IN THE NEWS
Data-Based Interval Throwing Programs for Baseball Players
Michael Axe MD, * Wendy Hurd PT. PHD, and Lynn Snyder, PT ScD.
Context: Baseball throwing injuries are common. Emphasis on injury prevention and rehabilitation is made in an attempt to keep athletes on the field of competition Interval throwing programs are an integral part of training, conditioning and returning an injured baseball player to the game.
Shane Greene was 14, but his right elbow felt 84. That hadn’t kept him from blowing thousands of fastballs by other kids in Clermont’s youth leagues.
But that ache in Greene’s elbow got worse, so one day he visited a trainer he’d heard about.
The guy told Greene to take off his socks and shoes, tuck in his shirt and walk away in a straight line. He carefully observed, then started spouting anatomical gobbledygook that flew over Greene’s head.
When he and his dad got back to their car, they agreed on one thing.
“This guy is nuts,” Greene said.
This guy was Chuck Wolf, an exercise physiologist who specializes in applied biomechanics. His unorthodox approach might sound crazy, but Wolf says it can help combat the epidemic of arm problems that has made Tommy John surgery a household baseball word.
One of his disciples is now a relief pitcher with Detroit. Though he still doesn’t quite get the gobbledygook Wolf imparts.
“He’s got all these big words,” Greene said. “I have to tell him to back off sometimes and dumb it down.”
That version goes something like this:
“There are certain principles and concepts of movement that have been with us since cavemen and cavewomen walked upright,” Wolf said.
One of them is that the human elbow was not specifically designed to throw fastballs, curveballs and sliders. Especially if that elbow is attached to a fifth-grader.
Overuse causes the ulnar collateral ligament to fray or snap. That used to be the death knell for pitchers, then Dr. Frank Jobe came up with a technique in 1974 in which he took a tendon from the patient’s body or from a cadaver. He essentially tied the elbow back together. Jobe’s first patient was Tommy John of the Dodgers. The procedure has salvaged thousands of arms since.
Nearly 30 percent of Major League pitchers have had it. More had it 2014 than in the entire 1990s.
The disturbing part, Wolf said, is that 56 percent of Tommy John patients that year were teenagers. Figuring out how to curb the carnage has become an industry unto itself.
Most of it addresses the point of the injury. Wolf says that’s just the last domino to fall.
Cue the old spiritual “Dem Bones”:
“Back bone connected to the shoulder bone.
“Shoulder bone connected to the neck bone.
“Neck bone connected to the head bone.
“Now hear the word of the Lord.”
In this case, that’s Wolf.
“You have to treat the cause,” he said, “and not the symptom.”
It’s as if they’re patching a flat tire on the front when the reason the tire went bald is a bad strut on the rear. The cause is bad mechanics, and it begins with a pitcher’s first motion. It can set off a chain reaction of faulty moves that eventually lead the elbow being out of whack at the most stressful point in the delivery. At the instant, the torque is similar to throwing a bowling ball. Wolf tries to smooth the mechanical glitches that contribute to the elbow’s “time under tension.”
He videotapes clients and has an app that can freeze and analyze their delivery points, planes, gross movements, internal hip rotation, acceleration phases and other things that sound like gobbledygook to the anyone who didn’t major in anatomy or biomechanics.
It made sense to Nick Swan, who has a typical Tommy John tale. Kids used to play a variety of sports, which gave various body parts (namely arms) time to rest.
Now many play baseball year-round and are on travel teams. Leagues have pitch counts, but that doesn’t keep a kid from throwing for one team on a Tuesday and a different one on a Thursday. “You’re living in the moment,” said Swan, who now pitches at Florida Atlantic. “Coaches are, too. They want to win.” He always heard his delivery was nice and smooth. But the wear and tear landed him on the operating table two years ago.
He was referred to Wolf, who runs Human Motion Associates in Orlando, and found out how glitchy his delivery really was. It typically takes a couple of months for pitchers to re-tool their deliveries.
Rollins pitcher Johnny Rivera has learned the biomechanics to the point he can watch other pitchers and tell trouble is on the way.
“Two months later, I see them go down,” he said.
Then it’s hello, scalpel.
Greene underwent Tommy John surgery in 2008. The Yankees signed him a couple of years later and he began his climb up the minors.
A roommate had gone to Wolf to rehab a torn ACL, and he told Greene he should check out Human Motion Associates when Greene got back to Clermont in the offseason. “I figured I’d give him a shot,” Greene said. “It wasn’t until four or five months later I realized this was the crazy man.” Crazy man said Greene’s problems begin with his left foot. How that eventually messes up the right elbow is where the gobbledygook comes in.
It’s too gobbledygooky for baseball’s conventional Tommy John wisdom. One of Wolf’s clients says his team’s workout regimen actually tightens the muscles Wolf’s program tries to loosen.
The Cubs videotape pitchers and reconstruct their skeletal movements to help avoid injuries and improve their games. Others teams still focus on “time under tension”, not everything that leads up to it.
“Baseball is old school, but it’s catching on slowly,” Greene said. “I bet in 10 to 15 years, it will be really popular.”
Wolf isn’t worried so much about Major Leaguers. It’s the lost generation of arms that are supposed to replace them. “My concern is young kids who have such miserable mechanics,” he said. “The education needs to get out there and filter into high schools, colleges and pros.”
Wolf said those kids need to take off their socks and shoes, tuck in their shirts and trust applied biomechanics.
They’ll discover he’s not so crazy after all.