Teaching Better Baseball

Written By Jim Moran, PT, Shoulder Specialist

What is shoulder impingement?

This condition can also be referred to as thrower’s shoulder or swimmer’s shoulder. Shoulder Impingement is when the all important rotator cuff tendons become pinched in the subacromial space. The subacromial space is where two bones, the acromion (roof of the joint) and the humeral head (the ball of the upper arm bone), come almost together creating a narrow passage way in which the supraspinatus (one of the four rotator cuff muscles) tendon must pass through. Under optimal conditions the rotator cuff tendon is not getting rubbed, infringed upon or pinched in this tight space. During impingement, the rotator cuff tendon is pinched between the acromion and the humeral head causing inflammation, fraying and tearing if this condition is not corrected.

What causes impingement in the overhead athlete?

Tommy John surgery, known in medical practice as ulnar collateral ligament (UCL) reconstruction, is a surgical procedure in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, knee, or foot of the patient).

In the last two years, you've seen two of the top pitchers in baseball shut down indefinitely for UCL injuries that will require Tommy John surgery:  Stephen Strasburg in 2009 and now Adam Wainwright in 2011.  What's the cause for these injuries?  Simply put, UCL and other pitching injuries occur over time as the stresses and forces pull the bones humerus, ulna and radius apart while the UCL holds it all together.  Imagine a tiny rubber band holding your bones together as the larger muscles in the body pull them apart.  Over time and as young players develop more strength, these ligaments (bands) which do not grow as muscles do begin to break down and in some cases, such as the two above, simply give out and tear.

How do we prevent injuries as serious as UCL tears?  Truth is, pitching injuries are repetitive stress injuries.  The only way to POSTPONE these injuries enough to have a long and prosperous baseball career (no matter how far you get), is to maintain a consistent throwing regimen coupled with proper mechanics and arm strengthening exercises.  

Stay tuned for my next article and video showing 9 simple exercises for strengthening and developing your pitching arm!

Yours in the game,

Coach Ruben Corral