Brian Schiff’s Blog
Injury Prevention, Sports Rehab & Performance Training Expert
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I recently featured this exercise in my online column for PFP Magazine. This is a great arm care exercise that should be part of every overhead athlete’s routine, especially my throwers. I like to use these types of exercises to prepare the shoulder for higher level lifts as well as serve as staples of an in-season or off-season arm care program.
Click here to read the full column.
High school baseball season is upon us. My son is a high school junior and recently verbally committed to pitch for a Division 1 school. He has worked hard to earn that offer, but the part most people do not see is the arm care and recovery work we do for him behind the scenes. Below is a recent picture of him in action.
I see lots of baseball players in my clinic ranging from 10 year olds to my MLB guys. One of the biggest issues I confront in my players (more commonly pitchers and catchers) is a condition known as internal impingement. While not the same thing as subacromial impingement, it still can impact the rotator cuff. Essentially, there is friction that causes irritation and in some cases injury to the rotator cuff and/or labrum. This usually manifests as pain in late cocking and the inability to throw hard without pain. Pitchers report decreased velocity and catchers struggle to thrown down to second with their their normal ease.
One of the most common issues leading to this is a loss of total shoulder motion on the throwing arm. Most notably, some players display significantly less internal rotation (IR) range of motion. Some loss of internal rotation is normal and expected over time provided they gain enough external rotation (ER) on the throwing side to counterbalance the asymmetry. Often, too much throwing early in the season or a big jump in pitch count/intensity/volume coupled with the ROM loss causes pain. This can occur suddenly or gradually build up over a few outings or games.
If you follow my blog, then you already know I have a 16 y/o left-handed son who pitches. As a sophomore, he is in the early stages of recruiting and has been to 3-4 showcase camps. He has good size at 6’3″ tall and 184 pounds. He has been up to 82 mph.
We have been told he projects at the D1 level, but he just needs to throw a little harder. Baseball is all about bigger, faster and stronger these days. Analytics and numbers rule the day. Coaches have told us that once he consistently throws 85 plus, the offers will start to roll in.
So, the big push for many pitchers today is gaining velo. There are lots of programs and “experts” on the subject offering online programs, weighted balls, velocity training tools, throwing programs, etc. The two questions I always have are:
- What is safe for throwing athletes?
- What is effective?
As a physical therapist, I only want to pursue things that satisfy both questions above. Personally, I do not believe there is a quick fix, or any one program that will deliver the goods.
Shoulder impingement is a common problem for many clients. Specifically, some clients will suffer from internal impingement as a result of a significant loss of internal rotation range of motion, also known as GIRD (glenohumeral internal rotation deficit). This has been widely researched in baseball players, and it is a common issue for overhead athletes. Of note, it can also impact those doing repetitive overhead lifts.
It is common to see asymmetry in internal range of motion for the dominant and non-dominant arms. For those clients who have a total shoulder motion asymmetry greater than 5 degrees, it becomes more important to resolve internal range of motion deficits based on the current literature. In my previous post, I revealed how to improve soft tissue mobility. In this post, I will review the sleeper stretch and cross body stretch to improve posterior shoulder mobility while increasing internal rotation.
The video below from my column ‘Functionally Fit’ for PFP Magazine will demonstrate how to do these stretches.
This is a follow-up to my previous post with respect to scapular strengthening for optimal shoulder function. Serratus anterior weakness is a common issue with overhead athletes, especially throwers. It may present clinically as scapular winging, however, it often fatigues quickly with repetitive throwing and contributes to scapular dyskinesia and shoulder dysfunction. Since throwing is an asymmetrical activity, I like to include some unstable and progressive strengthening exercises for the dominant arm.
In the video below (as part of my ‘Functionally Fit’ column for PFP Magazine) I will demonstrate how to use a bottom up kettle bell approach to strengthen the serratus anterior muscle.
To see the full article with progressions and regressions check out the link below:
http://fit-pro.com/article-4136-Unilateral-bottom-up-serratus-punch.html
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