WHAT IS SPORTS ARM CARE?

Taking proactive steps toward

gaining/sustaining a strong, well balanced,
pain free, high performance arm
WHO NEEDS AN ARM CARE PROGRAM?

All overhead athletes. Baseball, softball,

tennis, volleyball, golf, swimming, etc
Pitchers, position players and coaches.
 Forces on the Shoulder
90mph = angular velocity of 7000 per second
19.44 Revolutions per second
Distraction Force
Pulling ball out of socket
Approx. 75-100% body weight
Reinold
 ANATOMY AND BIOMECHANICS
Shoulder Complex
Most Mobile Joint in the Body
Static and Dynamic Stabilizers
4 Rotator Cuff Muscles and the role they play
Scapular Stabilizers
Lower Trapezius
Serratus Anterior
Scapulohumeral Rhythm
 ADAPTATIONS TO THE THROWING
SHOULDER
Humeral Retroversion
 ADAPTATIONS TO THE THROWING
SHOULDER
Anterior Capsule Laxity
 ADAPTATIONS TO THE THROWING
SHOULDER
Posterior Cuff Tightness
 ADAPTATIONS TO THE THROWING
SHOULDER
10 degrees of Increase External Rotation
10 degrees Loss of Internal Rotation
 ADAPTATIONS TO THE THROWING
SHOULDER
After pitching: adds Loss of 9.5 Degrees of IR
GIRD= > 20 degrees IR Deficit
Translation
Rate of Injury
 Flexibility
Circum-decompression
 Flexibility
Crossbody Over
 Flexibility
Crossbody Under
 Flexibility
Contraindications for Cuff Stretching
Under 14 yrs old
Focus on stability rather than mobility
Hyper mobile
 Stretches to Avoid
Sleeper Stretch
Not all throwing athletes have a tight Posterior Capsule
Impinging position
Often performed incorrectly
Crossbody Stretch is more effective
Perform by Medical Professional
 Stretches to Avoid
Stretching into External Rotation
Anterior Capsule is inherently loose
COMMON INJURIES AND HOW THEY
OCCUR?
Overuse
Definition: Pitching too often, not enough recovery
time in between outings
Prevention: Coaches and athletes keep a log to track
days pitched and number of pitches thrown.
COMMON INJURIES AND HOW THEY
OCCUR?
Overload
Definition: Too many pitches in a single game.
Sign of fatigue
Prevention: Set max limits on pitch count prior to the
game. This way emotion does not interfere with your
decision.
COMMON INJURIES AND HOW THEY
OCCUR?
Mechanics
Poor throwing mechanics can lead to excess stresses
being placed on the shoulder and elbow.
COMMON INJURIES AND HOW THEY
OCCUR?
Conditioning
Poor throwing conditioning
Not building your foundation in the pre-season
Increasing workloads too fast
30 pitch bullpens to 80-100 pitch games
Poor rotator cuff strength
Studies show that pre-season weakness in the external
rotators and supraspinatus can increase the risk of in-season
throwing related injuries
COMMON INJURIES AND HOW THEY
OCCUR?
Poor Scapular Strength
Poor scapula positioning can increase the risk of shoulder
impingement no matter how strong your rotator cuff muscles
are.
COMMON INJURIES AND HOW THEY
OCCUR?
Poor Total Body Conditioning
Poor total body conditioning can lead to inefficiencies in the
kinetic chain which put greater stress on the shoulder and
elbow.
 Additional Risks of 21st Century

Today's high tech world has created a forward

posture society
Showcases
Etc.
INEFFICIENCIES OF TRADITIONAL ARM CARE

Traditional rotator cuff programs are a derivative

of the Throwers 10 Program or rehab exercises
Throwers 10 program is actually 19 exercises not 10
Target rotator cuff, scapular muscles, and forearm extensors
INEFFICIENCIES OF TRADITIONAL ARM CARE

To complete all of the exercises correctly you will

need
Over 20 minutes if you are to work both sides of the body
Therapy table
Dumbbells
Resistance bands
INEFFICIENCIES OF TRADITIONAL ARM CARE

