The Science of Overhead Athletics
Former Division I & II Pitcher, Dr. Kevin Steinberger sat down with us on Episode 6 of the N2AthleteX Podcast. We discuss common myths of overhead sports, our thoughts on injury prevention, and proper programming ideas.
Intro
Former Division I & II Pitcher, Dr. Kevin Steinberger sat down with us on Episode 6 of the N2AthleteX Podcast. We discuss common myths of overhead sports, our thoughts on injury prevention, and proper programming ideas.
Steinberger understands first-hand the importance of shoulder care for throwers especially. As a pitcher, Kevin was recruited to High Point University but eventually ended his career at East Stroudsburg University. Now, as many overhead athletes enter their off-season, Dr. Kevin shares his best knowledge nuggets.
Breaking Down the Overhead Motion
Before diving into the science and studies behind overhead sports injuries, we must first understand the mechanics at play. There are 4 key phases of any throwing motion:
The first phase requires the athlete to generate momentum from the ground. For pitchers, this is considered part of the wind-up.
The second phase, or cocking phase, pulls the arm back to create what is called "pre-tension."
The third phase requires the thrower to use the ground to generate velocity -- termed the acceleration phase.
The fourth phase is the deceleration phase. In this phase, the muscles are working to slow everything down.
Misconceptions of Overhead Sports
As new research is conducted, many of the "rules of pitching" have been thrown out the window. Here are a few discussed during Episode 6:
Don't BB Bench/OH Press
Thought to cause extra strain on the shoulder, many throwers avoid barbell benching/pressing. However, as Dr. Kevin points out, the force generated through moving a barbell is far less than throwing a pitch. As he describes it, Force = Mass x Velocity^2. Athletes are throwing immensely faster than they are moving that barbell. However, it should be noted that athletes should not lift through pain. If pain is had, replacement exercises may be used to limit range of motion while the cause of the pain is explored.
Youth Pitchers Shouldn't Throw Curveballs
Many athletes heard this misconception from their parents. Believed to create too much torque for the shoulder to handle, curveballs are taboo for youth athletes. Yet, it's simply not true. Studies show the two pitches with the highest amount of torque put on the arm are the Fastball & Slider. And it has also been found that the Change-Up reduces torque... meaning velocity is the largest component of torque. Where common curveball-caused injuries occur is through the total volume pitched. The mechanical stress put on the tissues takes time to adapt, and therefore should be limited (but not avoided) in practice.
Throwing Sidearm has Higher Injury Risks
Understandably, the biomechanics of throwing sidearm can worry many coaches and parents. Sidearm throwers present increased torque at the elbow as opposed to the shoulder of overhead throwers. However, studies conducted longitudinally found no significant difference in injury frequency. The main predictor of injury is the total throwing volume throughout the year. Studies show throwing over 100 innings per year may be a significant indicator of injury risk.
Ice Reduces Soreness and Swelling
Gaining popularity during the days of the Thrower's 10 Protocol, icing has become a thrower's go-to recovery tool. Originally, ice was thought to reduce swelling and therefore speed up recovery. Although, recent studies have proven the opposite to be true. Icing reduces the rate at which swelling occurs... but also the rate at which swelling dissipates. This prolongs the inflammatory phase and the time needed for recovery.
Running Poles & Weighted Balls are Great Training Tools
Two of the most widely accepted and habitual training tools to come out of the sport of baseball: running poles & weighted balls. Both INEFFECTIVE for the purposes they're intended for. While running poles may be great for after training as a lactation suttling tool, they are ineffective in training the proper nervous system firing needed to pitch... and pitch explosively. As well, weighted balls may make athlete's arms feel light as a feather, they only prove to slow down the motion... and increasing throwers injury risks.
Thoughts on Injury Prevention
When it comes to preventing injuries in overhead sport athletes, it's important to keep in mind the extreme ranges of motion used. Throwers have a completely different shoulder than non-throwers. The amount of external rotation needed to throw (or spike) a ball is nearly double what's physically normal... and what can be realistically mimicked in training. If athletes are unable to teach their nervous system & musculature to control these extreme R.o.M. injuries occur.
Strength coaches & sports med professionals can use screening tools to help determine the risk of such injuries. Athletes with a total rotation of the shoulder greater than 182-degrees are at an increased risk of injury. And while it is regular for throwers to have more external motion than internal, caution must be taken. The global internal rotation deficit should be no greater than 20% to ensure safety. Other screening tests may include:
Greater Than 100 Innings Thrown a Year: Determine possible fatigue
Thoracic Spine Mobility: Oftentimes, what we think is a shoulder issue is actually a T-Spine issue
The Y-Balance: Determine asymmetry or "kinks in the whip"
Fatigue is possibly the greatest indicator of injury, especially in conjunction with overloading. Throwing over 100 innings a year may contribute to fatigue and overloading symptoms. As well, thoracic spine issues are very strong contributors to shoulder and elbow pain. These mobility issues travel down the chain and are absorbed wherever the peak forces are (elbow or shoulder).
These screening tools may vary depending on the overhead sport. The forces used in Volleyball may be less than Baseball, for example. And while the principles of motion are similar between the two sports, there are distinct differences. In Baseball, athletes can use the ground to create greater force and whip... while Volleyball hitters must whip with their body as they float in the air.
Training & Rehab Suggestions
For overhead athletes that feel they may already be experiencing shoulder or elbow issues, this is for you.
As Dr. Kevin & Dr. Jared Casazza describe it, there is a big difference between someone who feels tight and someone who is tight. The athlete may be facilitated, meaning the nervous system is holding more resting tension in a muscle, creating the feeling of tightness. Yet, if the athlete is actually limited, it is imperative to avoid over-stretching the anterior side of the body (chest). Instead, the athlete should spend more time on the internal rotation or posterior side of things. Try incorporating a side body stretch or sleeper stretch into the routine.
Next, and possibly the most important note to take away from this discussion, is to TRAIN WITH A PURPOSE. Athletes must first build a foundation of strength & tissue resilience, then learn to control it. This is done with heavier weight leading up to the season.
Too many athletes struggle with the desire to throw fast without proper training for it. They believe throwing harder is the key, yet Dr. Kevin suggests something else:
"If you want to throw fast not hard, you need to train [the muscles] to move fast."
— Dr. Kevin Steinberger
When athletes try throwing harder, they're actually creating a kink in the whip. They're slowing their motion down and creating unnecessary tension. Instead, athletes must train the nervous system to use muscles to move quickly. This can be done with explosive movements and lighter weight such as med-ball slams or rope slams.
Other effective training tools include speed pulleys, cross-training, and this weighted ball replacement: The Knotted Towel Drill
By tying a knot at both ends of a towel, and mimicking a throwing motion, athletes can determine their peak velocity. Listen for the whip. If the whip occurs before the release, the athlete is wasting energy.
Want to contact Kevin?
Find him on Instagram @dr.kevin_steinberger or Facebook @Kevin Steinberger. As well, Kevin can always be reached through email at ksteinbergerdpt@gmail.com or at Core Physical Therapy. Call 540.082.2208 to schedule an appointment or stop in at 1421 3rd St SW, Roanoke, VA 24016