Overhead Throwing: A Strength & Conditioning Approach to Preventative Injury

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1 By: Michael E. Bewley, MA, CSCS, C-SPN, USAW-I, President, Optimal Nutrition Systems Strength & Conditioning Coach for Basketball Sports Nutritionist for Basketball University of Dayton Overhead Throwing: A Strength & Conditioning Approach to Preventative Injury Throwing a baseball is one of the single most stressful activities in all of sports in terms of the stress placed on the shoulder joint. However, baseball players and coaches neglect this physical tool every day at practice. Coaches spend countless hours with pitchers working to improve technique, yet very little emphasis is placed on strength training as a means to combat the high-velocity mechanical stress associated with overhead throwing. Often a coaches idea of strengthening the throwing arm consists of his players throwing together in the outfield before practice or a game so that their arm is warmed up enough to play. By introducing a strength-training component into a weekly regimen, players and coaches can expect reduction in the mechanical stress associated with overhead throwing while preventing injuries and the on-set of muscle imbalances. These imbalances are what lead to injuries and these injuries hinder a player s ability to train at a high level. Before we take a look at a specific strength-training program itself, I think it is important that we review the anatomical structure of the shoulder and the muscle groups that are heavily responsible in accelerating and decelerating the throwing arm. By becoming familiar with these structures I believe the overhead throw can be better evaluated and incorporated into a strengthening exercise.

2 Of the nine muscles that cross the shoulder joint the four deep muscles of the shoulder---subscapularis, supraspinatus, infraspinatus, and teres minor---strengthen and stabilize the shoulder joint (Figure 1). The muscles join the scapula to the humerus. The tendons are arranged as to form a nearly complete circle around the joint. This arrangement is referred to as the rotator cuff and is a common site of injury in baseball pitchers, especially tearing of the supraspinatus muscle tendon (5). This tendon is especially predisposed to wear and tear changes because of its location between the head of the humerus and acromion of the scapula, which compresses the tendon during shoulder movement (2). If, for some reason these muscles cannot do their job, major motions of the shoulder become impossible---forget throwing a ball, bench pressing, or even combing your hair! The Rotator Cuff Muscles (Figure 1) Tortora, G.J. Principles of Human Anatomy, 7 th Edition Throwing motions involve the rotator cuff in two ways. First, throwing a ball is basically an attempt to throw your arm away from your body. The rotator cuff muscles, along with several others, prevent you from succeeding. As a player throws the baseball, the front of the shoulder accelerates the arm forward while the back of the shoulder is relaxed. The back of the arm must then decelerate there after the ball is released. Second, although throwing involves several actions at the shoulder, it really

3 amounts to a case of high-powered internal rotation. It is the external rotators the infraspinatus and teres minor which are responsible for deceleration of the arm (2). These muscles are the ones responsible for deceleration of the throwing arm that are the major focal point in our strengthening program. The reason for this is the front shoulder (accelerator muscles) is repeatedly trained from daily throwing more than the rear shoulder (decelerator muscles). As a result of this, nearly 72% of all throwing injuries occur during deceleration, especially rotator cuff related (3). When designing a strength-training program for baseball players it is important that the strength-training program be effective in preventing injuries and muscle imbalances. This can be accomplished by developing muscle strength throughout the entire shoulder joint while targeting the muscle groups heavily responsible in decelerating the throwing arm. The following thrower s exercises are designed to strengthen the major and minor muscle groups involved in throwing. The strength program requires 2 training days per week. Players alternate between 2 workouts (Table 1) and allow at least 48 hours of recovery between each workout. Each workout has a different emphasis so that each muscle is challenged. The reps and sets for each exercise can be found in Table 2. Players perform the greatest number of exercises and sets in the off-season when they are attempting to build shoulder strength and stability. As the in-season training approaches the number of exercises and sets decreases to compensate for increased throwing. Strength Training Exercises (Table 1) RTC Series #1 RTC Series #2 Internal/External Rotation 0 Abduction Internal/ External Rotation 90 Abduction Medial Deltoid Exercise Supraspinatus Exercise Prone Shoulder Extension for Latissimus Dorsi Prone Shoulder Abduction for Rhomboids Diagonal Pattern (D1) Flexion Diagonal Pattern (D2) Flexion Diagonal Pattern (D1) Extension Posterior Deltoid Shoulder Flexion Seated Row for Rhomboid Strength Serratus Anterior Strengthening Exercise

4 Exercise Periodization (Table 2) Week 1 & 2: Week 3 & 4: Week 5 & 6: Week 6 or <: 1 set x 10 reps of each exercise 2 sets x 10 reps of each exercise 3 sets x 10 reps of each exercise 3 sets x 15 reps of each exercise Internal Rotation at 0 Abduction Involved hand will grip tubing with arm at the side of the body and the elbow bent to 90. Keeping the elbow of involved arm fixed to the side, pull the arm across the body. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level. External Rotation at 0 Abduction Standing with involved elbow fixed at the side, elbow at 90 and involved arm across front of the body. Pull out with arm keeping elbow at side. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level.

