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Arm Care Starts with the Scaps

The two most commonly reported areas of pain in baseball players are the shoulder and elbow.

However, the area in pain may not actually be causing the pain itself.

The body is a chain and weakness in one link of that chain can cause pain in another area. This is certainly the case when it comes to arm pain. Often when pain is felt in the arm it is due to a lack of mobility elsewhere in the body. That “elsewhere” is often from the scapulothoracic joint.

In order to understand the importance of the scapulothoracic joint, which is comprised of the scapula (shoulder blade) and the rib cage, we have to appreciate the functional. The shoulder joint is made up of the head of the humerus and the glenoid cavity of the scapula. The humeral head sits right on top of the glenoid cavity like a golf ball on a tee. As the shoulder joint goes through various motions, the scapula has to move with it. It does this by gliding on top of the rib cage. For every two degrees that the shoulder moves, the scapula should move one degree (2:1 ratio).

Here’s a great video showing the anatomy of this movement:

If the scapula is unable to move close to a 2:1 ratio with the shoulder, then we are going to be limited with how far we can move our arm. This limit, when trying to throw a baseball, is problematic, as the thrower will place undue pressure on the shoulder and elbow in an attempt to reach the proper range of motion.

Scapula Exercises for Baseball Pitchers

As you can see, it’s pretty important to not just focus on the arm, but also the scapula.  Below are my four favorite correctional exercises to develop scapulothoracic movement.

Side Lying Half Moon Thoracic Stretch

In addition to mobilizing the thoracic spine, the lying half moon stretch is exceptional at promoting scapulothoracic range of motion.

Have the athlete flex their top knee at 90° and sit it on top of either a medball or a foam roller. This will keep their spine aligned properly. The athlete should try to drag their fingers along the ground as they progress throughout the motion. It is important to note that athletes who lack ST mobility will not be able to get their hand all the way to the ground initially.

As the athlete moves their arm through the motion the scapula will go through all of its movement patterns.

 

Back to Wall Shoulder Flexion

For baseball players it is critical that the scapula is able to elevate and upwardly rotate as the arm extends forward towards ball release. This drill is an example of how an assessment test can also be used as a corrective exercise.

Have the athlete stand with their feet 4-6 inches away from the wall and cue them to keep their back completely flat against the wall. With the amount of lumber extension we see across the population this may be very challenging for some athletes. If the athletes cannot keep their lower back flat on the wall, instruct them to bend their knees and active their core.

Forearm Wall Slides

As the athlete slides their hands up the wall they are getting more elevation and upward rotation of the scapula; but as they pull their hands off of the wall, they’re going to retract the scapula and get some slight posterior tilt as well.

Make sure that athlete engages their core and doesn’t fall into lumbar extension as they bring their hands off of the wall as this should be an exclusively scapulothoracic movement.

Prone 1-Arm Trap Raise

The last exercise in my scapulothoracic joint mobilization series is very similar to the classic Blackburn’s exercises.

I prefer to have athletes do these exercises unilaterally and on a table because when done bilaterally and on the floor we often see more spine movement than actual ST movement. This is another good exercise for developing posterior tilt of the scapula by allowing the lower trap to get involved.

The beautiful thing about all of these exercises is that they require very little to no equipment at all. This means that athletes can do these exercises in the gym, on the field, or at home.

Give these scapular exercises for baseball pitchers a try and keep that arm healthy this season!

 

Want EBP’s FREE Arm Care Program?

EBP Reinold Throwers Arm Care ProgramOur mission at EBP is to provide the best and most trustworthy information.  That’s why we now are offering Mike Reinold’s recommended arm care protocol for absolutely FREE.  A proper arm care program should be one of the foundations of injury prevention and performance enhancement programs.  The EBP Arm Care program is the perfect program to set the foundation for success that EVERY baseball player should perform.

 

 

 

Is Rotator Cuff Strength the Key to Preventing Tommy John Injuries?

