baseball

Maybe it's not your arm.

I'm back talking about baseball again... I would apologize, but it's definitely going to happen more!

Spring and summer baseball is in full swing.  Now that the cold has finally left us, baseball tournaments are pretty much every weekend around here.  It's pretty common for youth leagues to have 3-5 games in a weekend (which is crazy, in my opinion), and so with more baseball comes the risk of more injury, especially for the pitchers.

But what if I told you that arm fatigue may not be from the arm?

It's fairly well known and documented that player fatigue is correlated with a higher rate of injuries, and youth players are more likely to pitch in multiple games in a day and rest less.  This is a big reason USA Baseball started the PitchSmart program, a guideline to how many pitches a player should throw dependent on their age.

So we know too much pitching can lead to injury, but it is arm fatigue that is leading to these injuries?  Some studies may show otherwise...

A study done in 2016 by Chalmers et al showed that fatigue and a drop in velocity is normal within a game situation.  What they found, however, that the loss of velocity is not due to arm speed, but actually to leg muscle fatigue first.  This study demonstrates that velocity may be directly more correlated with leg strength than arm speed!  But if you look up all these programs online, every coach promises you more arm speed or strength.  Maintaining shoulder-hip separation, proper thoracic flexion and rotation, landing leg knee flexion, and total shoulder range of motion are also important factors into pitching injuries.

We talk a lot about arm injuries when speaking of pitchers because it is the most common injury to happen! If you look at our blog from March 28th, you can see what the chances of being injured and what that injury is.  It's important to discuss because we are seeing a significant increase in youth and adolescent injuries and surgeries.  While we may not know EXACTLY what's causing this rise, we have an educated guess as to multiple reasons why and try to hit all of the factors involved.

Remember when I said leg fatigue leads to lower velocity?  To me, this is one of the EASIEST fixes in sports!  Although it's not glorified like football, strength training is incredibly important for a baseball player.  All of the power for a baseball player comes from the legs, whether it's pitching, throwing, running, or hitting.  Without properly strengthening the body, you are losing out on power potential!  Now I know that strength training isn't fun, nor does it make for good stats and Instagram posts.  I get it, chicks dig the long ball.  But in order to hit home runs, throw a nasty fastball or breaking ball, or throw out the runner at home, you have to prepare your body.  And that preparation is a combination of skill work, strength training, mobility and body care, and just general maturity.

It's easy to focus on what hurts- it's much more difficult to focus on what is causing the pain to begin with.

"What's the best stretch for..."

This has honestly become one of my LEAST favorite questions.  As soon as people hear what I do, they'll start telling me about all their ailments and then will usually ask me, "What is the best stretch for *insert joint problem here*?"

The answer- it depends.

There is no assigned stretch for each pain.  Now that answer varies from the other junk that it is online.  I see it every day on Facebook and Instagram- 7 stretches for should pain, 3 stretches you should do every day, relieve back pain with these stretches.  But it's not that easy.  All pains are not made equal, so all "stretches" are not the same either.

All that being said, I do assign stretches to almost all of my patients! Now I seem like a hypocrite... but here at Victory, we try to assign appropriate stretches according to the diagnosis and the type of pain.  So let's discuss all of the different types of stretching:

  1. Static stretching- this is the one that everyone is familiar with.  You take a joint, stretch it, and hold.  However, I usually see just about everyone doing this wrong.  For the most part, a stretch should not be painful, so stretching beyond what is tolerable is not necessarily better.  Once you feel a stretch in a muscle/tissue/etc, then you should stop there and hold.  Also, most people do not hold a stretch long enough.  10 seconds does not change anything.  If you want to actually stretch something, you need to hold it somewhere around 2 minutes.  Now, that doesn't have to be 2 minutes straight, but a total of 2 minutes of stretch. So if you hold for 30 seconds, you should repeat that 4 times.
  2. PAILs- this stands for Progressive Angular Isometric Loading and is a foundational component of the FR and FRC system.  I teach this a lot to my patients due to it's therapeutic benefit.  The idea behind this is to really enhance a static stretch, but also increase strength in a lengthened position.  If you take a joint, stretch it, then start contracting the muscle (or stuff) into the opposite direction with about 10-20% max effort, you are adding extra signal to the stuff you are trying to stretch.
  3. PNF- proprioceptive neuromuscular facilitation is a popular stretch for athletes.  A similar idea to PAILs, but using a lot more effort against someone or something.  You push the joint against a resistance for 10-15 seconds then relax and your joint magically gets more range.  Except it's not magic, it's science.  You are taking advantage of the nervous system and telling certain tissues to temporarily relax.  While this is a moderately good warmup, it does not lead to any permanent change and the tightness will come back in a few minutes to hours.
  4. Dynamic stretching- this is what is involved during a typical warmup.  Spending time moving a joint through a range of "motion to get the blood flowing".  While this does help circulation, it is actually more of a primer for the nervous system.  Increasing signal to the joints you are going to use helps prepare the brain to utilize the joints you want to be using for whatever activity you are doing.  At Victory, we highly utilize CARs, another element to the FRC system.  This slowly take your joint through it's full range of motion to both increase the efficiency of the nervous system to that particular joint, help increase range of motion or keep it, help keep joints healthy, and decrease pain or inflammation.

So when people ask me "whats the best stretch...", my answer is "depends".  Assigning stretches to random body parts can be beneficial but also detrimental and make the problem worse.  If you want to learn more about you can take care of your body, schedule an appointment to figure out what your problem is or come join one of KINSTRETCH classes, where you take your body through full ranges of motion and teach really great exercises to do at home for your joints.