5 Internal Rotation at 90 Abduction Grip tubing. Stand with shoulder abducted to 90, externally rotated 90 and elbow flexed 90º. Keeping shoulder abducted, rotate shoulder forward, keeping elbow at 90. Hold 2 seconds and slowly. Refer to Figure 2 for rep and sets that correspond to your exercise level. External rotation at 90 Abduction Grip tubing. Stand with shoulder abducted at 90 and elbow bent to 90. Keeping shoulder abducted, rotate shoulder back keeping elbow at 90. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level.

6 Deltoid Exercise Stand with arm at side, elbow straight and palm against the side. Raise arm to the side, rotating palm up as arm reaches 90. Continue to raise arm to shoulder height, lower slowly. Refer to Figure 2 for rep and sets that correspond to your exercise level. Supraspinatus Exercise Stand with elbow straight and thumb down. Raise arm to shoulder level at a 30 degrees angle in front of the body. Do not go above shoulder height. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level.

7 Prone Shoulder Extension for Latissimus Dorsi: Lie on table, face down, with involved arm hanging straight to the floor and palm facing down. Raise the arm straight back as far as possible. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level. Prone Shoulder Abduction for Rhomboids Starts by assuming a 90º bent over position with the back flat, chest parallel to the floor and arms hanging fully extended in front of the body. Then lift the dumbbells up parallel to the floor with a slightly forward motion. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level.

8 Diagonal Pattern (D1) Flexion Grip tubing in hand of involved arm, begin with arm out from side 45 degree and palm facing backward. After turning palm forward, proceed to flex the elbow and bring arm up and over uninvolved shoulder. Hold for 2 seconds. Turn palm down and slowly reverse to take arm to starting position. Refer to Figure 2 for rep and sets that correspond to your exercise level. Diagonal Pattern (D2) Flexion Involved hand will grip tubing across body and against thigh of opposite side leg. Starting with palm facing down, rotate palm up to begin. Proceed to flex elbow and bring arm up and over involved shoulder with palm facing inward. Turn palm down and slowly return to starting position. Refer to Figure 2 for rep and sets that correspond to your exercise level.

9 Diagonal Pattern (D1) Extension Involved hand will grip tubing handle overhead and out to the side. Pull tubing down across body to opposite side of the leg. During the motion lead with your thumb. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level. Posterior Deltoid Shoulder Flexion Starts by assuming a 90º bent over position with the back flat, chest parallel to the floor. Bring elbows to shoulder height first, then extend arms straight out until parallel with ground. Keep arms for 2 seconds and slowly return to starting position. Refer to Figure 2 for rep and sets that correspond to your exercise level.

10 Seated Row for Upper Back and Rhomboid Strength Begin by facing the machine and placing the feet on the foot rests with the legs slightly bent. The torso is erect while holding the seated row handle with elbows fully extended. While pulling backward, keep the body erect and stationary. Once in this position the athlete pulls the weight to the stomach with the arms tracing the side of the body while concentrating on squeezing the shoulder blades together. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level. Serratus Anterior Strengthening Exercise Start in a push up position on the floor. Hand position should be just outside of shoulder width with elbows at 30º from torso. Press the torso up while maintaining a flat back. Hold 2 seconds and slowly return. Refer to Figure 2 for rep and sets that correspond to your exercise level.

11 Resources 1) Arroyp, JS. Special considerations in the athletic throwing shoulder. Orthop. Clin: 1997, Vol.28, No.1 2) Belvin, F.T. Rotator cuff pathology in athletes. Sports Medicine, 1997, Vol. 24, No.3 3) Fleisig, G.S.; et. al. Biomechanics of the overhand throwing with implications for injuries. Sports Medicine., Jun:21(6): , ) Kvitine, R.S. Shoulder instability in the overhand or throwing athlete. Clin. In Sport Med, 1995, Vol. 14, No.4 5) Tortora, G.J. Principles of Human Anatomy, 7 th Edition. Biological Sciences Textbooks, Inc., 1995

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