NOT PRACTICAL ON THE FIELD

INEFFICIENCIES OF TRADITIONAL ARM CARE

Coaches select the practical exercises

Exercises that can be done standing up and using a
resistance band
The problem with this is:
Nearly all are rotator cuff exercises
NO SCAPULAR STRENGTHENING
 GOALS OF SPORTS ARM CARE
Practical
Structured
Muscle Activation
Strengthening
Flexibility
Recovery
Sport Specific
Performance Enhancing
Identify Risks
 Practical
On the Field
Portable, Durable
Equipment
Time Efficient
 Structured
Exercises should not be pieced together
 Structured
Sequencing of the Exercises
Scap Cuff Activation = Crossover Symmetry Standard
Can take shoulder out of impingement
 Structured
Visual Aid
Improved Technique
Improved Compliance
 Muscle Activation
Kinetic Chain Activation
Requires resistance
Lower body Activation
Gravity
Core Activation
Partner
Scap/Cuff Activation
Bands

Everyday Prior to Throwing

 Strengthening: Rotator Cuff
Stabilizes Humeral Head in Glenoid
5 year MLB Study finds the Preseason Rotator
Cuff Strength of MLB Pitchers is directly
related to rate of Throwing Injuries
Muscle groups identified in the Study
External Rotators
Supraspinatus
 Strengthening: Rotator Cuff
External Rotation at 90 = Crossover 90/90
 Strengthening: Rotator Cuff
Supraspinatus = Crossover Scaption
Humeral Head Depressor
Most commonly torn
 Strengthening: Rotator Cuff
Additional Finding in the 5 year MLB Study
Strength Ratio for Internal Rotation to External
Rotation and the rate of Injury
Crossover Symmetry focuses on the
decelerating muscles or the brakes
Strengthening: Scapular Stabilizers
Scapular Stabilizers
Weak Link in the Kinetic Chain
 Strengthening: Scapular Muscles
Scapular Stabilizers
Improve Energy Transfer throughout Kinetic Chain
 Recovery
The rotator cuff tendons have poor blood
supply where they attach at the Humerus
(1) Set of Crossover: Standard or Iron Scap
Increased blood flow delivers nutrients and
speeds up recovery process
 Recovery
Self Trigger Point Massage
Myofascial Release
 Recovery
Self Trigger Point Massage
 Sport Specific
Sport Specific
Opening the chain as overhead sports demand
Standing in an upright position which is
proprioceptively and arthrokinematically
appropriate for throwing athletes.
Fast Twitch Training...neuro-adaptation to improve
speed
 Performance Enhancing
Can Increase throwing velocity
Maximizing Energy Transmission throughout the
Kinetic Chain
Fast Twitch Training
Crossover Symmetry Advanced Program
 Identify Risks
Weather
 Identify Risks
Muscle performance decreases as temperature
decreases. Your body fights to maintain your core
temperature so it diverts blood flow from active
muscles to your core to conserve heat.
Neoprene sleeves
Chilly Billy Heat pack
 Identify Risks
Poor Communication
Strength Trainer, Athletic Trainer, Coach, Parent, Player
Who is in charge of arm care
Roles of relief pitchers
Who is up first
Long relief
Short relief
Closer
Be aware of the situation, get your body ready to pitch
 Bullpen Warmup
Lower Body Activation
Distance 90 ft.
(2) Sets of 50% Form Running (T&B)
(1) High Knees (T)
(1) Butt Kicks (B)
(1) Backpedal (T)
(1) Side Shuffle Switch (B)
(2) Exaggerated Carioca (T&B)
(1) Knee to Chest (T)
(1) Elbow to Instep (B)
(1) Skip to hip adduction (T)
(1) Skip to hip abduction (B)
Core Activation
Core Rotation with Crossover Cords
15 reps each way
Scap/Cuff Activation (5 minutes)
Crossover Symmetry Standard Program
Only 5 reps of each exercise
Thank You