Training The Overhead ATHLETE SSM Updatesprobaseballchiros.com/files/2017/02/training-the-overhead-athlete.pdf · Training The Overhead Athlete ... Improving biomechanics can increase

Training The Overhead Athlete

THE LATEST SPORT SCIENCE & MEDICINE UPDATES

MARK KOVACS, PHD, FACSM, CSCS*D@MKOVACSPHD

WWW.MARK-KOVACS.COM

DIRECTOR, LIFE SPORT SCIENCE INSTITUTE

ASSOCIATE PROFESSOR, SPORT HEALTH SCIENCE DEPARTMENT, LIFE UNIVERSITY

[email protected]

KOVACSINSTITUTE.COM

Baseball

Dines et al. The Kinetic Chain of Overhead

Athletics: A Systematic Reviw of Biomechanics

and Associated Pathoanatomy. Hospital

for Special Surgery

The Shoulder & Elbow Are Many Times Not The Cause of The Problem… Many Times Shoulder & Elbow Pain Are The Result

Elbow Position From Start Till Contact

Typical Muscle Sequencing Pattern for a Simple Right Arm Elevation Movement

Deactivation of the left soleus

Activation of left semitendinosisand glute max

Activation of the right TFL and rectus femoris

Activation of right erector spinae

Initial deltoid activity

Baseball Pitch Pelvis vs Thorax

Nissen et al. MSSE 2007

This image represents a right handed picture, where the top image is the hips, and the bottom image is the torso (right and left shoulder joint centers of rotation).

Understanding the Overhead Athlete Pitcher rotates his pelvis - then upper trunk to face the

target - while abducted arm externally rotates at the shoulder.

Peak values of shoulder internal rotation torque & elbow varus torque are produced at/near maximum external rotation to decelerate shoulder external rotation, prevent elbow valgus opening, and initiate shoulder internal rotation.

Tension in the ulnar collateral ligament (UCL) absorbs about half the maximum varus torque in this position

Fleisig, G.S. and Andrews, J.R. (2015) Prevention of elbow injuries in youth baseball pitchers. Sports Health. 4 (5), 419-424

Understanding the Overhead Athlete

Research has shown similar motions and timing between youth and adult pitchers but with increased elbow and shoulder velocities, forces, and torques at higher levels.

Pitchers at the youth level also have greater inconsistency in their biomechanics from pitch to pitch. Like an adult pitcher, the young pitcher swings his arms apart and up during the leg stride



At the time of front foot contact, the throwing shoulder is abducted about 90°, and the elbow is flexed about 80°.

Elbow flexion at the time of maximum shoulder external rotation varies greatly among studies, reportedly from 57° to 100°.

From this cocked position, elbow flexion and shoulder internal rotation are initiated. Peak elbow extension velocity of approximately 2000 degrees per second is achieved shortly before ball release.



Improper pitching mechanics can lead to increased varus, late arm rotation (measured as insufficient shoulder external rotation at the instant of front foot contact), excessive shoulder external rotation, excessive elbow flexion, and improper shoulder abduction and trunk tilt.

Correcting flaws in pitching mechanics can reduce the stress on the elbow, reduce the stress on the shoulder, and/or increase ball velocity. Improving biomechanics can increase a pitcher’s chance of staying healthy and succeeding.


The misunderstood CURVEBALLDun S, Loftice J, Fleisig GS, Kingsley D, Andrews JR. A biomechanical comparison of youth baseball pitches: is the curveball potentially harmful? Am J Sports Med. 2008;36:686-692.

29 youth pitchers (11 to 14 years old) who threw fastball, changeup, and curveball pitches. There was no screening of curveball “good” or “bad” mechanics.

All who threw fastballs, changeups, and curveballs were included. As expected, the curveball had greater forearm supination than the fastball. However, elbow varus torque was significantly less in the curveball (31.6 ± 15.2 Nm) than in the fastball (34.8 ± 15.4 Nm).

Nissen CW, Westwell M, Ounpuu S, et al. Adolescent baseball pitching technique: a detailed three-dimensional biomechanical analysis. Med Sci Sports Exerc. 2007;39:1347-1357.

High school pitchers (14 to 18 years) found significantly less varus torque in the curveball (54.1 ± 16.1 Nm) than fastball (59.6 ± 16.3 Nm).

Fleisig GS, Kingsley DS, Loftice JW, et al. Kinetic comparison among the fastball, curveball, change-up, and slider in collegiate baseball pitchers. Am J Sports Med. 2006;34:423-430.

Evaluated collegiate pitchers and found no significant difference in varus torque between fastballs and curveballs. Previous cadaveric research has shown that supination does not affect tension in the UCL during elbow varus torque.

No consistent data to show curveballs before the age of 13 lead to greater surgery rates. Multiple studies have shown no difference -


Curveballs

Curveballs at a young age DO NOT/MAY NOT pose a greater threat to young pitchers.

Differences among fastball, curveball, and change-up pitching biomechanics across various levels of baseball. Fleisig, G.S., Laughlin, W.A., Aune, K.T., Cain, E.L., Dugas, J.R. and Andrews, J.R. Sports Biomechanics 15 (2). 2,2016

Ball Velocity Alone Likely Not The Only Reason For Pain/Injury

Although a weak positive correlation was present between ball velocity & shoulder-distraction force, no significant association was seen between ball velocity and elbow-valgus torque or shoulder external-rotation torque. Therefore, other factors, such as improper pitching mechanics, may contribute more to increases in joint kinetics than peak ball velocity.

