As each new baseball season begins, we learn of more pitchers coming down with elbow problems that often lead to Tommy John surgery. To prevent this increase in pitching elbow problems, baseball teams are keeping stricter records of how many innings are pitched, how many games are played etc.
When the pitcher experiences elbow pain or discomfort, they immediately shut him down. After some rest, in some cases prolonged rest, the pitcher begins to throw again and as long as he does not experience pain, he continues to throw and eventually pitches in games.
They usually undergo some physical therapy or strengthening program during recovery which may prove effective in some cases. However, it appears that most pitchers, even those coming back from Tommy John surgery, rarely regain the ability to effectively pitch again.
To prevent injury, most teams limit the number of innings that the pitcher can pitch. This seems to be a very strict rule as there have been some recent cases where the pitchers were not allowed to pitch in crucial games for championships because they had already reached their limit. It’s as though one more pitch would rupture the elbow tendon or ligament which would then lead to surgery.
Is this the most effective way to control elbow injuries? It appears that this method which has been used for the last few years is not preventing injury. In fact the problem appears to be getting worse. This is understandable because they are ignoring two very important factors that not only prevent injury, but improve pitching performance.
Teams do not look at pitching technique (how they throw the ball) from a scientific viewpoint nor do they look at strength of the muscles specific to the actions that they perform in the pitch. For example, most coaches believe they do an adequate job of analyzing the pitchers technique simply by looking at how they pitch.
However, this is physically impossible because the action is too fast. You can only see the beginning and end of the pitch by eye. The most important part of the pitch (from a biomechanical point of view) is in the middle of the pitch where the power is produced and where most injuries originate. These actions are too fast for the eye to see.
A camera can record the pitching motion up to 32 or more frames per second. The human eye can only see about 10 frames per second and the brain but cannot recall all the detail. To see in detail the actions and how they are executed, you need stop action video film.
Perhaps even more importantly, you must have a deep understanding of the biomechanics involved in these actions. Pitching coaches must understand the full biomechanical aspects involved in the sequential kinetic chain of the joint actions. Equally important is to know what constitutes an error or incorrect action and how it can be corrected and improved
This is the only way that one can determine if the problem is in pitching technique and which joint action or actions in need of correction. The person analyzing the video clip must understand how each joint action is related and what role each joint action plays.
Most importantly, the analyst must know what the most effective joint action (technique or movement pattern) is. Only in this way can he or she determine if there is a problem and how the problem can be corrected. This is an art that must be developed over time.
The other factor that is involved in determining the cause of an injury is the strength of the muscles as they relate to the pitching technique. In other words, does the pitcher have adequate strength of the individual muscles and are to handle the forces that are experienced in throwing different pitches.
Understand that many pitchers are placed on strength training programs to strengthen the muscles of their shoulders, arms and other body parts. But if these are general exercises, (which in almost all cases they are) they will do little to prevent injury in the throwing motion. The reason for this is that general exercises are good for overall strengthening of the muscles but they do not improve performance in the skill. They have no effect on how the pitcher throws the ball.
To strengthen the muscles you need specialized strength exercises that target the muscles in the same manner as they are involved in the pitching motion. In specialized strength exercises the joint action is the same as what occurs or should occur in the pitching motion.
Most critical here is that the use of specialized strength exercises should be reserved for individual joint actions. Strength exercises that duplicate the entire throw do not strengthen each of the muscles as they are involved in the throw. Only one or two of the joint actions may be improved.
This concept of specificity is new to the field of strength training. Understanding and applying it is however, in him him critical for the prevention of injury as well as improving performance in a particular skill. In other words, not only do specialized strength exercises enhance the technique of the skill, but they also strengthen the muscles exactly as they are involved in execution of the skill technique.
Specialized strength exercises have specific criteria. Not only must they duplicate the same neuromuscular pathway as involved in the pitch but their strength must be developed in the same range of motion and with the same type of muscular contraction as involved in the skill execution. Very few exercises can do this!
Thus, the skill involved in executing a pitch (technique) and the strength of the muscles that are involved in the skill execution, are the two key factors that are responsible for the prevention of pitching injuries as well as the rehabilitation of elbow injuries or Tommy John surgeries.
Without a using technique analysis and the application of specialized strength exercises baseball pitching injuries will continue. We must start looking at these two factors. If needed, we must develop more coaches and/or assistants who are capable of doing this. If not, it should be no surprise when pitchers go down with an elbow injury. There will be no need to shed tears.