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Oblique Strains in Baseball: 2011 Update

Posted Mar 29 2011 8:56am

Just over three years ago, during a period where oblique strains were on the rise in professional baseball and the USA Today profiled this “new” injury, I wrote an article on what I perceived to be the causes of the issue.  Check it out: Oblique Strains and Rotational Power .

This year, the topic has come back to the forefront, as players like Joba Chamberlain, Sergio Mitre, Curtis Granderson, and Brian Wilson have experienced the injury this spring training alone.

While my thoughts from the initial article are still very much applicable, I do have some additional thoughts on the matter for 2011:

1. Is anyone surprised that the rise in oblique injuries in baseball is paralleled by the exponential rise in hip injuries and lower back pain? I don’t care whether you work in a factory or play a professional sport; violent, repetitive, and persistently unilateral-dominant rotation (especially if it is uncontrolled) will eventually chew up a hip, low back, or oblique; it’s just a matter of where people break down.

In other words, pro athletes are generating a tremendous amount of power from the hips – moreso, in fact, than they ever have before thanks to the advances in strength training, nutrition, supplementation, and, unfortunately, in some cases, illegal “pharmaceutical interventions.”  Assuming mechanics are relative good (as they should be in a professional athlete), rotate a hip faster and you’ll improve bat speed and throwing velocity; it’s that simple.  This force production alone is enough to chew up a labrum, irritate a hip capsule, and deliver enough localized eccentric stress to cause a loss in range of motion.  The Cliff’s Notes version is that we’ve increased hip strength and power (more on this in a bit), but most folks have overlooked tissue quality (foam rolling, massage, and more focal approaches like Active Release and Graston) and mobility training .

If the hips stiffen up, the lumbar spine will move excessively in all planes of motion – and, in turn, affect the positioning of the thoracic spine.  Throw off the thoracic spine, and you’ll negatively impact scapular (and shoulder), respiratory (via the rib cage), and cervical spine.  Hips that are strong – but have short or stiff musculature can throw off the whole shebang.

2. “Strong” isn’t a detailed enough description. I think that it goes beyond that, as you have to consider that a big part of this is a discrepancy between concentric and eccentric strength.  Concentrically, you have the trailing leg hip generating tremendous rotational power, and eccentrically, you have the lead leg musculature decelerating that rotation.

Moreover, because the front hip can’t be expected to dissipate all that rotational velocity – and because the thoracic spine is rotating from the drive of the upper extremities – you put the muscles acting at the lumbar spine in a situation where they must provide incredible stiffness to resist rotation.  It is essentially the opposite of being between a rock and a hard place; they are the rock between two moving parts.  Structurally, though, they’re well equipped to handle this responsibility; just look at how the line of pull of each of these muscles (as well as the tendinous inscriptions of the rectus abdominus) runs horizontally to resist rotation.  That’s eccentric control.

How do we train it?  Definitely not with sit-ups, crunches, or sidebends.  The former are too sagittal plane oriented and not particularly functional at all.  The latter really doesn’t reflect the stability-oriented nature of our “core.”  The bulk of our oblique strain prevention core training program should be movements that resist rotation:

While on the topic, it’s also important to resist lumbar hypextension, as poor anterior core strength can allow the rib cage to flare up (increases the stretch on the most commonly injured area of the obliques: at the attachment to the 11th rib on the non-throwing side) and even interfere with ideal respiratory function (the diaphragm can’t take  on its optimal dome shape, so we overuse accessory breathing muscles like pec minor, sternocleidomastoid, scalenes, etc).

So, to recap: I don’t think oblique strains are a new injury epidemic or the result of team doctors just getting better with diagnostics.  Rather, I think that we’re talking about a movement dysfunction that has been prevalent for quite some time – but we just happen to have had several of them in a short amount of time that has made the media more alert to the issue.  The truth is that if we worried more about “inefficiency” and not pathology,” journalists could have “broken” this story a long time ago.

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