Last week, the NY Times published an article on Tommy John surgery, examining what seems like an inevitable surgical procedure for many of major league baseball’s high-speed pitchers. In an effort to preserve the arm health of new pitchers, protocols limiting the amount of pitches per game have been set to minimize the stress on a pitcher’s elbow tendons. Unfortunately, even this protocol doesn’t seem to prevent damage to young or old pitchers.
If you are a pitcher, scout, or coach, please read this carefully as it may make a huge impact on your thinking. Why aren’t the physical screens, the physical therapy, and the emphasis on mechanics and mandated rest time saving a pitcher’s elbows? What if I told you it wasn’t the elbow? Or even the shoulder? Very often when you have elbow and shoulder pain in high torque and velocity sports, the true cause is in the hips and upper back. The elbow tendinitis issue could even start as far away as the feet because collapsed arches and excessive pronation will bring about a misalignment of the hips.
Pitching has a number of similarities to Crack the Whip, a playground game we played as children. Take a look at the way it is played, courtesy of You Tube. The connection to Tommy John surgery has to do with momentum and transferred energy, just like Crack the Whip.
Imagine the energy used throughout the entire body of a pitcher throwing a 90+ mile-an-hour baseball. If the back and hips don’t allow for a smooth transfer of energy from the hips to the arms, the elbow gets jerked hard with a force that it can’t support. The elbow, like the knee, is a stability joint. It is not meant to twist or to be twisted. That twisting, turning, and rotation belongs to the thigh (hip), ankle, shoulder, and wrist. These are the designated rotatory joints of the chain, not the elbow, or the knee.
The standard response may be that pitchers are already strong. An example could be that they can gym-squat more than their own body weight. So, they already have strong backs and hips. Wrong! Just because they can move mass doesn’t mean they can move their joints and bodies in a healthy pattern.
What imbalances does an alignment therapist look for? For starters, they look to see if one hip is rotated or turned more forward than the other? Is one hip higher or lower than the other? Is it the hip or is there something going on in the ankle or the foot that is causing the hip rotation? What do the shoulders look like? Are they forward or are the tops of the shoulders resting in a nice clean line below the ears? Is there a curve in the neck and is the head balanced over the shoulders or? Is one shoulder higher, lower, or more forward than the other? Has all the muscle mass built up in the upper back, forcing a rounded over look? The more yes answers to these questions, the more likely the player is to be injured one season into his sport.
But pitchers are one-sided humans. Of course, one side will be different from the other! This tendency needs to be corrected by cross training through various modalities to develop neutral shoulders and hips. A pitcher should train for strength and mobility resulting in a proud chest with shoulders back and even, resting comfortably under the ears of a head resting on a slightly curved neck. Tight and over-developed biceps may seem cool but they can’t keep the rotator cuff engaged and the shoulders stress free. Pitching should be graceful, not mechanical.
Train to neutralize the hips so that one isn’t higher or more forward than the other. Train to make up for all the throwing on one side. Don’t rely on heavy lifts to do this. Don’t strengthen what is already strong. For full optimal stabilization, recruit all muscles, not just the big ones.
For an initial look at the overall postural and mechanical balance of a player, use the BodyFix Method™ posture and gait analysis system for an estimate. Evaluating players with this system can be like having x-ray vision for faulty movement patterns and compensations, all of which will lead to permanent dysfunctions.
With a trained BodyFix Method™ therapist, after the posture and gait analysis is complete, the therapist can then test for specific muscles that aren’t firing properly by using her skills in Muscle Activation Technique (MAT). This assessment is a series of comparative movement tests to pinpoint which muscle and even which region of the muscle isn’t firing properly. Either palpation or isometrics can then be used to wake up that inactive spot so that it can operate with the rest of the team.
What have we learned today? Elbow and shoulder pain, whether it’s from pitching, golfing, or swimming is usually caused by a dysfunction elsewhere in the body. The elbow was just the weakest point the force was traveling through.
How can we prevent this? Find the strong and overworked muscles and relax them; find the weak and underutilized muscles and make them stronger. Find the forward, hiked, and rotated joints and make them neutral. We must have symmetry in order to have grace and fluidity in movement.
Lastly, a discerning eye and proper alignment testing is key. Work with a professional and learn how to see the imbalances in action so you can test and correct the imbalances before they shake the “machine” apart.
If you have questions, comments, or would like to know more about alignment and function, please get in touch with me at firstname.lastname@example.org.