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Message
re: Tommy John - Not If, but When?
Posted on 5/3/23 at 11:01 pm to deathvalleytiger10
Posted on 5/3/23 at 11:01 pm to deathvalleytiger10
quote:Okay strawman.
If it’s just velocity, everyone would get injured that’s hitting high numbers. That’s not happening.
0
Posted on 5/3/23 at 11:18 pm to GeauxATX
Advances in strength straining and the science of the game that has made a pretty good big league fastball in the mid 1990’s anywhere from 90-92 mph to today where that would be considered below average with 94-97 as the norm with many that can routinely hit 100 mph. The spike on breaking balls has also greatly increased and to do that requires more torque on the elbow. Also in the last 30 years the widespread use of the cutter has upped the amount of elbow injuries. Pitchers that don’t have the natural mid 90’s heat could get by throwing cut fastballs at 90 relying on movement over velocity. That pitch has ended the careers of countless players much like the almost now extinct splitter. As a Dodger fan I remember growing up watching Hideo Nomo come from Japan in a time where that didn’t happen he started the now rich pipeline of Japanese talent much like Chan Ho Park did for the Koreans. Nomo had the nastiest forkball I’ve still ever seen in the begging of his career when he was throwing 93-95. In just a few short seasons injuries to his elbow and shoulder had him topping out at 90 on a good day and a shell of his former self. This is only going to continue too. Kids are going to get stronger and stronger but there’s only so strong you can make soft tissue.
Posted on 5/3/23 at 11:19 pm to GeauxATX
TJ is widespread because it is effective. Causing an increase on two fronts.
1. Some players recovering from Tommy John would simply no longer be players but for the advances in the surgery.
2. Some players/coaches view it as a get out of jail free card. Trade arm care for reps and game experience and hit the TJ reset button when it catches up to you.
I don’t endorse #2. it’s just my opinion on a contributing factor.
1. Some players recovering from Tommy John would simply no longer be players but for the advances in the surgery.
2. Some players/coaches view it as a get out of jail free card. Trade arm care for reps and game experience and hit the TJ reset button when it catches up to you.
I don’t endorse #2. it’s just my opinion on a contributing factor.
This post was edited on 5/3/23 at 11:20 pm
Posted on 5/4/23 at 1:07 am to lsu777
quote:
hs kid needs to get their bodyweight to min 2.5xheight in inches and really to 2.75 to really be able to throw with high intent safely
That is interesting. So, a HS kid with an atypical height of 6'2" (74 inchs) would need to weigh ~200 lbs. I could see that being a problem as the kid likely only got to 6'2" with an abnormal growth spurt in height leaving him rather thin.
I don't disagree at all with the theory, but that it would be tough to attain for your average HS baseball player. And I do agree with you strongly that any kid going into HS planning to play any sport should be doing significant resistance training and moderate weight training before 9th grade and ramp up from there.
I also have a family member involved with Driveline so I'm probably a little biased, but what they are doing is extremely impressive.
Posted on 5/4/23 at 7:28 am to Basura Blanco
quote:
I also have a family member involved with Driveline so I'm probably a little biased, but what they are doing is extremely impressive.
you are not biased, you are educated. driveline, cressey, atp, thread, brx, florida armory and couple others are leading the charge but driveline, cressey, atp and thread are so far out front on everything its insane.
the baseball performance center at LA Tech is one of the leading places for looking into the science of these things.
