Feel the warm weather? Hear the birds chirping? You know what that means, baseball is around the corner! . We have all our equipment ready to go and are excited to get to a new season. Now that I have been done playing the game of baseball, this is the time of year when I miss it the most. Hopefully, you took some time off to recover the body and mind, but in the baseball world that may be impossible for pitchers.

Unfortunately, I have seen a number of great young pitchers who have ended their pitching career due to UCL tears aka Tommy John Surgery. Tommy John surgery has been shown to be successful, but that is not guaranteed. Shoulder pain is a common complaint among baseball players. What is scary about this is that young players are experiencing shoulder pain. Pain experienced during the throwing motion results in an inability to throw with velocity, causing what is referred to as “dead arm” syndrome (Carson 1998). Studies have shown that young players whose growth plates are still open, shoulder pain is often the result of a fracture at the growth plate at the upper end of the humerus [upper arm]. If you have ever heard the term “Little Leaguer’s Shoulder”, this is a separation of the of the growth plate in the shoulder joint.

There have been a lot of studies that have looked at shoulder, legs and trunk tightness when in comes to Tommy John surgery. In the many years of baseball and being around many players that have had this surgery, forearm tightness can be a big sign for something bad to happen. A good friend of mine told me that the doctor said his forearm tightness ultimately lead to his flexor tendon giving out and surgery was required. Unfortunately, the research on the baseball pitcher with forearm tightness and Tommy John are limited.

I have been reading a lot of articles online about players taking a month or two of preseason training to go back to the basics of injury prevention and the fundamentals of their pitching, hitting or defense. Especially for some of my favorite team’s, the Oakland A’s, pitchers such as Jarrod Parker and A.J. Griffin. These pitchers are returning from Tommy John surgery. Players who have Tommy John surgery, during their rehab they are working on their weaknesses that may have led to these problems. I have always enjoyed pitching, and recently I have been watching baseball pitcher videos, analyzing those who have had Tommy John. Besides the fact that a lot of these pitchers have been pitching and throwing their whole lives, could muscle tightness lead to injuries?

Endo (2014) examined injury occurrences and the risk factors for muscle tightness, core stability, and dynamic standing balance among junior high school student baseball players. In this study thirty young baseball players were tested on their muscle tightness and trunk endurance by using the Star Excursion Balance Test. The Star Excursion Balance is a dynamic test that requires strength, flexibility, and proprioception. The test involves four pieces of tape that are placed into a star. You stand on one foot and with the other foot you touch each point of the star without falling. The trunk endurance test involved a plank and a side plank and they did one set for as long as they could hold it with proper form. Muscle tightness was measured by the angle of each joint connected to the bilateral iliopsoas, quadriceps, hamstring, and gastrocnemius muscles.These tests were given in the beginning of the season and the end of the season. Fifteen players experienced episodes of elbow or shoulder pain while throwing. Players in the pain group demonstrated a significant increase in the tightness of their shoulder internal rotators, quadriceps, and hamstrings. There was no clear evidence of differences of changes in core stability and dynamic standing balance between the groups. These results suggest that lower extremity muscle tightness early in a season and the decline in the flexibility of the axis-leg quadriceps and hamstrings during the season may be due to an increased upper extremity load while throwing, thus producing shoulder and elbow pain.

When you examine the flexibility in overhand throwing athletes, there are definitely going to be imbalances in flexibility when it comes to the stride leg and the push off leg. Some studies have stated that the hip internal rotation and the extension range of motion of the stride leg is greater than the push off leg. The research suggests that with this imbalance in flexibility, the throwing arm has to work harder than it should. This could be a reason why elbow and shoulder injuries could occur. It is important to understand that the power of the pitch comes from the legs, more specifically the stride length. According to Stodden (2006) stride length has been associated with ball velocity, accounting for nearly 70% of variation in ball velocity among novice pitchers. If we are tight in our adductor muscles, our stride length is not going to reach it’s full potential. This study all noted that strides greater than 50% of your body weight showed greater ball velocity. Why do you think Tim Lincecum, who is 5’8 and had a stride length like a 6’5 baseball pitcher could throw the ball 100 mph (well, not anymore).

I bet you didn’t know that all the muscles from your glutes and below are very active in every pitch or throw. A pitching coach of mine told me that pitching starts from your feet, core then arm. To be a baseball pitcher, you must be religious when it comes to taking care of the arm, they ice and do band or weight work. How often do you take care of your legs?

Mobility Tips for Leg Tightness:

Baseball/Tennis Ball on the bottom of Foot. 1-2 mins
Baseball/Tennis Ball on the calves and Anterior Tibialis. 1-2 mins
Foam Roll/Baseball/Tennis Ball on the Quadriceps 1-2 mins
Foam Roll on the Hamstrings 1-2 mins
Foam Roll on the Adductor (groin) 1-2 mins
Foam Roll/Baseball/Tennis Ball on the IT Band 1-2 mins
Foam Roll/Baseball/Tennis Ball on the Tensor Fascia Latae 1-2 mins
Baseball/Tennis Ball on the Glutes 1-2 mins
Baseball/Tennis Ball on the Quadratus Lumborum (lower back) 1-2 mins
Foam Roll Thoracic Spine 1-2 mins

Training Program for Pitchers:

Exercise Sets Reps Rest
Squat 3 5 :60
Lunge 3 8e :60
Donkey Kicks 3 12e :60
Hip Thrust 3 6 :60
Glute/Ham Raise 3 10 :60
SB Hamstring Curls 3 12 :60

Reference:
Carson WG, Gasser SI. Little leaguer’s shoulder. A report of 23 cases. Am J Sports Med 26(4): 575-580, 1998.
Endo Y, Sakamoto M. Correlation of shoulder and elbow injuries with muscle tightness, core stability, and balance by longitudinal measurements in junior high school baseball players. J Phys Ther Sci. 2014 May;26(5):689-93.
Stodden DF, Langendorfer SJ, Fleisig GS, Andrews JR. Kinematic constraints associated with the acquisition of overarm throwing Part I: Step and trunk actions. Res Q Exerc Sport2006;77(4):417-427.

Written by Chris Barber, CPT