Posts Tagged ‘arm injuries’
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 »
Probably the most difficult facet of the recovery process has been me, in my head, wondering if I have plateaued, and whether or not I will continue to improve in the coming months.
I remember the first time I threw off the mound. It was timed so that I started in Florida, during our spring break trip, and I can recall my 3rd bullpen session, which I threw on the side at the University of Miami. That day I felt really fresh, and was confident in my arm after having two mound sessions already under my belt.
So I did my 45 throws or whatever at 60 feet, and I remember feeling like I was popping the ball. It was on a line, and it had a nice crisp sound, and I was just pleased as shit about it.
3 or 4 weeks later, I was still doing largely the same routine, but throwing with more intensity. I felt like it was time to get out the radar gun. I was throwing 75%, so I figured I should be around 70 with very little effort. So I start throwing, and they start shouting back my velocities…
64. 62. 61. 64. Really? So now I try to throw a little harder. 64. 64. 63. What? I just muscled up and its still only 64? This is ridiculous. Thing was, I didn’t feel like I was throwing 75%, I felt like I was throwing 100%. It was the hardest I had thrown in 6 months, and it looked and felt like I would never again throw a ball over 65 mph. Not happy. Read the rest of this entry »
You may have heard of the Y-T-W-L circuit, which develops scapular stability by strengthening the shoulders and upper back. Scapular stability is of the utmost importance for overhead throwing athletes like pitchers. Talk to someone with healthy shoulders, and they probably have been using the YTWL.
Yet despite it’s popularity, the YTWL circuit is often done improperly, and actually contains some movement patterns that aren’t useful: specifically, the W.
My shoulder routine has consisted of the YTWL for a few years, coupled with an additional standing shoulder/rotator cuff circuit. However, for the YTWL, it is time for a upgrade, and that is why I have made the switch to the YTLP.
My friend Nick Tumminello at Performance University has been evaluating the YTWL for a while now, and has done a series of videos on how to perform his newly developed L-Y-T-P circuit perfectly, many of which are featured below. Read some of his other great training articles on this page.
Nick has made a lot of changes to the circuit, which I am going to highlight in this article. The biggest is a call to eliminate the W pattern, which he swaps for the (P)ivot Prone. Rest assured, adopting the new circuit is going to give you stronger shoulders and more scapular stability than you’ve ever had before, even if you’ve already been doing the YTWL.
So at week 12 it was time to start throwing. Because I was pain free and swelling free I was given the go-ahead.
That first throw was pretty scary, but I knew I was ready for it, and it went fine. It felt just like it used to. I started out at 30 feet, progressing to 40 feet x 60 throws by the month’s end. Month two moved me back to 50 feet, and month three to 60. Midway through month three, however, I switched to a different throwing program because I was progressing faster than my throwing program would allow.
I talked earlier about falling on my arm when I was running and how important that was in trusting my arm. The first day I let a ball go on a line was another such moment. After every single throw was on a soft arc, letting one go on a line was one of the first tests of my new ligaments. I can remember that first throw, and how liberated I felt when I did it without pain. I only uncorked a few of these per session, but they always provided me with a release from the tension of wondering if my elbow was really strong enough to get me back to where I once was. Read the rest of this entry »
Pitchers are weird people, mostly because of the physical act of throwing. The motion is so violent and powerful that it throws a pitcher’s body out of whack and causes major asymmetries in strength, size, flexibility and range of motion, bone structure, etc.
One major adaptation of the pitcher is in shoulder range of motion (ROM). Pitchers have incredible, otherworldly external rotation. The average person couldn’t dream of contorting his arm in such a way.
My buddy Andrew Germuth showing off his external rotation
And what price do we pitchers pay for enjoying such lavish external rotation? You guessed it! A tight rotator cuff and a subsequent deficiency of internal rotation. (there is always a catch!)
So what? Does it matter if a pitcher has poor shoulder range of motion internally?
The answer to this question is unequivocally “yes.” Any trainer or physical therapist will tell you that a lack of ROM in any joint is pathological and indicative of underlying problems. Normal ROM should exist in all one’s joints, and if not, there is a probably a problem as to why. In many populations these imbalances in flexibility might not impair day-to-day functioning, but for athletes and especially pitchers, inflexibility poses major problems.
Dr. Craig Morgan and colleagues are researching the link between elbow pain (up to and including full blown ligament tears requiring Tommy John surgery) and internal rotation. What he is finding (as he found in me) is that a huge amount of pitchers coming to him have significant GIRD (glenohumeral internal rotation deficiency), and once that GIRD is reduced to an amount within 20 degrees of the internal rotation of the non-throwing shoulder, the pitchers very often return to throwing without pain. Internal rotation deficits are caused by posterior shoulder capsule tightness, which can be alleviated using the sleeper stretch. Restore your internal rotation ROM and you will be throwing healthier and harder. Read the rest of this entry »
Getting surgery sucks. It is, however, usually the only option for someone who tears a tendon, ligament, or muscle while playing a sport and wants to play competitively again. So it’s a situation where one needs to suck it up and take some solace in the fact that they are on the road back to the top. Especially with TJ surgery, the prognosis is great and with proper attention to rehab there’s a good chance of making velocity gains on top of having the elbow of a superhero and time off to improve mechanics.
The first 3 months post-op were exciting in the sense that everything was new and changes were dramatic. Things returned to normal rather quickly, and it was all building up to that fateful day when I would chuck that pill again, even if it was only for 30 feet at first. Read the rest of this entry »
Everyone understands pain, soreness and fatigue on some level, because we’ve all had them. Problem is, some people don’t quite know the difference between the three, and sometimes misrepresent the state of their bodies. This is concerning because to continue exercising under certain conditions is dangerous, such as when pain or fatigue is present due to an underlying or developing injury. It is imperative to understand one’s body and what the signals it sends mean.
