Hello forum, sorry, but this will be a long one. And I hope it’s okay that it’s really a throwing topic, not a pitching topic.
I have looked in here on occasion but not posted since 2011, when my youngest, Patrick, was a 12yo LL pitcher. He’s now a HS frosh and no longer pitching, but with all the good baseball minds who post here I still think this is the right place for this question.
My son played with mild but chronic shoulder pain throughout his 14U season, primarily playing 2B and SS, with occasional trips to the mound and OF. During the season he saw a sports doctor who diagnosed rotator cuff impingement, and advised stretching, icing, and rest. Patrick went 6 weeks without any throwing before the unofficial fall baseball season, but continued to have pain when he started up again. He played through that until we saw the doctor again, who ordered an MRI. It showed a Hill-Sachs lesion, which is a dent or defect of the humeral head resulting from a dislocation. But Patrick has never dislocated his shoulder. At this point Patrick stopped throwing. Sports doc sent him to an orthopedic surgeon, who ordered x-rays and a second MRI with dye injection. This MRI confirmed the humeral defect, but showed no damage to the labrum or other tissues that would be expected from a dislocation. Orthopedist said he must have at least had a subluxation at some point. He said that he had never seen this exact case and would have to consult with others for treatment options. Orthopedist recommended avoiding contact sports or other activities that could cause the humerus to impact the glenoid and cause more damage, so my son has given up, at least for now, his other sport, basketball.
Worried that we were about to get a recommendation for surgery, and wanting Patrick to see a doctor with experience treating elite baseball players, but limited by the fact that we’re with Kaiser, I found an orthopedist from another KP medical center who had done a fellowship at ASMI and requested a consult. After examining him, Orthopedist #2 said he had treated many thousands of shoulders and many hundreds of college and pro baseball shoulders, but had never seen one that presented like Patrick’s, and he wasn’t sure how to proceed, but he didn’t think that surgery was required. And he has also implied, that if it did happen, surgical repair of the humerus would end Patrick’s baseball career.
Though he’s still waiting to talk to his colleagues at ASMI about the case, orthopedist #2 has given his blessing to Patrick starting it up again. He is hitting the Jaegar bands, working out, etc. He’ll start throwing by the first of the year.
Orthopedist #2 feels that if Patrick is going to continue to play baseball, he has to adjust his throwing mechanics so that he can do so without pain and without causing his humeral head to bang into his glenoid. What hurts him most is reaching back from a high arm slot. I have suggested that short-arming could help, and that many short-armers throw very hard. O #2 does not disagree, but says that what will really help is if he can change his arm slot and drop down to ¾ or lower, which he feels should be possible without pain.
My question to you all his how best to learn to throw from that slot, and how best to get his arm strength up while throwing from that slot so that he can compete effectively at the HS level. Would you think that a pro coach could help? Or just let the kid listen to his own body? My thought is that he and I should begin by playing catch with a whiffle ball while he tries to figure out what will work for him. He’ll see a physical therapist as well. Any advice and suggested drills, exercises and regimens will be appreciated.
Second question, as long as I’m burning bandwidth here, his how would you deal with the HS coaches on this? They are aware of the general situation, and I’ve let the kid do the talking for himself mostly, and not talked to his coaches except in passing. But in this case I think they need to know a couple things that might best come from a parent, for example, that the kid should not slide head-first ever. He is also a limited player at this point who probably should not play anywhere except 2B or maybe LF and CF, but I figure it’s up to them to see that and to determine whether or not his other attributes make up for that enough so that he belongs on the roster or not and the field or not.