. Our year around program is 100% sport specific, however I would not know how to test for some of these areas. Below is a list of things I would like to know how to test for to see if my pitchers are not going to be hurt. 1. Core Strength 2. Flexibility 3. Balance 4. Scapula Stability
Posts: 158 | Location: So Cal | Registered: June 11, 2008
#12 If you can't extend (back-bend) through your spine, you can't reach back into external rotation as easily so you are going to evetually strain the elbow and/or shoulder leading to injury.
Can you give me an explanation here... youtubes or anything that would show this test?
Posts: 1377 | Location: Kansas | Registered: January 20, 2006
Great stuff. Our year around program is 100% sport specific, however I would not know how to test for some of these areas. Below is a list of things I would like to know how to test for to see if my pitchers are not going to be hurt. 1. Core Strength 2. Flexibility 3. Balance 4. Scapula Stability
A good sports chiropractor can do this.
Posts: 5698 | Location: Canada | Registered: October 13, 2005
Can you give me an explanation here... youtubes or anything that would show this test?
I'm not sure it would be the same, but I saw a javelin training photo of the athlete doing a standing backbend using the javelin to stabilize his weight so he didn't fall over. Also here is link to some backbending excercises that look like they might be applicable. There are several clips of different bends with medicine balls. http://www.teachpe.com/track_a...velin/javelin1_1.php
More knowledgeable posters please correct this if it would be detrimental.
It seems to me that the OP's point is especially a problem in baseball. My observation is that baseball has one of the highest ratios of competition time to practice time of any sport that teenagers do.
Posts: 25 | Location: Northeast | Registered: January 26, 2009
#9, #10 and not having pitcher specific modifications for lifting + overuse, and showing players that playing through pain is required (coaches often say one thing and act otherwise on this)
Posts: 5121 | Location: Southern CA, USA | Registered: January 02, 2003
Socal, Trojan-skipper, he responded with this post, I left in the retort to our old buddy O'Leary, just for amusement purposes;
jdfromfla: It is very difficult to "show" you what I do to fully assess the areas that you mention. It is a progressive clinical evaluation. Your best bet would be to go to www.apta.org and search for a PT in your area that is a board certified sports physical therapist and spend a couple hours with them while they are evaluating throwing athletes to get a little idea about what we do all day. Or call the local university/college and see if you can do the same at the athletic training room with the ATC with the baseball team.
painguy: I didn't write the post to "convince" you of anything. I have been on here long enough to know that noone on this board can do that. Anytime you "question" my posts I have posted numerous research articles to prove it to you and "poof" you magically disappear. So I won't waste my time trying to "convince" of anything anymore. The post was written to inform parents of common problems. It was not authored for your approval. And, there is nothing dangerous about the sleeper stretch. Nothing. It is prescribed as part of an intervention after an all encompassing clinical evaluation of the athlete. It is not for everyone.
Roger: yes, we use our hands, eyes, and a goniometer in the clinic as part of the overall assessment. And, thanks for your kind remarks.
So instead of going to them, maybe you can convince one to come by and assess your respective teams, maybe he'll do it for you inexpensively for a group look, while doing the assessment you can get an idea or learn what to look for.
Posts: 299 | Location: Green Cove Springs Fl. | Registered: October 30, 2007
Excellent stuff right there. My son has had labrum surgery, and I can tell you that several items on that list were applicable to his injury, imo. JD, do you know if there are 2 different schools of thought with regards to the effectiveness of the sleeper stretch?
Posts: 419 | Location: North Carolina | Registered: January 11, 2004
Personally I'm a believer in the sleeper stretch. My son was seeing the doctor for a forearm issue a few years ago and the doctor noted an internal rotation deficit. He was sent to a PT who worked on the internal rotation and prescribed the sleeper stretch to do each night. He almost immediately picked up 5 mph.
Posts: 5121 | Location: Southern CA, USA | Registered: January 02, 2003
My son does not like the sleeper stretch. He feels it limits his external rotation when he throws. We thought of doing the sleeper stretch both ways, external and internal but dont know if that would be OK. I am not saying not to do it though.
Posts: 14 | Location: NJ | Registered: January 05, 2005
do you know if there are 2 different schools of thought with regards to the effectiveness of the sleeper stretch?
O'Leary thought it led to too much joint laxity. I think that, as I indicated in that thread, it has application when indicated, note when Cason was using it was in the process of pt.
Posts: 299 | Location: Green Cove Springs Fl. | Registered: October 30, 2007
Be careful, son was told he had an unstable capsule, too loose, had to do excercises to tighten, now he is finding out it's too tight, has to do excercises to loosen it.
Don't fool with the capsule unless you get a qualified doctor or sports trainer that is familiar with shoulder instability.
