'Tommy Baseball’: a 17 year-old, 5’11”, 180lb high school baseball player walks into your clinic complaining of right shoulder pain he recently started feeling after a tournament over the weekend. He is a right handed pitcher and has been playing for years without shoulder pain so he “doesn’t understand why all of a sudden this is happening”. He has an exercise program that he has been on for the past year. The program was written for him by his PE teacher. He received a scholarship to a DII university and needs to be pain-free and ready to play at a much higher level within the next 3-4 months.
Where do you start? Almost all rehab professionals are familiar with the tests that we would use to come to the actual diagnosis. There are also some tests that coaches and trainers could use to see if an issue is serious or not. This is a great start but how do you relate this back to throwing a baseball and MOST IMPORTANTLY, how can we get this player back to competition without increasing his risk of being back in PT soon thereafter?
What are the most important items you need to assess and then how do you treat those limitations/dysfunctions related to throwing? If you’re just giving pendulums out to every painful shoulder that comes through the door, you’re not doing anyone any favors.
What types of things are you looking for when you watch this young baseball player move? The following is a list of common limitations we see in these young athletes:
1. Limited internal rotation of throwing shoulder
2. Limited thoracic spine rotation and extension toward throwing arm
3. Limited internal rotation of opposite hip
4. Weak, ‘knotted’ rotator cuff muscles
5. Unstable and weak lower and middle traps of throwing arm
6. Slackened “coil” between the hips and the shoulders
If you’re not closely examining these top movements you’re missing the big picture. If you do find these dysfunctions, how do you treat them so as to be specific to baseball?
2. Progress exercise to involve TONS of hip extension and rotation with power
3. Single leg stability exercises to involve baseball specific positioning and movements
4. Rotator cuff and lower trap stabilization in varying positions specific to baseball throwing mechanics
Strengthening the shoulder retractors and depressors as well as the rotary power ‘coil’ are the keys to keeping these athletes on the diamond.
We hope that this gives parents, coaches and rehab pros another place to begin this process. We are excited to be going into great detail on all of the above and MORE during our “Elite Thrower’s Seminars” Our aim is to provide a rock solid foundation for local physical therapists, baseball/softball coaches and strength & conditioning pros to treat, train or coach these athletes for maximum gains.
|Advanced Rehab and Treatment of the Elite Thrower|
Dr. Carlos J Berio, PT, DPT, MS, CSCS, CMTPT is a licensed Doctor of Physical Therapy, Certified Strength and Conditioning Specialist and a Certified Myofascial Trigger Point Therapist. He has treated high school, collegiate, recreational, and professional athletes of various sports including baseball, softball, football, hockey, tennis, swimming, golf and the martial arts. His experience as a collegiate and semi-professional athlete as well as a professional baseball coach make him a sought after resource among elite level athletes on the field and in the training room. Carlos remains active in several sports and is an avid agility training, power lifting and adventure race runner. He can be reached at firstname.lastname@example.org.