The Rotator Cuff and Pitching

15 Oct The Rotator Cuff and Pitching

The rotator cuff is referred to frequently at all levels of baseball from the professional ranks down to little league. This anatomical area of the kinetic chain is integral in the throwing motion and the high rate of shoulder injuries in pitchers highlights the importance of injury preventative modalities for the rotator cuff.

Introduction

The rotator cuff is a unit comprised of four muscles located in the shoulder area of the upper torso. It consists of four separate muscles which are as follows: supraspinatus, infraspinatus,  subscapularis, and teres minor (“SITS” muscles). These independent muscle function as a unit within the kinetic chain. Each of these four muscles connect to the humerus and scapular region of the upper body.

The main function of the four rotator cuff muscles as a unit are to stabilize the humerus head in the glenohumeral socket. The glenohumeral socket is very shallow thus not offering stabilization of the humeral head thus requiring the rotator cuff musculature to “pull” the humerus into the shoulder socket during upper extremity movement patterns.

In addition to creating a muscular cuff around the humerus, the rotator cuff muscles have independent functions as it pertains to upper extremities. Medial rotation, lateral rotation, abduction, and adduction are additional function of the rotator cuff.

Overhead Throwing Motion

Looking at the overhead throwing motions of the pitcher the rotator cuff is involved to a very high degree. Not only is the rotator cuff required to stabilize the humeral head during the excessive forces generated in the throwing motion, the SITS muscles function within the movement patterns of the pitcher.

Research indicates the pitching motion creates excessive angular forces. For example, during the late cocking phase where external rotation is extreme this arm position places high levels of stress on the anterior portion of the shoulder. Secondly, after release of the baseball it is necessary to decelerate the arm and body. This requires the posterior portion of the shoulder complex to “slow” the arm down  loading the posterior ligaments and muscles of the rotator cuff to a very high level.

Statistics provided by research from the American Sports Medicine Institute indicate internal rotation of the shoulder reach velocities in excess of 7500 degrees per second in the late cocking phase and proximal forces of over 1200 degrees per second into release. All of which point to the excessive stresses placed upon the rotator cuff and shoulder complex during the pitching motion.

Recognize these stresses and arm positions occur each and every pitch during competition, and over time causes fatigue, potential instability, and compensatory patterns within the structural components of the rotator cuff. In order to prevent continual breakdown of the structural integrity of the rotator cuff is it necessary to take proactive steps in the repair and prepare components of maintaining a healthy arm.

Rotator Cuff Health

The “repair” steps are a reference to the proactive steps a pitcher will take post competition to assist in the repair process of the rotator cuff, arm, and body in general. The throwing motion as indicated from the information above is a stressful and repetitive athletic action which over time causes fatigue, micro-trauma in the muscular system, and long term instability. Proactive steps in the “Repair” stage after competition can assist in the recovery of the rotator cuff from fatigue, micro-trauma, benefit long term health, and prepare the pitcher for their next competitive outing.

The post competition repair stage will include modalities to reduce inflammation and promote tissue recovery. Modalities frequently used are ice, manual therapy, joint mobilization activities, and rest. Once the repair stage has begun an overlapping “preparation” stage begins where the pitcher is preparing for their next competitive start. At the Major League level these two stages will occur over a 5 day period with starting pitchers. Relief pitchers will have shorter periods where the “repair” and “prepare” stages coincide.

The preparation stage are the activities a pitcher will participate in to maintain the endurance, strength, mobility, stabilization, and integrity of the shoulder complex.  The preparation stage modalities will include active and passive range of motion modalities, traditional rotator cuff exercises, total body functional strength training, and PNF exercises.

Summary

The pitching motion places extreme levels of stress on the arm, rotator cuff, and kinetic chain in general. In order to maintain arm health, and reduce the potential for injury a pitcher must be proactive in both the “Repair” and “Prepair” stages between competitive outings. This will assist in the recovery from competition, prepare the pitcher for their next outing, and assist in long term health of the rotator cuff.

About Performance Coach Sean Cochran: Sean Cochran, one of the most recognized performance coaches in sports today. A career spanning positions with 2 major league baseball organizations, over 10 years on the PGA Tour and work with top professionals including three-time Masters, PGA, and British Open Champion Phil Mickelson, future hall of fame Trevor Hoffman, and Cy Young award winner Jake Peavy provides Sean a proven track record of success.  He has been involved in the production of numerous performance videos and authored books including; Performance Golf Fitness, Complete Conditioning for Martial Arts, and Fit to Hit. He has been a presenter of educational seminars for numerous organizations including the world renowned Titleist Performance Institute.

Article References

Baechle, T.R., R.W. Earle, and D. Wathen. 2000 Resistance Training. In Essentials of Strength Training and Conditioning (2nd ed.), edited by T.R. Baechle and R.W. Earle. Champaign, IL: Human Kinetics

Boyle, M. 2004 Plyometric Training for Power, Targeted Torso Training and Rotational Strength. In Functional Training for Sports, edited by E. McNeely. Champaign, IL: Human Kinetics

Chek, P. 1999 Power Training, Flexibility: A Balancing Act, How to Warm-Up for Golf in The Golf Biomechanic’s Manual, edited by J. Alexander. Encinitas, CA: C.H.E.K Institute

Clark, M. 2001 Integrated Training, Human Movement Science, Current Concepts in Flexibility Training, Core Stabilization Training, Neuromuscular Stabilization Training. In Integrated Training for the New Millennium, edited by J. Jackson. Thousand Oaks, CA: National Academy of Sports Medicine

Clark, M., Corn, R., Lucent, S., Kinetic Chain Checkpoints, Corrective Exercise, Calabasas, CA:  National Academy of Sports Medicine

Chang WK. Shoulder impingement syndrome. Physical Medical Rehabilitation Clinic, NY

Cook, G. 2003 Mobility and Stability. In Athletic Body in Balance, edited by M. Barnard. Champaign, IL: Human Kinetics

Enoka, R. 1998 Human Movement Forces, Torque, Musckoskeletal Organization, Movement Strategies. In Neuromechanical Basis of Kinesiology, edited by R. Frey. Champaign, IL: Human Kinetics

Fleisig, G. 1995 Kinetics of Baseball Pitching with Implications About Injury Mechanisms. American Journal of Sports Medicine, Birmingham, AL

Hay, J. 1993 Angular Kinematics, Angular Kinetics, Golf in The Biomechanics of Sports Techniques, edited by T. Bolen. Englewood Cliffs, NJ: Prentice-Hall

House, T. 1995 The Pitching Edge, Champaign, IL: Human Kinetics

Santanna, J.C. 2004, Training Variables in The Essence of Program Design, Boca Rotan, FL: Optimum Performance Systems

Verstegen, M. Williams P., 2004 Movement Prep, Prehab, Elasticity in Core Performance, edited by J. Williams. United States of America: Rodale