Posted on 5/4/23 at 7:55 am to GeauxATX
Overuse with inconsistent technique at an early age has been wrecking arms for years.. throw in the importance placed in velocyand you have a lot of youth overthrowing for their body. Velocity without injury usually takes years to develop.. now we have all these programs attempting to add unsustainable amounts of velo in to short a timeframe
Posted on 5/4/23 at 12:02 pm to deathvalleytiger10
quote:
The American Academy of Orthopedic Surgeons classifies UCL injuries as “overuse injuries.” This article with some of the best in the world at treating UCL injuries provides much more information
just understand that fixing UCL tears is not the same as understanding how to prevent them
here is some links to read. much of this info comes from in house studies
hoe the 90mph formula helps prevent ucl tears
so the above link goes into it but here is a overview
-the UCL ligament can only handle 30-40NM of valgus stress
-a fast ball puts the most stress on the elbow, more than a curveball, change, splitter, slider etc LINK
- the fastball causing the most stress is based on velocity only. once velocity is equated the curveball then slider causes the most, but overall fastball causes much more stress on the elbow. there is quite a bit of debate in the community right now if the supination of the forearm during a cruve/slider is distributing the load differently onto the elbow that we dont understand right now. again no definite answer. Phil Rosengren actually lays out the case they should throw curves LINK
- what we do know, pitching off a mound puts roughly 50-120nm of valgus stress on the elbow at the ucl....
quote:
Looking at the current research on valgus stress levels that the ulnar collateral ligament is up to 3 times weaker than the amount of force is exerted on a throw with a baseball.
so if the ucl can only 30-40nm how do we not tear it immediately when throwing off a mound?
-simple the muscles surrounding the elbow and those that provide stability and deceleration need to be really strong. what are those muscles
forearm- we know grip strength is huge and loss of grip strength is big indicator that UCL injury could happen if you throw with intent knowing that you have had a loss of grip strength from baseline. you can find the research here LINK the links to the studies are in the article.
lat strength- we know that the lats are the primary deceleration muscle used during the pitch. How do we test this and mobility required to throw....we test chin up strength, chest to bar. direct from ATP in house study on 1000 athletes
quote:
-If you can do a 1.5+x bw reverse lunge, 2+x deadlift, and 13+ bw chin ups you increase your likelihood of not having UCL surgery by 480%
?
quote:
Correlation to decrease risk of injury (in order):
1) chin-up
2) reverse lunge
3) deadlift
reverse lunge-....to quote Dr Heenan
quote:
If you ahve elbow pain, the answer isnt advil and icing, its fixing your reverse lunge
Fix the lunge — you fix the pelvis
Fix the pelvis — you fix the lumbar spine
Fix the lumbar spine — you fix the thoracic spine
Fix the thoracic spine — you fix the ribs
Fix the ribs — you fix the scap
Fix the thoracic spine and ribs — you fix the cervical spine
Fix the cervical spine and ribs — you fix the glenohumeral joint
Fix the glenohumeral joint — you fix the elbow
why does this work, lets look at kinimatic chain? because most elbow issues are derived from scap stability issues. scap stability issues are usually trunk issues. most trunk issues are pelvis issues and most pelvis issues derive from lack of stability in the lunge position.
from heenan, based on a 1000 person in house study at ATP--
quote:
-If you can do a 1.5x bw reverse lunge, you increase your likelihood of not having UCL surgery by 98.3%
LINK
deadlift- the why....
quote:
t’s a multipurpose metric to test force production, control of the spine, and grip strength (which has many neurological benefits for everyday people and some unique to throwers) for limiting factors that can decrease ball velo and potentially increase risk of injury. -
The deadlift is self-limiting in many ways and tests whole spine/pelvis control which has implications from basically every joint in the boys. It’s a fantastic catch all.
-
Utilized properly, the deadlift is arguably the most important movement we have in our gross movement database. How you execute has large global impact to the body.
-
The deadlift asks you to control the totality of the spine (most people forget to control their neck). We want the body to have a diverse set of movements that we can control. Total body tension/relaxation and control are vital for force transfer. It’s just a simple way to test a ton of qualities.
[url=https://ibb.co/Vj7ZcX5]
[/url] i dont have time to go into each one of these. but Ryan Crotin has a bunch of research out on things LINK where he talks about relationships of ER/IR strengths and other items where he discusses injury prevention.
here is a paper on the "throwers 10" for armcare LINK
driveline items that go over the studies on the ucl stresses
how elbow injuries happen LINK
comparing-flat-ground-mound-elbow-torques
post TJ research
what causes TJ surgery why overuse is not the problem
how muscles protect the ucl
why dr andrews is wrong LINK
final one im gonna post and is essentially a review of everythign and blowing holes in many of the myths by Kyle Brody
LINK
This post was edited on 5/4/23 at 12:04 pm
Posted on 5/4/23 at 4:49 pm to lsu777
Thanks for the links. Unfortunately, I was hoping to get actual scientific research to support your previous posts. Most of these are claims, theories, and opinions by the different authors. These ideas could all be proven 100% correct, but as of now it is not.
