SOS! Here’s the 411 on the 911 of Arm Injuries

I’m from Tampa, and since the day I sat in Tropicana Field’s left field bleachers and watched Wilson Alvarez spike the first pitch in team history, I have been a HUGE Tampa Bay Rays Fan.

I suffered through the doldrums of the Vince Namoli era.

(Not exactly sure what our team colors were)

I was equally amused and embarrassed when Wade Boggs dropped to his knees and kissed home plate after his 3000^th hit.

And I rejoiced and jumped through my ceiling in 2008 when Aki Iwamura snagged a bad hop rocket off the bat of Jed Lowrie and stepped on second base to send my beloved team to the most improbable World Series appearance in recent history.

But this year my Rays are in a little trouble.

Like nearly every team in major league baseball, the rash of injuries to pitchers has left them without the services of three of their top five pitchers. It’s a plague that nearly every team in the league has experienced, as highlighted by last night’s announcement of an injury to former Alonso High School (in Tampa), and Marlins ace Jose Fernandez.

As the injuries have mounted, MLB officials, national media, and the gurus at the ASMI have been quick to blame youth baseball. Overuse and emphasis on velocity development, they say, are the most significant causes of the avalanche of arm injuries to young pitchers.

Regarding overuse:

For the past decade, most organizations and coaches I have been around have done a pretty good job of managing workload. In my experience parents and coaches of the premier pitchers are usually very aggressive in managing their sons’ workload and are often overly cautious in the amount of innings they allow a top prospect to log.

Don’t get me wrong. I’m not discounting the importance of workload as a possible contributing factor; I‘m just saying it’s probably a VERY small piece of the puzzle.

Also, I find it interestingly hypocritical of the powers-that-be in the game to criticize velocity development among high school and college pitchers as a significant factor.

Everyone will agree that velocity alone does not make for an outstanding pitcher, but have you seen the number of radar guns present at a perfect game event when a highly touted pitcher is throwing? If a young pitcher has aspirations of playing at a top NCAA program or of getting drafted to play professionally, the ability to throw the ball 3-5 mph harder than anyone in his peer group is just about his ONLY ticket to the dance.

Here’s a tip to those who stand in judgment of training with radar guns:

If you don’t want high school and college kids focusing on gaining velocity, then stop drafting and signing ONLY the guys who throw hard.

When they start giving out scholarships and pro contracts to guys throwing in the low 80s with great command and quality off speed stuff, young pitchers will stop seeking to improve their velocity. Until then, velocity enhancement is here to stay, so I say our best hope is to learn to develop velocity safely—it can be done.

A second wave of explanations has emerged from the multitude of internet pitching experts, many of whom I study and greatly respect. A flurry of Monday morning quarterbacks have attempted to explain the mechanical contributors to each fallen warriors’ demise. Dozens of explanations have been offered as to why each guy broke down. One particular self proclaimed guru actually declared a pitcher’s mechanics perfect and “injury proof” only to recant and report that he “forgot to look at video from two different angles” when the allegedly bulletproof pitcher blew out within weeks of the declaration.

Everyone seems to be searching for plausible mechanical explanations for injury, but let me say this:

Until you directly assess a pitcher for physical constraints you are not in the slightest position of authority to make any conjecture as to what might be the “cause” of his injury.

Here again, I am not discounting mechanical factors as significant contributors to injury. In my opinion, mechanical or movement pattern constraints are even more important than workload issues. However I believe that many are still missing an enormous part of the equation. You see, it’s easy to sit in an office and look at still pictures and video and make assessments about the causes of a particular pitcher’s breakdown.

But the more I study, the more I realize how intricately interwoven physical and mechanical constraints are.

It’s impossible to analyze a pitcher for potential injury risks without performing a head-to-toe assessment for physical constraints.

To attempt to help a pitcher improve his velocity without conducting such an assessment is flat out DANGEROUS!

I’ll probably catch some flack for what I am about to say, but that’s fine by me. The way I see it, if you are in high school or beyond and you’re currently seeing a pitching instructor who isn’t trying to help you improve your velocity, you probably won’t be given the opportunity to play at the next level, so this article really doesn’t matter much to you.

On the other hand, if you are seeing a pitching instructor who is trying to help you gain velocity and he hasn’t performed a thorough head-to-toe physical assessment and a video analysis of your pitching motion prior to allowing you to aggressively chase pitching velocity, then YOU ARE PLAYING WITH A LOADED GUN! My advice is to run away….as fast as you can. Anyone can gain velocity, 2-3 mph, through increased intent. Trying to throw harder will definitely result in improving your ability to throw harder.

But adding energy onto a bad movement pattern or to a significant physical constraint is a recipe for disaster.

