Rehabilitation Workouts
March 31, 2011 | 
Author Does your trainer at home know the little exercise tweaks that can make an exercise safe or unsafe for a baseball player?
Being injured is tough. It raises questions in oneself such as, is it really healed? Am I going to re-injure it? Am I going to have to endure another rehab stint, or worse yet, another whole surgery? Is my career going to end if I hurt it one more time?
All of these gnawing questions plaque every ballplayer who undergone rehab or the surgeon’s knife. Many get over these fears once they return the mound and are assured by their pain-free performances that problems are safely in their past. Yet, many players never fully get over this mental hurdle and face decreased performance as they hold back, protecting their body from the 100% effort that they fear will result in further injury.
Thing is, this is no way to live, and certainly no way to play. It takes a lot of reckless abandon to sprint full speed on a hamstring that has been painfully pulled, or really try to hammer a fastball by someone on an elbow ligament that tore from the bone just a year ago. Even years down the road from an injury these doubts still persist and can hold a player back from his true potential. So, how do we get past these mental speedbumps and roadblocks?
This is, unfortunately a tough question to answer. I think for many, it just takes a gradual approach building confidence in the repair bodypart, with sustained pain-free performance that will ease the mind completely. This is the path the sensitive person would probably prefer, the guy or gal who doesn’t like to push through pain that might not be indicative of any structural damage.
I make mention of structural damage because it’s an important distinction to make in one’s rehab. Especially after surgery, the repaired bodypart is never like it used to be, and weird, random pains are a daily occurrence, even well down the road. Thing is, they usually don’t mean a damned thing. Speaking from experience, I had some pain in my forearm that was unrelated to my Tommy John surgery. They told me just to keep going, because it wasn’t something worth slowing down for. Talk to anyone who has undergone surgery, and they most likely received the same advice from their surgeon at some point.
So, some people need to see pain-free results to be convinced to allow themselves to put forth a little more potentially-injurious effort, but others just need to feel their back against the wall…
I had this conversation with my friend Zach Clark, who has enjoyed a great pro career in the Orioles system for the past 5 years. He worries about his arm sometimes, despite being a number of years out from his last major injury. With a guy like him, who is only a level away from the Major Leagues, he has more reason than others to protect his arm by holding back. His career has been maintaining on his current effort level, and an injury would seriously compromise his future. So, he has a lot to lose and not too much to gain (since he has been successful doing what he has been doing) by trying to a little harder.
But, for a guy like me, who is in post-surgical and post-collegiate limbo, I have much less to lose. The way I see it, if I hold back to protect myself and only throw, say 88, I jeopardize my attractiveness to scouts and pro coaches. Yet, if I throw without inhibition, I may (or may only perceive to) put my arm at greater risk. Now, my arm is certifiably fixed, but remember we’re not talking about reality here, only perception.
Either way, for a guy in my situation with his back against the wall, it’s damned if you hold back or (perceptibly) damned if you don’t. So, I choose to attempt to reinjure myself with each and every pitch. Sounds reckless, right? Well yeah, it is, but not more than any other pitch thrown by any other pitcher at full speed…
A pitcher has to have confidence in himself and his arm to throw at his maximum velocity any and every pitch if he needs to. So, post-surgery or not, the intent needs to be to throw the shit out of the ball every single time. Throwing the ball with such intent is what separates pitchers labeled “aggressive” and those labeled “nibblers” or “conservative.” And you don’t have to throw 100 miles per hour to throw your pitches aggressively…
So reason with yourself, and make a deal with your arm if need be. I’ll give you an example of the deal I made with my elbow a few months ago:
Me: Elbow, I’ll make you a deal: I’m going to abuse you, and I’m going to throw each of my pitches from here on out with the intent to destroy you again.
Elbow: Whats in it for me?
Me: I’m going to give you more strengthening exercises than you could ask for, so that if you get hurt again, it’s your own fault. I’ll ice, massage and treat you better than any of my past girlfriends. You’re gonna be taken care of, so you better start taking care of me and my career…
Elbow: That sounds like a lot of work. Do I have a choice?
Me: No. And f you start hurting and complaining to me, I’m gonna get angry and start throwing even harder out of frustration, because I know there’s nothing actually wrong with you, and that you’re structurally sound and plenty strong to withstand at all.
Elbow: So I should just keep my mouth shut, is what you’re saying, because you’re not gonna stop no matter what I do?
Me: Babies often cry for attention, and I’m done babying you. Cry all you want, no one will be listening. I’m not gonna pitch scared anymore. I’m giving you all the strengthening you could possibly need, so it’s just go time, no questions asked.
Elbow: I hate you, Dan.
Me: I hate you, too, but we’ll be friends again someday.
I still get a lot of emails, comments, and have had a few phone conversations regarding Tommy John Surgery from players and parents wanting to know what to expect. There is a real need in cyberspace for more firsthand accounts of injuries and how the recovery process went.
