How to Throw Heat, and over 200ft Pain Free with a large SLAP tear that Needs Surgery
Do you have shoulder or elbow pain? Do you want to know how to prevent a SLAP tear, UCL -Tommy John sprain or any significant injury from potentially happening as a baseball or softball player? If you don't even think about getting injured, you'll want to read below to maintain that mental status.
Enter Chris, a 15y/o left handed pitcher who was throwing good heat for his age (sitting in the low 80's) without any formal pitcher training. Chris began developing a painful pinch on the back of shoulder early in the Spring of 2014 in the late cocking position. This pain eventually brought him to my clinic, where he could only crow-hop a 90ft throw before he experienced his painful pinching. I gave Chris 2 exercises to perform and 2 weeks later here's what happened:
Long Toss Distance: 180ft without pain or pinching (a 200% improvement in distance, without pain)
Pitching Velocity from the mound: Not tested, but Chris said he was throwing at 85% without any pain or pinching.
Sure, you might be thinking to yourself, "85% of his usual low 80's isn't throwing heat, and that's NOT impressive."....and you're right...about the heat. What is impressive is that Chris was then diagnosed with a very large SLAP tear, which he eventually had surgically repaired, and is now rehabbing. Let me say it again a different way: Chris was able to throw 180ft pain free with a large SLAP tear after only 2 weeks of 2 simple exercises. Had he been doing these exercises since he began competitively pitching, surgery may have been avoided.
Brandon came to McKenzie Sports Therapy with pain throwing from the outfield. His pain was on ball release more so than a late cocking position. While he could still throw hard from the OF, it was painful to really let his arm go full speed. Brandon had suffered an avulsion fracture of the anterior-inferior or middle glenohumeral ligament as was noted on MRA [(magnetic resonance imaging w/ arthrogram)...a contrast injection into the shoulder joint with MRI mainly used to find labral tears.] Brandon's medical diagnosis is also termed a HAGL lesion. I gave Brandon 1 exercise to work on for his shoulder, and 1 exercise for his hips and 1 week later:
Brandon had no pain with throwing from the OF at 100% effort, time and time again.
6 months later still no mention of surgery; throwing heat, at 275+ feet, he began training as a pitcher, and college scouts are drooling. He is still performing the program.
Taylor a 12y/o right handed thrower, along with his father, came to my clinic with complaints of shoulder pain during the acceleration and deceleration phases while throwing in the back yard. Taylor's father also reported shoulder pain which precluded him from throwing very far or hard anymore because of shoulder pain for the past 10+ years (he was a prior baseball player). I gave Taylor 1 exercise to do every day. Unbeknownst to me, Taylor's father also took this same advice (and the same resistance, too!), and 1 week later:
Father and son BOTH had NO complaints of shoulder pain when throwing. Taylor's dad said he "hasn't felt this great throwing in years!"
The magic behind these exercises isn't just the exercise itself--It's how they are performed. I hypothesize that 80% of you reading this right now have heard this training term (or a derivation of it) that I'm about to use, maybe even from me, but less then 10% of you actually use it. Which is weird, really weird.
Why is it weird? Because even though many of the 25,000 scholarly articles on baseball throwing injuries detail exactly what is happening during a throw, almost nobody trains the body this way--and it boggles my mind. The "nobody's" get half the picture, not the whole thing.
In order to throw heat, and long distances with known shoulder pathology, or to prevent these injuries from happening in the first place, specific parts of the body must be trained with an eccentric muscle contraction. Maybe you're thinking to yourself, "What the heck is an eccentric contraction?"
An eccentric contraction of a muscle is when the muscle is lengthening, but still contracting. In many gym-goers, it's also referred to as a "negative." Think about pulling milk out of the fridge and what happens to the biceps; the bicep pops right up, like Popeye's.
In this case the bicep is shortening--also known as a concentric contraction. It's when you put the milk back in the fridge that the Biceps lengthens under a load. Lowering that milk back into the fridge represents an eccentric contraction of the biceps. If you didn't slow that arm down the milk would likely spill, as your arm would come careening downward onto the shelf.
