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Last month we talked about how we leverage technology in the decisions we make on injury risk and performance. Coupling our strength, flexibility, and motion capture data acts as a road map to traversing through one’s mechanics, allowing us to see speedbumps and where they occur along the way. If our throwing velocity was in the form of water within a bucket, our goal would be to move from point A to point B as efficiently as we can without any water splashing out. Each speedbump, or movement inefficacy, causes water to splash out of the bucket. Our bodies often combat movement inefficiencies through compensations in our throwing mechanics. These compensations are essentially your body parts “cutting corners” to get to where they need to be to get the ball out on time. The more we cut corners, the more stress that’s placed on the body, especially the throwing arm. Below, we’re going to dive deeper into these stresses, what they mean, and how to go about understanding their effect on our health.

*DISCLAIMER: This content is meant to purely skim the surface of the mechanisms behind throwing injury and meant to lightly inform the average reader. Some concepts are generically touched on for the sake of content length*

Throwing-related injuries in pitchers don’t just go from completely healthy tissue to completely tearing suddenly during a throw. Throwing-related injuries happen as a result of small micro-tears that gradually get bigger if not properly taken care of. These tears start microscopically small. Due to the violent and swift nature of the throwing motion, these tears incrementally grow as we throw day-to-day. The good news though, is that with proper rest, our bodies can heal these tears on their own!

What causes the tears to become more severe is when we don’t allow time for the body to heal. Overuse injuries happen as a result of muscle fatigue. In fact, pitchers who threw with pain or fatigue were found to be 4 to 36 times more likely to sustain an injury.¹ Fatigue is influenced by two fashions, loading and rest. Imagine that you have never squatted before and that you’re tasked with squatting the barbell every day for a month. At first, the bar is going to feel pretty heavy as you’ve never subjected your body to that load before. You’ll likely feel sore and tired those following days, but the soreness goes away soon after. As you approach the 30^th day, you’ll notice that you can more easily squat the barbell compared to the beginning of the month. Now, why are we talking about squatting during a discussion about arm injury? Well, the same principle applies to the tissues and fibers within your arm. When you first picked a ball up as a kid, I’m sure it felt way heavier to you back then compared to right now. That’s because your body has become substantially stronger since then while the weight of the ball has remained the same. Where tearing (remember: micro-level, not large tearing) occurs is when we suddenly increase the loading on the musculature, typically induced by weighted balls.

DISCLAIMER #2: I am a huge proponent of weighted balls and recommend them daily. This article is not against them in any fashion

When squatting, we don’t jump from the barbell to 225 lbs in a day, right? The same goes for when we use weighted balls. On-ramping is a term relating to the process of meticulously and effectively increasing the weight of plyocare balls that allows athletes to train with them at reduced risk for injury. The term stems from the on-ramps we use when driving onto the interstate, where we gradually increase our speed to match that of the cars already on the interstate. In terms of weighted balls, this involves athletes starting at low weights. As an athlete’s body becomes more accustomed to the weight (and ultimately the loading placed on the throwing shoulder and elbow from said weight), a diligent pitching coach who has been closely watching their progress increases the weight slightly. Altering the sets and reps used between drills for each weight helps acclimate athletes as well, where sometimes athletes will go up in weight across sets. As disclaimer #2 astutely points out, I’m a big believer in weighted ball use and prescribe it daily to our guys here at UNO as well as those in the UNO Pitching Lab.

The second way we can influence muscle fatigue is through rest. Relating back to the squatting example, think about which scenario will have you more rested: a) one minute between sets or b) five minutes between sets. The correct answer is five minutes between sets as it allows more time for the body to get back to its resting state. As you would have guessed, this same principle applies back to throwing. Our bodies are more fatigued when we throw in back-to-back games, if we lift heavily in the weight room before we play a game, if we throw more pitches than we’re used to, etc. This doesn’t mean you can’t or shouldn’t do either of these things, we just have to be cognizant of how we go about each situation. If you’re a starter who normally throws competitively once every week, then your body is not going to be used to the loading placed upon it from back-to-back appearances. The same goes for if you move your heavy upper body day to the day of your start. Your muscles will likely be more fatigued as they’ve been given less time than normal to repair themselves. This is why we see starting pitchers, especially at the college and professional level, only go a few innings during the first weeks of the season as their bodies haven’t been subjected to the massive pitch counts typically brought on from throwing later in the game. Any time we are making adjustments, whether it's with a new pitching role or your weekly schedule changed, we need to be aware of how much rest we give our bodies. If a change is made, gradually adjust your weekly schedule to accommodate the heavy and light days you expect to face.

In your pitching biomechanics report, we will cover variables such as Shoulder Distraction Force, Shoulder Abduction Torque, Elbow Varus Moment, and more. These variables describe the stress placed on your throwing shoulder and elbow as you pitch. Underneath each section, you’ll find descriptions written by myself detailing what each variable means, why we care about it, and how much of it your body experiences. Typically, larger amounts of stress are a result of your throwing mechanics. The greater your movement inefficiency, the more loading that’s going to place on your shoulder or elbow as it, for lack of a better term, “shoulders the load”. As a general rule of thumb, pitchers that address movement inefficiencies responsible for the observed joint loads typically see the loads decrease. Sometimes though, loads are high just because we throw hard. Force = mass x acceleration, right? The bigger we are and the harder we throw relates to the force our body experiences, regardless of mechanics.

Variables that are higher than preferred are flagged within the text and noted for monitoring going forward. This doesn’t mean that you’re due for a SLAP tear or TJ within the next month. Athletes A and B might have the same amount of stress on their elbow, but Athlete A may be unaffected by it due to their muscle health. If they’re in good shape from a flexibility and strength standpoint, their body can better handle and accept loading compared to Athlete B who isn’t as strong. Biomechanics evaluations, whether done at the UNO Pitching Lab or anywhere else, are not black magic. At the time of this post, they will not be able to specifically state that any certain individual is going to tear their UCL within their elbow fourteen days, six hours, and two minutes from now. The beauty behind our current state of knowledge is that we can spotlight specific areas and bring them to the attention of players, parents, coaches, etc. We might flag something to monitor and a player might never feel anything. Or, we might flag something, and two months down the road that player starts to feel a new sensation within their arm. Knowing that their pitching evaluation flagged them for a high amount of stress within that area, they know to speak up and be real with their parents and coaching staff. Getting as many personnel on the same page regarding one’s health is crucial. Multiple minds can then decipher the root of the new sensation and thus, address it.

It would take weeks (or a textbook-sized post) to give a discussion about injury the respect it deserves. When touching on forces and torques during report meetings, the energy can leave the room when something is mentioned to be a tad too high. This is why I wanted to bring this issue to the forefront in that high forces and torques throughout the body don’t spell immediate doom. Instead, we need to educate ourselves on the cause, evaluation, and treatment of throwing-related injuries so that we are prepared once something arises. Our pitching evaluations look at injury risk from a clinical and biomechanical lens, allowing us to compare and contrast results to more accurately understand what’s happening and what’s causing it. If you’re a pitcher currently struggling with a nagging arm injury you can’t shake, I highly encourage you to come check us out.

¹Olsen, S. J., Fleisig, G. S., Dun, S., Loftice, J., Andrews, J. R., Olsen 2nd, S. J., Fleisig, G. S., Dun, S., Loftice, J., & Andrews, J. R. (2006). Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. American Journal of Sports Medicine, 34(6), 905–912.

We’ll “talk more shop” in the lab when that day comes!

Tyler Hamer, Co-Founder & Head of Operations

Have an idea for our next post? Email us at bmchpitchinglab@unomaha.edu!