At the menu bar at the top of the site is a tab for “Injury Stories,” which will take you to a submission form. You can write whatever you want there, and it will submit directly to me for approval. I would love to post anything you want to write, because it really will mean something to someone out there, even if you never meet them.
I have a lot of former teammates who have a lot to share, but I’m not gonna be pushy with this and keep pestering people. All I’ll say is, if you have a story, you should share it, help someone else out, and spread the knowledge around. And if I don’t know you but maybe you’ve gotten some info from me, return the favor. You can submit directly, or email me if you’re unsure of how you want to go about it. I’ll look forward to hearing from you…
S.I.C.K Scapula is an acronym for a pathological condition in which one shoulder blade sits lower than the other, resulting in an asymmetry that leads to a wealth of additional shoulder problems.
Picture from a Clinical Diagnosis
I had movement assessments with 3 baseball player clients this week, and ALL of them had this and are in need of correction. This is one of the first examinations I make with a new client, and a low throwing shoulder is a really common problem in throwing athletes, even well-trained ones. Luckily, with my three, we are going to cure the problem before it manifests itself into something much worse.
The exercise prescriptions for curing SICK scapula are ones that strengthen the scapula in all its movement patterns: elevation, depression, protraction, retraction, upward rotation and downward rotation.
Blackburns are probably the most well-known of the scapula-strengthening exercises. The L, Y, and Ts that I recommend all pitchers do (and overhead athletes, for that matter) are 3 of the 6 Blackburn exercises.
Each of the 6 positions works the scapula in a different plane or angle of motion. There are numerous other exercises designed to help clear up shoulder dyskinesis, and it is essential to have these exercises in one’s regular training routine to keep shoulder function optimal and ward off any potential problems.
One of 6 blackburn exercises
High repetitions of unilateral exercises, like throwing, are what cause the body to maladapt and create these asymmetries, so it is important to monitor oneself or consult a professional. Not all unilateral dominance or asymmetry is bad, as my friend Coach Nick explains in The Truth About Muscle Imbalances Pt.1, but we have to make sure they don’t cause dysfunction and become pathological.
As I was in there, it suddenly dawned on me: Pitchers are just unlike everyone else in the sense that what they do is so physically violent, that they have to do what is called “prehab” just to reduce the likelihood (or in reality, delay) injury.
Its pretty much a fact that if a pitcher doesn’t do regular rotator cuff, scapula, and forearm work (basically the whole pitching arm), he is doomed to inevitable, catastrophic arm injury. Doing prehab doesn’t guarantee health by any means, as tons of diligent pitchers still injure themselves regularly, but its our insurance policy, and at the very least gives us a better chance of not being injured. Read the rest of this entry »
One of my readers here wanted to share his throwing program with everyone. It’s unique; I haven’t seen one like his and like I have said before, every player and doctor are different and it’s always interesting to see how the same surgery is handled in different ways. He left this to me as a comment, but I figured I’d do one better and post it.
This is actually a really nice idea, sharing each person’s surgery information. If anyone out there is interested in doing any writing, or sending me anything that they think would benefit the tommy john community, please hit me with an email. I’ve posted my thoughts, maybe we can post yours…
*Understand also that this, and any program posted here, is for reference only, and one should always consult a doctor before starting or altering a rehabilitation protocol*
The following is all courtesy of Steve Eagerton, so I want to send a big thank you out to him for providing this to all of us. I wish him all the best in his recovery, and it’s easy to tell that he is strongly in control of his rehab, which is great.
I thought I would leave my throwing program on here my Dr was Dr. Jordan out of Tallahassee, FL FSU team doctor has well as several other team doctors. I have been following this and am starting week 5’s throwing this week. I don’t follow this to the letter more than anything just listen to your arm. The first 6 weeks are not about velocity at all the DR has stressed just tossing. The Dr actually cleared me to start tossing @ 16 weeks and not at 4 months. My 1st day of throwing was August 16th. I am a 21yrs old RHP pitcher at Jacksonville University redshirt sophmore.
Week 1 @ 4 months
Tossing 50ft 25 throws every other day
Week 2
Tossing 50ft 25 throws daily Read the rest of this entry »
The following six exercises are prescribed to any ballplayer with elbow pain. Be it tendinitis, UCL strains, sprains, or surgery, these forearm exercises are the ones that strengthen the whole forearm and ward off future elbow problems. To the untrained thrower doing this prehab can also add a few MPHs, as the forearm and hand are the last mechanical parts in the delivery of a throw. Today is the perfect time to start doing these exercises regularly.
These exercises can be done with dumbbells or a flat or tubular Thera-band (Flat is preferred). You can find Thera-Bands here: Thera-Bands 6 Yard Box (6 in. wide)
Pronation, supination and ulnar deviation are best done with a ban, mini-sledge hammer or baseball bat (though they are shown below with a dumbbell).
Forearm Flexion
With palms facing up, curl the weight toward you using your wrist.