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Preventing Pitching Injuries: You Get What You Train

Posted Apr 02 2013 7:34am
Today's guest post comes from my friend and college, physical therapist Eric Schoenberg.  Eric is an integral part of our Elite Baseball Mentorships , and will be contributing more and more regularly here to outline some of the topics we'll cover in these mentorships.

As this great article from Tom Verducci at Sports Illustrated pointed out a few years ago, injuries cost MLB clubs $500 million dollars (an average of $16+ million/team) in 2011. In addition, over 50% of starting pitchers in MLB will go on the disabled list each year. Although there are many factors that contribute to these staggering numbers, an overwhelming majority of these injuries are due to five simple words:

"You Get What You Train."

This saying was made popular by the great physical therapist Shirley Sahrmann in her work at Washington University in St. Louis. This premise (in baseball terms) covers almost every issue that we encounter in the areas of injury prevention and performance enhancement. Here are some examples to illustrate the point:

    If a pitcher is allowed to throw with bad mechanics (misuse), the result is a kid who is really good at throwing wrong and an increased risk of injury. If high pitch counts (overuse) are allowed at a young age, the result is a pitcher throwing with fatigue, mechanical breakdown, and ultimately decreased performance and injury. If a pitcher “throws with pain” (poor communication) due to pressure from coaches, parents, and teammates (culture of baseball), the result is compensated movement, decreased performance, and ultimately injury. If a “one-size fits all approach” is rolled out in a strength and conditioning program or a pitching academy, then the result will be a program that doesn’t adequately “fit” anyone. If performing “arm care programs” and long toss programs incorrectly before a game or practice is the norm, then the result will be athletes that are improperly “tuned” neurologically and fatigued before they even step on the mound for their first pitch. If a hypermobile athlete performs a stretching program to “get loose”, then the result will be an athlete that has more instability than he can handle ultimately will get injured. If we teach an athlete to get his shoulder blades “down and back” when his throwing shoulder is already depressed and downwardly rotated, then what we get is more strength in a dysfunctional position. If we don’t teach proper movement, then we will get exactly what we train. The correct exercise performed incorrectly is a bad exercise.
This point is illustrated in the videos below. In the first video, the only instruction given to the athlete was to hold the top of a pushup on the elevated surface. As you can see, there is clear dyskinesia in the scapulae which if repeated without correction would result in reinforcement of the faulty movement pattern. Without actually seeing the shoulder blades (shirt off) or at the least putting your hands on the athlete, this faulty pattern is missed and the athlete will get worse.

In the next video, the athlete is instructed to get into the same position, however the athlete is cued to “engage the shoulder blade muscles and don’t let the shoulder blades come off your ribcage”. This simple cue can be coupled with some manual correction to activate the proper muscles to achieve a proper movement pattern.

In summary, both of these videos can be called a “pushup hold” or “elevated plank,” but only one achieves the desired movement and activation pattern.

This concept of “you get what you train” becomes a bigger problem when you realize that baseball players rarely play for the same coach or in the same “system” for more than a year or two (different leagues/levels, coaching changes, etc.). In addition, it takes a while before faulty movements and overuse reach the threshold where an athlete becomes symptomatic. As a result, there is no direct cause and effect and no “blame” to assign. A coach that overuses a kid in his 13 year-old season is never identified to be the actual cause of that same kid’s UCL tear in his 16 year-old season. This lack of accountability is a huge factor in the injury epidemic across all levels of baseball.

The goal of the Elite Baseball Mentorships is to bring together leaders in the baseball and medical communities in an effort to be proactive and share ideas to help improve the overall health of the game of baseball and its players.  We'd love it if you'd join us for one of these events; please visit for more information.

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