A disclaimer... I have spent time with several of the people you linked in this and previous post. I have known Randy Sullivan with the Florida Armory since before he even opened the facility. I have seen his training first hand at his Florida facility. I am a big believer in what he teaches.
I have also been involved with Dr. Jeff Dugas at Andrews Sports Medicine, along with Kevin Wilk(the pt that has rehabbed countless professionals in pretty much every sport), and also Dr. Glenn Fleisig that has published several research papers with Dr. Andrews, Kevin and Dr. Dugas.
Back to Randy at Florida Armory. His program involves much of the training metrics you list from the other groups. He uses the motus to measure stress on the elbow and utilizes film to correct biomechanical flaws.
Like others, his program works on stability, external and internal rotation, strengthening to help protect the joint as much as possible.
All of that being said, he will tell you, just like several of the articles you linked, that UCL tears are not a one pitch injury. It is cumulative, thus overuse is involved.
He will also tell you that you can do everything "right" and still get the injury.
Now, to the measurements you listed with all of these wild claims of 480% decrease in chance of injury, etc.. There is no science to back it up. It is just a claim by the author. There is no scientific study to back it up. Just his "survey" of athletes. That doesn't cut the mustard. Sorry.
Also, these measurements are not obtainable for the vast majority of baseball players until well after puberty and until they have fully developed. By then, they have years of baseball behind them. The UCL has been subjected to microtears the entire time.
That is why so many advocate getting several months of rest each year from competitive baseball and from high leverage throwing. Especially during growth phases of physical development. You can strength train all you want, but if there is not adequate rest, you are still at a higher risk.
Dr. Dugas told me is sees countless kids that get injured while they are having large growth spurts and when their body as not developed. This supports your claims of physical development helping to prevent injury. The problem is that every kids goes through this process and at various times and speeds of development. They are not going to stop playing. And, you can't get every kid to stop pitching. Although, as a parent, I would have my boys not pitch for a few years during this time.
Dr. Mike Marshall??? Wow, haven't heard that name in years. He is a loon. I am guessing you happened to see his article you linked that went against Andrews and Fleisig. Go look at the video on his site from years ago and how a pitcher is supposed to pitch to prevent UCL injury. It is comical. And is the reason that I have yet to see a single person pitching the way he advocates at any level of baseball.
All that being said, I commend you doing everything you can to educate yourself and protect your players( I assume to work with players?) All we can do is do our best to help them with the information we have. But, there is no surefire method to stop this.
IMO, players should have their biomechanics evaluated and measured. (that is not possible as not very many have that capability). They should work to train appropriately starting as young as possible to protect their arm. (Again, not everyone has access to people that know how to do this.) They should take off adequate time from pitching, train, ramp up for the season, and be PO's if they really want to protect their arm. (not feasible for a lot of kids with small high school teams). Lastly, not push hard for velocity until their bodies are developed.
Even with all of this, injuries will still occur. You just give yourself a chance.
A disclaimer... I have spent time with several of the people you linked in this and previous post. I have known Randy Sullivan with the Florida Armory since before he even opened the facility. I have seen his training first hand at his Florida facility. I am a big believer in what he teaches.
I have also been involved with Dr. Jeff Dugas at Andrews Sports Medicine, along with Kevin Wilk(the pt that has rehabbed countless professionals in pretty much every sport), and also Dr. Glenn Fleisig that has published several research papers with Dr. Andrews, Kevin and Dr. Dugas.
Back to Randy at Florida Armory. His program involves much of the training metrics you list from the other groups. He uses the motus to measure stress on the elbow and utilizes film to correct biomechanical flaws.
Like others, his program works on stability, external and internal rotation, strengthening to help protect the joint as much as possible.