Need another analogy? Indy and Formula 1 cars have break away parts when they are in a collision. These parts (wheels, suspension, axle's) fly away from the car body to decelerate force away from the driver, to keep him/her safe by slowing the car body down. These cars have the luxury of break away parts. Human bodies don't....and they shouldn't. Our arms and legs must stay attached and decelerate our body. If they tear...game over...for 9-12 months (depending on injury severity).
Now think of a baseball pitch, or throw. What kind of muscle contraction do you think slows down your arm from being ripped off your body? Yes! Connection made! Eccentric contractions!
Are you training your body to slow down, or just go fast?
Have you ever been injured? Do you want the best chance to avoid soreness or prevent significant injuries from happening which could equate to lost playing time, lost money (college scholarships, pro contracts, etc.), and lost pride?
With baseball throwing, most injuries occur in:
The late cocking phase:
And the deceleration and follow through phases when you release the ball:
I'm not saying you won't feel pain elsewhere, but these are two prime spots in baseball throwing where pain and injury occur. Can you guess what type of muscle contractions are occurring in the two positions? That's right...eccentric contractions. This is simple science, and here are two articles of many (article 1,article 2) that show clear as day, eccentric muscle contractions are occurring.
Some of the baseball community has their heads in the right place.
Brought into the baseball training scene back in 2006 by Dr. Mike Marshall, (Ph.D, and former MLB baseball pitcher) who strapped 10lb wrist weights to his pitchers and had them perform a throwing motion. He then instructed the pitchers to try to stop their arm in the deceleration phase to generate eccentric muscle contractions on the posterior rotator cuff (back of your shoulder).
More recently, Tom House and the National Pitching Association have a "Holds program" that is meant to eccentrically stress the muscles on the back of shoulder similar to a tennis player holding/not letting go of their racquet; quite similar to the concepts in Marshall's program from the observing eye.
Rewind to the early 1980's, Frank Jobe, M.D. (he invented Tommy John surgery) did EMG (Electromyography) studies of muscle contractions on the throwers shoulder (study 1, study 2)--his results were much like today's results; showing spikes of muscular activity during specific portions of the throwing phase. And getting a little more in depth, if you know anything about muscle origins and insertions, you know what type of muscle contraction is occurring at any phase, or point in time of the throwing motion.
Again, if you know your muscle origin, insertion and primary action, graphs like these blurt out where the eccentric muscle contractions are occurring. If you don't that's fine...I've already figured it out for you.
You: "Ok! Eccentric contraction. Slow down the shoulder/rotator cuff. Arm not get ripped off. Prevent injury. Got it! What are those exercises!?"
Me: Hold your horses cowboy!
Nobody ever said eccentric muscle contractions are limited to your shoulder. In fact, that couldn't be further from the truth.
A friend of mine, Lantz Wheeler, said that to generate arm and ball velocity, your initial goal should be to move your center of mass as far and as explosively away from it's starting point as you can--so you can generate a long stride. You need strong, powerful legs to get "the ball rolling." (Quasi-pun intended) In short, we need to generate much speed and velocity with our legs to speed up our center of mass. This is more difficult for pitchers, and obviously easier for position players like outfielders as they can get a running or hopping start.
Now, that center of mass needs to slow down....
How to put it all together:
The Concentric Process
The center of mass speeds up, and passes it on to the trunk/torso/core. (choose whatever term you like best)
The trunk, acting as a velocity conduit to the arm, speeds up via rotation and flexion (hence the need to practice linear into rotational power training). The trunk passes this velocity onto the shoulder, and finally the elbow and wrist. Concentric muscle actions are responsible for moving *most* of the velocity in a throw, forward, from that initial leg drive to ball release.
Now remember...eccentric contraction = arm health.
As one body part speeds up, the the one right behind it automatically slows down--This is an automated response by your body. However, this deceleration must be purposefully trained with strength training overload principles if you want to have good arm health now, and in the future. Specific deceleration movement patterns should also be trained with a throwing coach who is skilled in deceleration patterns.
