The words Tommy John have gotten as much publicity as a lot of modern celebrities over the last few years. As baseball season gets underway we hear all too often about elbow injuries, not only in the Major League, but in our youth and adolescent throwers. Unfortunately, these injuries sometimes lead to Tommy John surgery, reconstruction of the ulnar collateral ligament. So it’s not surprising that one of the most common questions I get when I work with overhead athletes is “What can I do to prevent an elbow injury?”
There are many factors that should be addressed for the throwing athlete. A few general suggestions would be:
- Don’t throw through elbow or shoulder pain
- Respect pitch counts and recommended days rest after each outing and take a minimum of 2 months of active rest every year
- Overuse and specialization have been proven to lead to elbow injury so athletes should be encouraged to play non-throwing sports in the off-season.
Strength and Conditioning
Off-season and in-season strength and conditioning programs are critical and should address not only the core and legs but rotator cuff and scapular muscle strength and control as well. The scapula and its muscles are the link between the arm and the thorax (chest).These muscles need to be strong in order to dissipate some of the stresses placed on the arm during the throwing motion. Maintaining flexibility of the throwing arm is also very important in order to stay healthy. The arm has to be able to internally rotate and come across the body during the throwing motion. A cross-body stretch as well as a modified sleeper stretch is recommended to maintain or gain internal range of motion.
Proper Pitching Mechanics
Strength and flexibility will only benefit you if proper mechanics are used during the pitching motion. At the Thrower’s Performance Program in the HSS Tisch Sports Performance Center, we perform a biomechanical video throwing analysis in order to assess pitchers mechanics during each phase of the overhead throw. During the throwing motion, power is generated from the initial push off and is transferred from the legs, to the core and finally up to the shoulder and hand. If there is a weak link along the kinetic chain, power will be lost and the arm will have to work harder to gain more velocity which usually results in injury. Using high-speed cameras and video analysis software we are able to identify these weak links and provide suggestions on how to correct individual impairments. Each thrower receives a biomechanical breakdown of their pitching motion along with a performance profile to enhance their strength and flexibility deficits. Throwing with proper mechanics, following basic guidelines and maintaining proper strength and conditioning should help reduce the risk of elbow injury in all overhead throwers.
Terrance Sgroi, Clinical Supervisor at the HSS Sports Rehabilitation and Performance Center, is a Doctor of Physical Therapy, Sports Certified Specialist, and certified in manual therapy. He has worked with a spectrum of sports medicine patients with a focus on the overhead thrower. His interests lie in the treatment of the shoulder and sports elbow, ACL pathology and hip arthroscopy. Terrance is both lead and co-author on multiple baseball biomechanical research initiatives published in peer-reviewed journals.