All of that being said, he will tell you, just like several of the articles you linked, that UCL tears are not a one pitch injury. It is cumulative, thus overuse is involved.
He will also tell you that you can do everything "right" and still get the injury.
Now, to the measurements you listed with all of these wild claims of 480% decrease in chance of injury, etc.. There is no science to back it up. It is just a claim by the author. There is no scientific study to back it up. Just his "survey" of athletes. That doesn't cut the mustard. Sorry.
Also, these measurements are not obtainable for the vast majority of baseball players until well after puberty and until they have fully developed. By then, they have years of baseball behind them. The UCL has been subjected to microtears the entire time.
That is why so many advocate getting several months of rest each year from competitive baseball and from high leverage throwing. Especially during growth phases of physical development. You can strength train all you want, but if there is not adequate rest, you are still at a higher risk.
Dr. Dugas told me is sees countless kids that get injured while they are having large growth spurts and when their body as not developed. This supports your claims of physical development helping to prevent injury. The problem is that every kids goes through this process and at various times and speeds of development. They are not going to stop playing. And, you can't get every kid to stop pitching. Although, as a parent, I would have my boys not pitch for a few years during this time.
Dr. Mike Marshall??? Wow, haven't heard that name in years. He is a loon. I am guessing you happened to see his article you linked that went against Andrews and Fleisig. Go look at the video on his site from years ago and how a pitcher is supposed to pitch to prevent UCL injury. It is comical. And is the reason that I have yet to see a single person pitching the way he advocates at any level of baseball.
All that being said, I commend you doing everything you can to educate yourself and protect your players( I assume to work with players?) All we can do is do our best to help them with the information we have. But, there is no surefire method to stop this.
IMO, players should have their biomechanics evaluated and measured. (that is not possible as not very many have that capability). They should work to train appropriately starting as young as possible to protect their arm. (Again, not everyone has access to people that know how to do this.) They should take off adequate time from pitching, train, ramp up for the season, and be PO's if they really want to protect their arm. (not feasible for a lot of kids with small high school teams). Lastly, not push hard for velocity until their bodies are developed.
Even with all of this, injuries will still occur. You just give yourself a chance.
Posted on 5/5/23 at 11:05 am to deathvalleytiger10
quote:
Thanks for the links. Unfortunately, I was hoping to get actual scientific research to support your previous posts. Most of these are claims, theories, and opinions by the different authors. These ideas could all be proven 100% correct, but as of now it is not.
most are from in house studies dude.
quote:
I have also been involved with Dr. Jeff Dugas at Andrews Sports Medicine, along with Kevin Wilk(the pt that has rehabbed countless professionals in pretty much every sport), and also Dr. Glenn Fleisig that has published several research papers with Dr. Andrews, Kevin and Dr. Dugas.
Back to Randy at Florida Armory. His program involves much of the training metrics you list from the other groups. He uses the motus to measure stress on the elbow and utilizes film to correct biomechanical flaws.
Like others, his program works on stability, external and internal rotation, strengthening to help protect the joint as much as possible.
All of that being said, he will tell you, just like several of the articles you linked, that UCL tears are not a one pitch injury. It is cumulative, thus overuse is involved.
He will also tell you that you can do everything "right" and still get the injury.
100% i wasnt saying you wont still get it, but more most of these are because individuals are weak and are using arm over speed without the ability properly decelerate. just like most of the shoulder injuries we see now are from being stupid strong in the ER and not having the ability to decelerate due to ER/IR imbalance.
quote:
Now, to the measurements you listed with all of these wild claims of 480% decrease in chance of injury, etc.. There is no science to back it up. It is just a claim by the author. There is no scientific study to back it up. Just his "survey" of athletes. That doesn't cut the mustard. Sorry.
no it was from an in house study on 1000 athletes that have come through ATP. Those that met those metrics vs those that didnt and the injuries that happened.
there is scientific studies because we have no way of measuring what causes the ucl tear but we can use the motus and other items to know that the ucl can not support the forces placed on it. pretty simple to know what is supporting the rest of the force. but you wont see much outside of in house studies because their is no funding for it.
quote:
Also, these measurements are not obtainable for the vast majority of baseball players until well after puberty and until they have fully developed. By then, they have years of baseball behind them. The UCL has been subjected to microtears the entire time.
