To: No one person but to every one
Reference: Elbow pain in the pitcher
This presentation is born out of frustration. But it is not meant to offend anyone.
As a certified athletic trainer (ATC) I see too many young baseball players with medial elbow pain. These young athletes come to me after it is too late – they have been practicing/implementing inefficient (and incorrect) mechanics.
I was once told in graduate school “common things happen commonly and uncommon things happened uncommonly.” This has never been more true than it is today with youth baseball. I am seeing more and more eight, nine and 10-year-olds (and older) that present with the same description. The script hardly ever changes. The mother usually brings the patient to the clinic because her son is in pain. After an evaluation of the athlete, it is explained to the mother that her son has a tight shoulder and it is expected that her son's mechanics may be contributing to his elbow pain. A video analysis of her son's mechanics is recommended. The mother usually states that she would like to have her husband present. The video analysis is scheduled for another visit.
At this next visit the father begins the session by saying that his son has taken pitching lessons and he is quite sure his son’s mechanics are not flawed. The father continues by saying that his son’s pitching coach instructs him by using any combination of the following statements/mantras:
Get into a tall balance point
Break the hands quickly to get on top of the ball
Fall toward the plate
Land with the front foot closed
Extend the arm out in front of the body so the release point is closer to the batter
Snap the wrist down hard and fast
At this point, many of you who are reading this are saying to yourselves “yeah, those sayings/mantras seem right” because you or your own son have been taught these same things.
A good friend and colleague of mine has a saying, “people don’t know what they don’t know”. Being taught only one way of doing a task doesn’t mean that one way you were taught is the only way or even the best way of doing that task. You don’t realize/know that there is another way. Therefore you don’t know what you don’t know.
Much of (if not most of) the pitching instruction that I am encountering today is what has been called by some “belief based”. Belief based revolves around the basic concept of “that was the way I was taught so that is the way I teach.” Does anyone see a flaw with that thinking? What if what is being taught isn’t the only way or the BEST way of instructing our young players? What if what is being taught is hurting our young players? What if the next “great pitcher” never realizes his potential because he was instructed based on someone’s “belief”?
On the contrary, there is a concept of instruction that has been labeled “evidence based”. Evidence based instruction comes from the practical application of research. What does the research say? Without getting technical, the research tells us that if a pitcher has a decreased ability to rotate their arm/shoulder down by a certain number of degrees, then that pitcher’s mechanics change placing unnecessary and excessive strain on the elbow. Therefore, that pitcher experiences elbow pain.
Without this fundamental biomechanical understanding and detection, a pitcher and his parents are placed in what appears to be a never-ending cycle. It goes something like this:
The pitcher experiences either shoulder or elbow pain
The pitcher is told to take an over-the-counter anti-inflammatory medicine
The pitcher temporarily feels better but the pain returns
The pitcher’s parents take him to a physician asking for a steroid injection (after all that is what the big leaguers do, right?)
The pitcher is instructed to stop pitching for 2, 3, or 4 weeks and is given a prescription strength anti-inflammatory medicine by the physician
The pitcher plays another position (usually 1st base – because there is not much throwing, right? When in all actuality throwing from 1st base, in my opinion, is one of, if not the most, arm-dominant throwing positions.)
The arm feels “better” after a couple of weeks
The pitcher resumes pitching
The pitcher throws 1, 2 or maybe even 3 innings and the pain returns (often times more intensely than the original bout of pain)
The parents take the athlete back to the physician or perhaps to a “sports specialist” for a second opinion
Rest and anti-inflammatory medicines are again prescribed
An MRI may be ordered
An injection may follow
Rehabilitation is recommended
The season is 1/3 to 1/2 over with at this point and frustrations from the pitcher, parent and coach are really getting high
The season is “pieced together”
The parent and pitcher vow to get instruction in the “off-season” (this is an oxymoron – baseball is a year-round sport now-a-days)
The pitcher receives instruction based on someone’s “belief”
The next season begins
The cycle starts all over again
Have you been there? Do you know someone who has? I see it every spring. Is there anyone to blame? I don’t think any one person is to blame. Because “people don’t know what they don’t know.”
Analogy time: Have you ever been walking and you suddenly feel something in your shoe? Sure you have. What is your reaction? Often times you try wrinkling your toes to redistribute the object that has found its way into your shoe. You begin walking on a different part of your foot than you normally do. You may even limp for a while. But what would be the logical thing to do? That’s right – take the object out of your shoe!
This pebble in the shoe analogy is so applicable to the pitcher and elbow pain cycle mentioned above. The pitcher begins to experience some type of discomfort. He consciously or subconsciously (because the body is a remarkably created machine) makes a change to his pitching mechanics. He “limps” around for a few outings (or even seasons). When in all actuality to break that cycle, one only has to stop long enough to identify and take out the “pebble” that is in the pitcher’s mechanics.
There are other causes of elbow pain in pitchers besides the tight shoulder issue. Belief based instruction puts emphasis on the pitcher’s arm being the prime mover/accelerator of the ball. The elbow leads the body through the acceleration phase of pitching vs. the body pulling the arm through. These pitchers are labeled as arm throwers.
Arm throwers have many things in common but a few of them include:
Slow/robot-like side steps as their first move from the rubber
A pause or hesitation at the top (i.e. balance point)
A short stride length
Minimal/No back side follow through
(There are a multitude of things to look for between the first side step and back side follow through)
On the contrary, evidence-based instruction places the emphasis on using the whole body in an efficient manner of creating, storing, and ultimately releasing kinetic energy. Tim Lincecum, 2008 NL Cy Young Award Winner, and his dad understand this concept. My understanding is that Tim is around 5’10” or 5’11” tall but can throw 98 mph and higher.
How did Tim Lincecum become that good? According to the 2008 Sports Illustrated article, Tim’s dad videotaped and analyzed nearly every pitch Tim threw growing up. I realize that many parents (and some pitching coaches) videotape their son pitching. When you view the video, what are you looking for? What checkpoints do you have? What objective measurements are you taking? What degree of hip rotation does your son have? What is the relationship of your son’s trunk lean to his front foot? What ball path does your son have from hand break to front foot plant? Tim’s dad looked at these things and many more. Are you looking for these? If you are, what are you (or your son’s pitching coach) doing with the information once you find it? How are you implementing these findings into your son’s pitching mechanics?
The previous paragraphs most likely caused you to have one of two reactions:
You were offended because you believe you can identify mechanical flaws just by watching a pitcher with your eyes. You may very well be able to. But I would have to say you have some very good eyes. For you see, a pitcher’s shoulder can rotate up to 7000 degrees/second (and beyond in elite pitchers). That is the equivalent of a shoulder going in a complete circle (like an airplane propeller) 20 times in one second (thanks C.K. for the numbers.) You don’t know what you don’t know.
You realized your son may very well have been taught to be an arm thrower and all kinds of light bulbs went off in your head.
If you are the latter and feel your son or one (or more) of your players could benefit from a professional, evidence-based video analysis of his pitching mechanics, visit…
http://www.athletictrainingandconditioning.com/P.I.T.C.H.html
Thank you for taking the time to read this article.
Wishing you health and success,
Joe