I like simple studies that answer complex answers.  A recent report in the International Journal of Sports Physical Therapy has shown the baseball pitchers with Tommy John injuries have weaker rotator cuff strength than healthy players.

This has long been studied and shown previously but the I really liked how the authors conducted this study.  Two things stand out to me from these results that have considerable implications.  Baseball players with Tommy John injuries had:

  1.  7% deficit in ER rotator cuff strength compared to their non-throwing arm.  Healthy players had no deficit between their shoulders.
  2. 30% deficit in ER rotator cuff strength compared to the throwing arm of healthy players.

So, players with Tommy John injuries were weaker in general and showed specific throwing arm weakness.  I’ve always said that shoulder strength and mobility is the key to reducing these Tommy John injuries, these results completely support the need for rotator cuff strength.

 

EBP Reinold Throwers Arm Care ProgramDownload Our Free Throwers Arm Care Program

So it’s pretty obvious that we should be performing a shoulder program.  I’ve recently put together a free arm care program for EBP that you can perform to get your shoulder and forearm strong, and hopefully prevent some of these Tommy John injuries.

 

 


Baseball Players With Ulnar Collateral Ligament Tears Demonstrate Decreased Rotator Cuff Strength Compared To Healthy Controls

Background: Ulnar Collateral Ligament (UCL) tears are common in baseball players. Alterations in rotator cuff strength are believed to be associated with injury to the shoulder and/or elbow in baseball players.

Hypothesis/Purpose: Baseball players diagnosed with a UCL tear will demonstrate decreased internal (IR) and external rotation (ER) force as an indication of isometric muscular strength in the throwing arm compared to IR and ER force of the throwing arm in healthy baseball players. The purpose of this study was to examine isometric IR and ER strength of the shoulder in baseball players with UCL tears at the time of injury compared to healthy baseball players.

Study Design: Case‐control study design

Methods: Thirty‐three of the participants were diagnosed with a UCL tear and thirty‐three were healthy, age‐ and positioned‐matched controls. All of the participants played baseball at either the high school or collegiate level and volunteered for the study. Isometric rotator cuff strength measurements for internal (IR) and external rotation (ER) were performed with the arm held to the side at 0 ° of shoulder abduction. All measurements were taken bilaterally and the means of the throwing and non‐throwing arms for IR and ER in the UCL group were compared to the means of the throwing and non‐throwing arms in the healthy group. One‐way ANOVAs were used to calculate differences between groups (p < 0.05).

Results: Baseball players with UCL tears demonstrated significant rotator cuff strength deficits on their throwing arm IR (p < .001) and ER (p < .001) compared to throwing arm IR and ER in the Healthy (UCL IR = 131.3 ± 31.6 N; Healthy IR = 174.9 ± 20.7 N) (UCL ER = 86.4 ± 18.3 N; Healthy ER = 122.3 ± 18.3 N). On the non‐throwing arm, the UCL group was weaker in both IR (135.0 ± 31.1 N; p < .001) and ER (93.4 ± 22.8 N; p < .001) than IR (172.1 ± 24.1 N) and ER (122.3 ± 19.1 N) in the Healthy group.

Conclusion: Participants with a UCL tear exhibit lower force values as an indication of isometric rotator cuff strength in both the throwing and non‐throwing arms than a healthy cohort.

Int J Sports Phys Ther . 2015 Aug; 10(4): 476–481. BASEBALL PLAYERS WITH ULNAR COLLATERAL LIGAMENT TEARS DEMONSTRATE DECREASED ROTATOR CUFF STRENGTH COMPARED TO HEALTHY CONTROLS Copyright © 2015 by the Sports Physical Therapy Section Abstract Background Ulnar Collateral Ligament (UCL) tears are common in baseball players.

Source: Baseball Players With Ulnar Collateral Ligament Tears Demonstrate Decreased Rotator Cuff Strength Compared To Healthy Controls