BS. just requires starting them training early. parents are scared for their child to lift heavy but doesnt think twice about them jumping off the side of the truck....yet the latter exposes the body to way more force.
quote:
That is why so many advocate getting several months of rest each year from competitive baseball and from high leverage throwing. Especially during growth phases of physical development. You can strength train all you want, but if there is not adequate rest, you are still at a higher risk.
and im ok with that but i see more get the injury from being way way underprepared than cumulative overlal throws.
quote:
Dr. Dugas told me is sees countless kids that get injured while they are having large growth spurts and when their body as not developed. This supports your claims of physical development helping to prevent injury. The problem is that every kids goes through this process and at various times and speeds of development. They are not going to stop playing. And, you can't get every kid to stop pitching. Although, as a parent, I would have my boys not pitch for a few years during this time.
and he is 10000% right. kids may be fine, 3 weeks and 2 inches of growth later and its a different kid. these things have to be monitored by the parents and its why im so big on the armcare.com app. its simple, either at risk or you are not.
quote:
Dr. Mike Marshall??? Wow, haven't heard that name in years. He is a loon. I am guessing you happened to see his article you linked that went against Andrews and Fleisig. Go look at the video on his site from years ago and how a pitcher is supposed to pitch to prevent UCL injury. It is comical. And is the reason that I have yet to see a single person pitching the way he advocates at any level of baseball.
ill be honest im not very familiar with him, but have seen some of his stuff. some is good, some not so much, certainly havent seen any of his viedoes though.
quote:
All that being said, I commend you doing everything you can to educate yourself and protect your players( I assume to work with players?) All we can do is do our best to help them with the information we have. But, there is no surefire method to stop this.
i only work with my own kids and a select few others. strength coaching is a hobby for me, but do have tons of certs. baseball strength training just happens to be a passion.
quote:
IMO, players should have their biomechanics evaluated and measured. (that is not possible as not very many have that capability). They should work to train appropriately starting as young as possible to protect their arm. (Again, not everyone has access to people that know how to do this.) They should take off adequate time from pitching, train, ramp up for the season, and be PO's if they really want to protect their arm. (not feasible for a lot of kids with small high school teams).
agree with all of this
quote:
Lastly, not push hard for velocity until their bodies are developed.
disagree completely with this as it tends to force you into a much smaller time frame and into riskier behavior. aging curve is 3.6ish, you need to be striving to get 50% or more better than that but it needs to be from completely safe behaviors. logn toss and pull downs should be the riskiest thing you do. i do agree with weighted balls and implements as part of arm care and warm up but not velo until later
quote:
Even with all of this, injuries will still occur. You just give yourself a chance.
was pretty much my point. i never said that you could prevent every injury just most you see....those guys are weak and weight is very low for height.
we prolly agree on 90% of things, maybe more. i think you took my post as saying you could prevent ucl from happening if you do these items....if it cam off as that...i apologize.
i was in a hurry on many of the above post and i certainly didnt want to come off as saying .....hey i got the key to prevent all ucl injuries...anything but.
but i am a huge believer that if you can meet the metrics from the 90mph formula, can squat 1.8x bodyweight @ 0.6 m/s from a box 1" above parellel, have balanced ER/IR and have good effecient mechanics....then the reduce the chance of a ucl tear greatly. especially when combined with 80 or less innings in a calander year below 16u and 100 after and combinged with in season training and an on ramp with proper arm care/warm up.....year you reduce the chance big time big time.
Posted on 5/5/23 at 1:32 pm to BatonrougeCajun
quote:
Maybe you never do but the odds keep getting worse for you every time
Gamblers fallacy.
Posted on 5/5/23 at 1:46 pm to GeauxATX
This is like ACL injuries. Ligaments are being pushed farther and farther beyond their intended limits. Athletes are much bigger, stronger and faster than ever before, but the ligaments are still basically the same.
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