Post et al (2015). Correlation of shoulder and elbow kinetics with ball velocity in collegiate baseball pitchers. Journal of Athletic Training, 50(6), 629-633

However, most other studies have shown a rather strong link with pitching velocities and UCL issues .

10 Evidence Based Recommendations for Youth PitcherWatch and respond to signs of fatigue (eg, decreased ball velocity, decreased accuracy, upright trunk during pitching, dropped elbow during pitching, or increased time between pitches). If a youth pitcher complains of fatigue or looks fatigued, rest is recommended.

No overhead throwing of any kind for at least 2 to 3 months per year (4 months is preferred). No competitive baseball pitching for at least 4 months per year.

Do not pitch more than 100 innings (in games) in any calendar year.

Follow limits for pitch counts and days rest.

Avoid pitching on multiple teams with overlapping seasons.


10 Evidence Based Recommendations for Youth Pitcher

Learn good throwing mechanics as soon as possible. The first steps should be (1) basic throwing, (2) fastball pitching, (3) changeup pitching.

Avoid using radar guns.

A pitcher should not also be a catcher for his team. The pitcher-catcher combination results in many throws and may increase the risk of injury.

If a pitcher complains of pain in his elbow or shoulder, discontinue pitching until evaluated by a sports medicine professional.

Inspire youth pitchers to have fun playing baseball and other sports. Participation and enjoyment of various physical activities will increase the youth’s athleticism and interest in sports.


Significant predictors of UCL reconstruction in MLB pitchers1) Fewer days between consecutive

games, 2) A smaller repertoire of pitch

variations, 3) A less pronounced horizontal

release location,4) A higher mean pitch count per

game,5) A smaller stature, 6) A higher mean pitch speed

significantly increased the likelihood of UCL reconstruction at the MLB level.

These data imply that recovery after pitching bouts may be just as, if not more, critical to injury prevention as pitch counts.

Whiteside et al (2016). Predictors of Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers. Am J Sports Med

According to this data, arm slots closer tothe midline of the body (ie, closer to ‘‘overhead’’) were more injurious.

Nearly one extra day of recovery between starts shows less surgeries

Predictors of UCL Injuries in MLB

1) A higher mean pitch count per game,2) A smaller stature, 3) A higher mean pitch speed significantly increased the likelihood of UCL reconstruction at th

MLB level. These data imply that recovery after pitching bouts may be just as, if not more, critical to injury prevention as pitch counts.

Whiteside et al (2016). Predictors of Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers. Am J Sports Med

What Baseball Can Learn From Tennis

Preparation Phase

From the first sign of movement until maximal external rotation of the shoulder. Which coincides at the point when the tip of the racket head points toward the ground.

1. Start

2. Release From the start stage (ball and racket at rest) until the ball is released from the non-serving hand

3. Loading From the release stage until a fully loaded lower body position. This position coincides with the elbows lowest vertical position and also maximum knee flexion

4. Cocking From the end of the loading stage until maximal shoulder external rotation coinciding with the tip of the racket head pointing toward the ground

Acceleration Phase

Begins from maximal external rotation of the shoulder until the end of ball contact.

5. AccelerationFrom end of the cocking stage until contact

6. ContactThe very short period where ball and racket impact

Follow-Through

Phase

Begins immediately post ball contact and continues through the end of the service motion.

7. Deceleration Following contact until the end of upper and lower body deceleration of the serve

8. Finish

The short period at the end of deceleration and before the initial movement to prepare for the next stroke

THREE PHASES EIGHT STAGES

Preparation PhaseFrom the first sign of movement until maximal external rotation of the shoulder. Which coincides at the point when the tip of the racket head points toward the ground.

STAGE 1. Start


STAGE 2. ReleaseFrom the start stage (ball and racket at rest) until the ball is released from the non-serving hand


Stage 3. LoadingFrom the release stage until a fully loaded lower body position. This position coincides with the elbows lowest vertical position and also maximum knee flexion

HYPERANGULATION


Stage 4. CockingFrom the end of the loading stage until maximal shoulder external rotation coinciding with the tip of the racket head pointing toward the ground

Stage 5. Acceleration

From end of the cocking stage until contact

Acceleration Phase


Acceleration Phase


Stage 6. Contact

The very short period where ball and racket impact

Follow-Through Phase


Stage 7. DecelerationFollowing contact until the end of upper and lower body deceleration of the serve

Long Axis Rotation

Follow-Through Phase


Stage 8. Finish

The short period at the end of deceleration and before the initial movement to prepare for the next stroke

Typical Issues

Internal ShoulderRotation Tightness

Tight Internal Right Shoulder Rotators

Sleeper Stretch Assessment (i.e. GIRD Self-Assessment)

Dominant ArmNon-Dominant Arm

Hip Range of Motion

Ankle Dorsiflexion Assessment< 10cm INCREASED RISK OF HAMSTRING INJURY in Australian Rules Football Athletes (Gabbe et al SJMSS, 2006)

> 14cm REDUCED RISK OF SHOULDER INJURY in Cricket Fast Bowlers (Dennis et al, BJSM 2008)

Take Care of The Details

Use Evidence TO Guide Your Training and Treatment Plans

Focus on The Kinetic Chain Lower Body FirstStability Before Strength Test, Train, Treat, Measure - REPEAT

Questions

Mark Kovacs, PhD, FACSM, CSCS*D@mkovacsphd

www.mark-Kovacs.comDirector, Life Sport Science institute

Associate professor,Sport health science department, life university

[email protected]

Documents

Training The Overhead ATHLETE SSM Updatesprobaseballchiros.com/files/2017/02/training-the-overhead-athlete.pdf · Training The Overhead Athlete ... Improving biomechanics can increase