Here is an example of what I’m talking about.

In a 2009 article in the American Journal of Sports Medicine called Correlation of Throwing Mechanics With Elbow Valgus Load in Adult Baseball Pitchers, researchers found four distinct mechanical factors that could put the UCL (Tommy John Ligament) under increased stress. The four variables identified were:

1) Increased shoulder external rotation at full lay back

2) Early torso rotation (i.e., rotation of the trunk before the front foot hits the ground)

3) Forearm flyout (when the angle between the forearm and the humerus exceeds 90 degrees when the front foot hit the ground), and

4) Side arm throwing

*Am J Sports Med October 2009 vol. 37 no. 10 2043-2048

Now let’s just consider factor number 2–early torso rotation.

Off the top of my head, I can think of several mechanical constraints that would result in early torso rotation. Lack of separation of the lead hip from the back shoulder (the classic torque position)—which is commonly seen as significant to velocity enhancement– is one possibility.

Another mechanical flaw that could contribute to early torso rotation is disconnection of the lead leg. If the lead leg acts independently and opens up early the torso would begin to rotate early as well. And although most pitching instructors would be able to offer some suggestions as to how to eliminate these faults, the solution might not lie in mechanical adjustments at all.

If a pitcher has a deficit in his thoracic mobility to his arm side, he would not be physically able to achieve the amount of torque necessary to keep his torso from unwinding early. Lack of torso rotation to the arm side could cause a pitcher to incorporate a less efficient movement pattern, such as rotating his torso before his front foot hits the ground.

Likewise, if the pitcher has a lead hip internal rotation deficit, he might not be able keep his lead leg closed long enough to keep it from opening prematurely. Once the lead leg opens, the torso must follow.

As an aside, I have seen a generation of lead leg disconnectors created by well meaning coaches (myself included) who in noticing that a player strides to the right or left of center, drew the infamous “center line: in the dirt and insisted the young hurler stride directly on the line. That proved to be an easy fix for most young guys. They simply opened their lead hip early, turned the toe toward the hitter and landed with their torso already open. The unintended consequence was a bunch of slow throwing kids who “fly open”, leaking energy and increasing their risk for injury. In trying to cue better stride leg direction, unwitting coaches created an erroneous movement pattern.

Here’s another example:

In a 1999 study in the Journal of Biomechanics, CA Putman reported that, “Maximum elbow varus torque to protect against elbow valgus strain is produced by the interactive moment resulting from shoulder internal rotation.”

In plain English, that means that internally rotating the shoulder, as we teach in our deceleration training, protects the UCL.

Again it’s easy to look at a video and see that a pitcher doesn’t adequately pronate his forearm and internally rotate his shoulder at ball release. And as reported above, that movement may be critical to reducing the amount of stress on the UCL. But the more important question is, “Why can’t he, or why doesn’t he do it.” Unless you lay the pitcher on a table and measure his shoulder internal rotation, you’ll never know if the way he was taught to thow (perhaps by utilizing the infamous towel drill) is the problem. Or maybe he simply doesn’t have enough shoulder internal rotation available to be able to execute the correct mechanical pattern.

So, do you see how physical constraints might prevent a pitcher from being able to perform appropriate mechanical patterns necessary to reduce the risk of injury?

Sometimes the variables that put you at risk are mechanical, sometimes their physical, and most of the time they are multifactorial.

Either way, if you’re not checking for physical and mechanical constraints, you are not doing everything you can to keep a pitcher safe and healthy.

In my book and DVD called Engineering the Superhuman

Pitching Machine, Vol 2: Conducting a World Class Pitcher Assessment, I offer a stepwise layman’s guide for assessing pitchers for all the physical, functional, and mechanical constraints we currently know about. It’s written in non-medical terms and is simple enough for any coach or parent to use to assess a pitcher.

We use SH2 as a guide when we conduct anywhere from 8-20 new and recurring assessments every week. It’s value in creating the template for individualized training is a huge contributor to the explosion in ability we have seen over the past year (sixty four 90mph pitchers at the time of this writing).

We also conduct a total body assessment to include a physical examination, and functional movement screen, and a high- speed video analysis on every client who attends one of our Weekend Rocket Launchers Training Camp.

And inEngineering The Superhuman Pitching Machine Vol 3: Taking Action, Targeting Your Training, we show you 3-6 corrective drills and exercises used to carve away any inefficiencies you find during the evaluation.

It’s a system that has proven to be unquestionably effective in helping our client SAFELY add the MPH they need to get to the next level. You could be next. We have big plans for a busy summer season. Why not up your game by clicking on any of the links above to get started on the most amazing journey of your life.

We’re here, and we’re ready.