ASMI 33rd Injuries in Baseball Course

Day 1 Take Home Points

Friday January 23, 2015

Session I was on the shoulder and it did not disappoint I could write a novel on the information that was reviewed but so I can get to bed at a decent hour tonight I will just highlight important points that I wrote down.

Glenn S. Fleisig, Ph.D. discussed the Biomechanics of the shoulder and had the following points that really hit home with considerations in training baseball players and the overhead athlete.

-       At ball release the shoulder is moving at 7500 degrees per second. What does 7500 degrees per second look like? Well if the arm could spin in a full rotation it would spin 20 times in 1 second.  This really helps put into perspective how important the decelerator muscles are in shoulder health.

-       At maximal external rotation there is a 100 newton meter force on the distal end of the arm. This force is equal to holding 60lbs at max external rotation.

-        Kids are born with some form of humeral head retroversion and over time from throwing or going into external rotation repeatedly this humeral head retroversion becomes greater. This needs to be monitored because it can lead to excess external rotation of the shoulder, which can lead to internal impingement at external rotation.

-       Slap tears can be caused from peal and pull, or just peal or pull.

Steve E. Jordan, M.D. discussed the shoulder exam: evidence based evaluation. This talk was geared more toward the clinical setting and trying to diagnose injury from evaluation. 

-       The biggest take home from Dr. Jordan’s talk for me was that in order to find a true external rotation on a overhead athlete we need to find where the biceps tendon become aligned then measure the external rotation. This allows for us to account for the humeral head retroversion that has taken place in the athlete and see if there is a possible external rotation deficiency.

-       Dr. Jordan also mentioned that we need to do longitudinal exams over the course of the season so we can catch problems before they arise.

Stan Conte, PT, DPT, ATC discussed the Epidemiology of Shoulder Injuries in Professional Baseball Players. This was a great talk as Dr. Conte has done in depth research on the epidemiology of injuries in baseball.

-       The majority of injuries happen in practice not in games. This got me thinking about two things one wait another month and you will realize that he is right as spring training starts the injury bug comes out. Also think about how much youth players practice and how little pitch and throwing is controlled in those practices, and how fast we try to ramp up volume. This is more prevalent in the north than south.

-       In 2005-2006 the shift in Shoulder and Elbow injuries took place. Meaning since the 05-06 season we have seen more elbow injuries in baseball then shoulder injuries. Adding to this the trend line for elbow injuries is up to this date.

The next talk that I had some good notes on was from Mike Reinold, PT, DPT, SCS, ATC, CSCS on non-operative rehab of the overhead thrower.

-       At ball release the arm is distracted from the body at 1 times your body weight. Yet again another reason why we must strength the decelerator muscles.

-       After a game a pitcher can lose up to 18% strength

-       Over the course of a season you will lose 3-4% strength

o   We need to education athletes and parents on why in season training is just as important as training in the offseason.

  • One more random fact that was discussed today was that labrum tears that are surgically repaired have about a 50% success rate for throwers. We need to do everything we can to prevent these injuries from occurring. 

Look for more notes coming tomorrow!


Kevin Hollabaugh, MHA, CSCS, USAW, FMSC