Keep in mind that I’m not a doctor or physical therapist, and my intention with this post is to create some body awareness and help people understand how their body may be feeling, and whether or not their expression of those feelings are in tune.
Call it Pain
Pain is typified by, and this probably is not news to anyone, sharp, short and sudden sensations that accompany a certain activity. Pain draws our attention strongly and immediately to certain areas of the body.
Now, pain is different in type and intensity for everyone, and being in tune with one’s body is important for reading into it. I know which pains, when throwing or pitching, are incidental and aren’t telling me anything about the health of my arm or body. These I largely ignore, because experience has taught me that they never manifest into anything pathological. Pitchers commonly have little pains here and there that are just a natural part of the violent act of throwing. Listening to one’s body and having experience with it is important, because one cannot become consumed with every little ache or pain that crops up. It’s too stressful.
But some pain is an indicator of present injury or developing injury, and these need to be attended to. These are usually stronger and don’t go away in a day or two, and may not respond to pain medication, therapy, ice, or other treatments. If they do respond, then they will probably work themselves out with therapy, but they should not be ignored, and the activity should be backed off.
During my rehab I have had little pains appear at different times and in different places. Some of them I ignore, and they go away, and others I have had to back off my throwing or training until my arm could catch up and recover. The key is understanding your body, and listening to it, and always being prudent about things. Hammering away is not going to solve things when your body needs rest.
Call it Soreness
Soreness is present usually after a hard workout following a long period of inactivity, or an unusually stressful workout. Its not the same as pain, though some people will claim that a part of their body “hurts” and they need to rest. Soreness can indicate a developing injury, but more often it is probably the result of a new and taxing physical stimulus. Soreness is typified by that burning feeling that encompasses larger areas of the body, and is usually very general and not pinpoint in nature.
I have found that the best cure for my soreness is to keep the exercise regular. If I am sore after a hard workout I won’t take off until it fades away, which could be up to a week, but rather will continue my regimen. The soreness seems to get flushed out by this and usually recedes much faster than if I were to rest it.
After a start early in the season I will be sore, but will still lightly throw the next day and then increase my workload the subsequent days. Rest is probably indicated when one can barely move from it, but other than that I have found that getting some exercise, or throwing a little for pitchers, is usually beneficial.
Call it Fatigue
Fatigue isn’t like the other two, because there isn’t usually a concrete sensation to go with it, other than aches and deadness. Sharp or burning sensations aren’t there, but rather the muscles just don’t want to go.
For pitchers this is a situation that calls for rest, because the arm is depleted and it just needs to recharge. The hazard with throwing hard when fatigued is that mechanics get sloppy, and biomechanical laxity can cause more stress on all of your soft tissues. You always want to be strong enough, when throwing hard, to maintain the highest quality mechanics possible. Throw through fatigue too hard and too often, and some pain and soreness are going to appear, making things worse.
Call it Correctly
The important message here is to understand what your body is telling you, and to know it well enough to take the appropriate action. All too often young pitchers will say their arms hurt when they are sore, or are sore when they are hurt, and the indicated paths to recovery for both are quite different. Little pains and big pains are different, and should always be monitored, but may or may not lead to injury.
When rehabbing from an injury there is often accompanying pains and tightnesses and sorenesses, and they, like all others, have to be analyzed to see if they are part of the healing process (which they often are) or a sign that progression is beyond the limits of the body. But overall, people usually have an intuitive sense of when something is wrong, but over-analyzation of every pain can make for one neurotic and sleepless athlete. The key is learning to know thyself.
For Today’s installment I want to discuss some of the non-protocol things I did to help my physical recovery. But before I do, I have some words about MRIs….
…Standard MRIs are garbage. When I felt my elbow go in the game, I was fairly sure that I was going to need surgery. When I got my MRI a week later, however, my doctor could get a very accurate picture of my ligament on the films. The regular MRI was just not clear enough in showing my ligament, and as such he recommended rehab and flexibility work, which had worked for me in the past. Teammates of mine had had MRIs with a dye injection, which makes diagnoses much easier. After 8 weeks of rest and rehab, I tried to pitch but couldn’t do it without pain. My elbow felt loose when releasing the pitch, as if my ulna really wasn’t attached to my humerus.
So I went back and got an MRI with a dye injection, and it was clear as day that my ligament was torn. My recommendation for others is to get a dye-injected MRI the FIRST time. Ask for it and see if the doctor will prescribe it. Read the rest of this entry »
So I tore my UCL in the conference tournament last May. I did not see it coming on that particular pitch, but I realized it probably was in my future. My head athletic trainer had told me that it could go at any moment, seeing how I had partially torn it in both high school and the previous season in college.
From March on I was having forearm and elbow problems, and could barely recover between starts. But I got through it and didn’t miss time, and made it through 5 2/3 innings of my last start of the year. I was actually starting to feel better by time it finally went.
So anyway, I figured I would put together some of the findings of this journey, of which I am almost through (8 months post-op and at 90% of previous velocity)
Today’s Topic: Doctor Discrepancies
Now, I got surgery from Dr. Craig Morgan in Wilmington Delaware. I had heard good things about him, seeing as how is world-renowned, and I trusted him above all others with my pitching future.
Five teammates of mine had this same surgery during my career, and there were differences in all five rehab protocols. And this is interesting, because everyone seems to make it to the finish line just the same. Thus, the question arises- which protocol is the best? If you’re not familiar with the tommy john procedure, check out the link in my About Me page.
That question is hard to answer but from my own experiences, I do have an opinion. I base this opinion on what I went through, what others went through, and what seems to intuitively make sense about the human body and its ability to heal. Read the rest of this entry »