This is part one of a four-part series where we will discuss common mistakes and misconceptions while working with baseball players.
Approaching Shoulder Injuries in Baseball Part One: Nick Thurlow, PT, DPT
With baseball season underway pitchers and position players alike are likely beginning to experience the rigors of high school baseball and the demands it places on their arms. These demands can lead to a myriad of shoulder issues, including impingement, bicep tendonitis, scapular dyskinesia, labral pathologies, and instability, just to name a few. Oftentimes, this brings the athlete to a physical therapist, chiropractor, trainer, etc. where a generic range of motion assessment combined with orthopedic special tests may recreate their symptoms. The provider then attempts to resolve these symptoms by addressing just that, the symptoms. Pain (ice, e-stim, ultrasound), tightness (Dry needling, stretching, foam rolling, massage), weakness (internal/external rotation exercises, scapular strengthening) are addressed in an attempt to make the athlete feel better and perform their best. However, as the athlete returns to sport they oftentimes struggle throughout the season with their symptoms. Coaches, parents, providers might chalk it up to too much playing time, not enough treatment, or improper offseason preparation.
The Problem: Feeling better DOES NOT equal moving correctly.
The Solution: Identify the Root Cause.
In order to identify the root cause of a shoulder injury (or any injury), we use a functional movement assessment tailored specifically to baseball players so that we can identify neuromuscular inhibition (we’ll talk about this later). Rather than using active and/or passive range of motion, a functional movement assessment will reveal movement dysfunctions throughout the athlete’s entire kinetic matrix. Possibilities include (but are certainly not limited to) squat asymmetries, decreased single leg stability, decreased thoracic and/or lumbar mobility, or ultimately dysfunctional arm patterns. Regardless, it is our responsibility to identify and correct these dysfunctions so that the entire body can work together as a matrix in order to throw a baseball and decrease the likelihood for shoulder problems. It is NOT our responsibility to make the athlete simply feel better. Athletes can feel better with rest, athletes can feel better with modalities, and athletes can feel better with manual therapy. But if we can make that athlete move correctly, not only will they feel better, they will perform optimally.
But why was the athlete moving wrong in the first place: neuromuscular inhibition. It is the primary ingredient in the recipe for injury and put simply, neuromuscular inhibition is the muscle’s inability to contract properly due to a lack of proper nerve stimulation (think lightbulb in a lamp flickering because it’s not plugged in right). If the muscle(s) cannot contract properly, the athlete will not move correctly, resulting in their shoulder symptoms. So if we identify the movement dysfunction and work to eliminate the neuromuscular inhibition causing it through our patented manual therapy technique, the athlete will feel better, but most importantly, move correctly.
If you have any questions please feel free to contact Dr. Thurlow at (720) 502-7023 or by calling our Loveland office at (970) 593-9300
Dr. Nick Thurlow, PT, DPT
In part two of this series, we will discuss Lat tightness, Glenohumeral instability and scapular dyskinesia. Stay tuned!