The Eccentric Process
The slow down of the center of mass begins just after the stride leg foot contacts the ground. Eccentric contractions begin with the hamstrings, then glutes (hip abductors, external rotators and extensors) as the hips rotate toward the plate.
Here's that proof again (Campbell 2010) :
As your core speeds into rotation and flexion, and passes that velocity to the shoulder--the back muscles (too many to list!) eccentrically contract to control the forces that go through your shoulder. Your shoulder passes the velocity down to an elbow that is just beginning to straighten, as the posterior rotator cuff is now eccentrically contracting. The elbow is now rapidly extending and the bicep and elbow flexors work to decelerate this. Combined with all 4 rotator cuff muscles, the bicep also resists/protects your arm from being ripped off your body as the ball is hurled away from you (this is known as a traction force that your body is actively resisting---the ball of your shoulder [humeral head] is actually being pulled forward and out of it's socket ever so slightly.) Lastly the wrist extensors eccentrically contract to slow down your wrist into end range wrist flexion and forearm pronation.
So what happens when you're deficient in eccentric strength?
When you lack eccentric strength and you continue to throw hard, abusing those deceleration muscles---The weakest link usually hurts, AND (this is important!) it puts more strain on the next segment down the chain causing risk of significant damage.
The stages look like this:
1. Muscle soreness/fatigue that goes away quickly in 2-12hours
2. Muscle soreness/fatigue that takes longer, >12-48hrs to go away. **Also known as DEAD ARM**
3. Muscle soreness/fatigue turns into muscle and joint pain(Low and mid back pain, shoulder impingement syndrome(s), Little league shoulder syndrome, small SLAP and labral tears, elbow tendonitis, UCL/Tommy John pain, elbow stress fractures, and valgus overload syndrome to name a few)
4. Muscle and Joint failure: Hamstring strains, abdominal strains, rotator cuff tears, large SLAP and labral tears, and Tommy John injuries.
Do you currently fit into any of those stages? If you think feeling sore after you throw is normal, think again. The guys that train with my arm care programrarely complain of soreness after they throw hard. They have learned the value of, and practice eccentric training for about 30min, on a daily basis.
And of course, proper mechanics is of the utmost importance for long term injury prevention. Still, remember Chris from earlier? He had terrible mechanics (sorry Chris :) but you know it!). He achieved his 200% increase of pain free throwing even without changing his faulty mechanics. Eccentric training can take you far, even to the point of "hiding" aches and pains from poor mechanics, but the crap always floats to the top...and it will come back to bite you some day. So get your mechanics checked!
Do you think that throwing itself is eccentrically training the shoulder enough, maybe over training, and that concentric training is the way to go? ?? My empirical studies have found this to be un-true. For the past 7 years, all my baseball patients report less, if any soreness post throwing, increased velocity and a quicker recovery time.
"But this article say's eccentric training causes muscle damage for up to 7 days!! Quicker recovery time my butt. HA--got ya!"
This article was on mice, with electrically induced eccentric contractions applied for one "training day." Have you ever used eccentric training? Long tossed? Went to the gym again after taking significant time off? How sore were you after that 1st outing? Probably REALLY SORE, progressing up to 3 days. How sore were you the next time you trained, or kept up a normal gym routine?---Hardly any. Your body adapts, and I wonder what would have happened to these results had they kept testing...I hypothesize less tissue breakdown.
We know for a fact that baseball players who go into the season with weakness of their rotator cuff have have throwing related injuries that result in surgical intervention (Byram, 2009). We also know most injuries happen when muscles in the throwing arm are under eccentric contractions. Muscles get weaker, and muscles lose the ability to decelerate force....Put 2 & 2 together.
The answer is: Specific eccentric overload training will force the body to adapt...so when it comes to decelerating a baseball, the body is over-equipped to do this.
This = less strength loss over time, and a greater ability to decelerate forces over the course of a game, and season.
So now you know what to do. Eccentrically strength train from the hip, down to your wrist. Here's two beauties to get you going: Enjoy :)
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