Posts Tagged ‘rehab’
June 9th, 2010 | 
Author: I feel that there is a ton of value in sharing stories about coping with injury. I’m ashamed to say that this section of my site has not taken off like I had hoped, but nonetheless, everyone goes through injuries during a long career in sports, and it’s good to know how things feel from someone who has lived it before.
One of my closest friends, fellow ballplayer and trainer, and occasion contributor to this site, Andrew Sacks, just underwent PCL surgery on his right knee. He is chronicling his recovery, which I think is a great idea – one that I wish I had done myself with my elbow. Unfortunately, Andrew has an even longer road than most, as his left knee needs at least one ligament replaced as well, so two or three months into rehab on his right, he is going to be on the surgeon’s table again to get his left knee repaired. For a lifetime athlete, he is in for a long battle with inactivity and rehab.
Apparently Andrew bruises easier than grandma.
So, check out his blog entitled Life After Knee Surgery. Andrew writes well, and if you’ve ever laughed at one of my random thoughts or jokes, then you’ll enjoy his brand of humor as well (we basically share that brand). And if you further find yourself wondering about the difficulties of going to the bathroom while in a straight-legged knee brace, look no further.
I jotted down notes about my bullpen or general throwing sessions from months 7-9.5 of my recovery. I discovered it while cleaning my place. I’m just rewriting what I had down, so I may or may not be able to clarify if you have any questions.
March 22 – Good, not sore
March 24 – Good, not sore
March 26 – 7 months – Good, not sore
March 28 – 15 Changeups; good, but not perfect
March 30 – 10 changeups, discomfort on 1/3 of them
April 1 – 3/4 speed; no changes, no pain, 66-71 mph. felt ok, not perfect next day
April 3 – felt good, not perfect; 45 pitches @ 3/4 (speed)
April 6 – 1st two digits had pain when pressure applied
April 9 – mid to upper 70s, little pain; felt good after 4 days off prior
April 17 – no pain! 65 pitches at 3/4
April 19 – long tossed to 240 no pain
April 21 – felt good. into low 80s maybe
April 23 – gun read 75-77. TIRED! but no pain
April 25 – 8 months – Hit 81, consistent 76-79 50/30 pitches
April 28 – long toss to 270, 45 pitches at 85%
April 30 – 30 + 45 vs hitters. 82-84. Felt good
May 2 – VERY tired from April 30. Arm achy and slight pain, very dead. threw 70 at 2/3 speed
May 4 – flat ground, 15 curves at 50 ft. pain still, arm not recovered from previous.
May 7 – Hard pen, felt good. 80 pitches at 90%
May 9 – good long toss, felt great.
May 11 – 100% from mound, 100% changes, 50% curves (15). felt good, no pain, but knotted up on forearm after.
May 14 – 100% fast + cu, no curves. Still knot in forearm but no pain
May 16 – 45 fast-curve-change, 75-75-50% respectively. less tightness, no knot next day.
May 18 – Light pen, 30 curves
May 20 – In game, 28 pitches. 30 curves beforehand. Bicep Dead, big knot afterward. No throw 21-24.
May 25 – In game 35 pitches, no knot after, felt good
May 27 – 70 pitch pen, 30 90% curves, felt good, bicep better
May 29 – 50 pitch, 70%, curves getting sharper!
May 31 – 60 in game; arm felt slow, but great after. 55 fb/ 5 curves. No tightness at all.
June 2 – Long toss, hard but not too many throws. Need to get intensity up and let go. Felt good next morning.
June 4 – Bullpen 20 max effort, 85-90. Arm felt achy, some occasional pain twinges, and very dead. Decent next day. Fatigue in bicep/tricep still, but not terrible.
Thats the whole log. Wish I had done more of that during it all, but I was more interested in getting after it than writing it all down. Hindsight…
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 »
Unilateral leg training is great for you. Plain and simple.
