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Thursday, May 1, 2008
Throwing Out a Few Pitching Ideas
Central Oklahoma, OK
By: Jimmy Conway, VYPE
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Photo(s) By: Kyle Danztler/MyActionPortraits.com
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Spring time means baseball season is upon us, from little league to all the way up.
Spring time means baseball season is upon us, from little league to all the way up.
As an orthopaedic surgeon who primarily treats patients with shoulder and elbow problems, I get asked a lot of questions about baseball and throwing. The most frequently asked questions about baseball usually involve pitching, like when it’s OK to start throwing a curveball, and how often is it safe to pitch.
The American Sports Medicine Institute has some very good guidelines involving these topics.
What ruins the career of every pitcher with talent is injury. In the 1990s, there was a tremendous amount of research done about the throwing motion and biomechanics of throwing. We know from these studies what position the arm should be in to lessen the forces on the shoulder and elbow, however, there has never been a scientific study that proves if you throw with good mechanics it lessens your chances of injury.
The most common injury from pitching is usually a strain of the rotator cuff from trying to over-throw or throw too hard. Fatigue also plays a huge part in throwing injuries, as there is a 3,600-percent increase in the risk of injury with fatigue. The most common shoulder injury from throwing that requires surgery is a superior labral tear, where the long head of the biceps tendon attaches inside the shoulder joint. This is also known as a SLAP tear which stands for Superior Labrum Anterior and Posterior to the biceps tendon.
This injury is almost entirely preventable with an exercise program and most importantly a stretching program, designed to stretch out the posterior portion of the rotator cuff and posterior shoulder ligament. This posterior stretch is called the sleeper stretch and is done for right handed throwers with the person on the ground lying on their right side, tilted slightly forward. The right arm is 90 degrees away from the body out in front of the person. The elbow is bent 90 degrees and the left arm is used to push the right hand towards the ground. Once slight pain is felt, the arm is held in this position for a count of ten and this is repeated between 25 and 100 times per day depending on how tight the posterior shoulder is.
This is, without question, the most important stretch every overhead athlete should do. We have known for years that overhead athletes have tight posterior shoulders but we did not know the significance of this until research was conducted on major league pitchers beginning in the early 1990s. Overhead athletes usually gain about 10 degrees external rotation of their throwing arm compared to their non-throwing arm and conversely lose about 10 degrees internal rotation of the throwing arm compared to their non-throwing arm. When the throwing shoulder loses more than this we start seeing problems develop.
This condition is called GIRD which stands for Glenohumeral Internal Rotational Deficit. GIRD is the number one cause of pain while throwing and is the number one cause of SLAP tears and Rotator Cuff tears in the overhead athlete. Because of the complex mechanical changes that GIRD causes, I also think this condition is one of the major causes of a thrower requiring the Tommy John surgery of the elbow. As GIRD worsens the thrower has to drop the elbow which significantly increases the load on the ulnar collateral ligament of the elbow, which is the ligament that tears requiring the Tommy John surgery.
AGE MAXIMUM PITCHES PER GAME GAMES PER WEEK
8-10 52 2
11-12 68 2
13-14 76 2
15-16 91 2
17-18 106 2
Age recommendations for learning various pitches:
PITCH AGE
FASTBALL 8-10
CHANGE-UP 10-13
CURVE BALL 14-16
KNUCKLE BALL 15-18
SLIDER 16-18
FORK BALL 16-18
SCREW BALL 17-19
For more information, call (405)427-6776 at the Oklahoma Sports Science and Orthopaedics and The Oklahoma Intergalatic Institute of Shoulderology.
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