For the athletic population, and especially one-side dominant athletes like baseball players, a big differential can develop between legs. Pitchers will often have increased tightness in their stride leg, especially in the hip joint (from rotating on it with each pitch), yet higher strength in their balance leg (chiefly from balancing, loading, and pushing off with it 100 times per game).
The disparity can be in flexibility, mobility, or strength, but no matter the symptom, unilateral training is always a big part of the cure. And, if you have a weak leg your regular bilateral lifts (squats, deadlifts, etc.) are needlessly suffering. Big strength gains can happen in those regular lifts from strengthening the weak link.
The two most prevalent uni-leg squats are the Pistol Squat and the Peterson Step-Down, but I’m also going to throw the rear-reaching uni-leg squat into the mix, which is a better variation of the pistol squat for a few reasons.
Pistol Squat
Take a close look at the above video. It’s important to notice two things about the pistol squat:
1. The back is very rounded, which might not cause problems if done with bodyweight, but would be a serious injury risk if additional weight is used.
2. Weight shifts way back on the heels, which puts more force on the knee than if the weight was more centered.
For the above reasons, I am not a fan of pistol squats. If the off-knee is bent it allows better weight distribution, but even then I think there are better options. Read the rest of this entry »
Having a strong shoulder is of the utmost importance for pitchers. Throwing velocity, injury resistance, durability and stamina are all improved by developing strong, stable shoulders. Why strength and stability? Because strength is what is going to allow you to throw as hard as you can, and stability keeps your upper arm properly aligned and firmly in the shoulder socket, preventing wear and tear on connective tissue.
Shoulder pops and clicks when you move it? Those are a result of weak stabilizers. Good thing is, the following shoulder circuit is going to make those a thing of the past, and add a few MPHs in the process.
This shoulder circuit is done for 2-3 complete cycles of 12-15 reps per exercise. For beginners, this is going to probably require only 2lb dumbells, and the goal is to build up to using 3, and then 4lb dumbbells with perfect form for 3 sets of 12-15. The circuit is performed straight through, but I have grouped the exercises according to the body position (prone or standing).
Prone Segment
This segment is performed on a tall bench, training table, or bent over with a flat back. Notice it consists of the LYT circuit plus prone skiers and scapula pushups.
L-Raise
Start with back flat. Pinch shoulder blades and raise arms. Finish by externally rotating
Y-Raise
Keep shoulder blades tight and reach out with hands
Most good things in life can arise from something bad. So is the case with Tommy John surgery. TJ is unique among major arm surgeries in that it potentially provides a greater than 100% recovery. Getting to 100% or above, however, is a matter of capitalizing on the time off, and making the most of a bad situation.
So here I’ve compiled a list of the top 5 good things one can get out of a little elbow-slicing action… Read the rest of this entry »
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 »
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 »
As previously mentioned, I spent a fairly good amount of time in the studio of Bikram Yoga Baltimore both before and after my elbow surgery. Eddie and Emily, the owners, are wonderful people are were super supportive of me. The other instructors as well were terrific and I felt at home there.
Bikram Yoga makes a lot of health claims, some of which may or may not be true, but overall I think it’s a great practice and will improve the health, flexibility, and recovery time of those who might bring a chronic injury into the studio.
The Basics
My sister wrote a nice piece for school explaining the Bikram phenomenon, and it’s a good read. But the class is relatively straight-forward : 90 minutes in a 105 degree, 40% humidity room which consists of 26 postures, each repeated twice. If it sounds difficult, that’s because it is. However, nothing worthwhile is easy and Bikram is no exception.
To class one brings a large jug of water, a yoga mat and towel to cover the mat, and a scant outfit to allow ease of movement and a cooling effect. One class costs about 14-20 dollars depending on the studio, which is actually pretty reasonable considering the length of the class (most yoga classes are an hour) and the intensity of the workout. Buying class cards brings down the cost per class down even more. Read the rest of this entry »