Mysterious Pitching Pain


#1

For the past two years I have been experiencing bad pain the seems to be coming from under or around the brachialis muscle. I am not quite sure how to explain this pain but although it tends to be pretty severe, I can’t quite pinpoint where its exactly coming from. During the past two season I have been to three different doctors none of them seemed to be very concerned with anything going on in my arm. MRIs have just shown inflammation in the brachialis muscle but no underlying cause. While on the mound, about 20 pitches in, the pain begins and with it my arm starts to feel weaker, (Specifically the brachialis, bicep, and forearm muscles feel weak). My velocity goes down and I slowly loose accuracy. I am a pretty strong kid, workout plenty, went through a throwing program and PT pre-season in an attempt to resolve the pain, and throw low 80’s at 16. None of the doctors have helped and nothing that I have done in my attempt to relieve the pain has worked.

Here were the doctor’s impressions from my most recent MRI:

“Low-grade muscle strain of the lateral aspect of the biceps brachii muscle manifest by
mild intramuscular edema. No intramuscular hematoma formation. No tendon tear visualized.”

Any help is appreciated as I am legitimately considering giving up pitching because of this issue.

Thank you


#2

Lots of things to consider that might need tweaking/improvement:

Flexibility/mobility
Mechanics
Workload
Lifting workload (lifting in-season?)
Technique
Rest (short term and long term)
Nutrition
Etc.

Could be a combination of things


#3

Just joined and saw your post. I am 15 and have the same exact symptoms. Wondering if you pitched this past season and if you had any improvement?


#4

“cmm014, AJS,”

“For the past two years I have been experiencing bad pain the seems to be coming from under or around the brachialis muscle.”

You are very perceptive in that normally Dr’s diagnose this as a Biceps problem, then have you mitigate it by time off. This injury is common and intuitive.

“I am not quite sure how to explain this pain but although it tends to be pretty severe, I can’t quite pinpoint where its exactly coming from.”

This is one of the many throwing related discoveries and mitigations put forth by kinesiologist Dr. Mike Marshall.

He charactorizes this injury as an eccentric (contracting while lengthening) contraction muscle failure, where the kinetic chain used is broken and causes degradation.

“During the past two season I have been to three different doctors none of them seemed to be very concerned with anything going on in my arm.”

They were more concerned with finding related joint injury knowing that even high graded muscle injury heals fast, 1 week to 8 weeks depending.

“ MRIs have just shown inflammation in the brachialis muscle but no underlying cause.”

The underlying cause is Kinesioanotomial and will be mitigated with the same science, this problem is never use in adults or youth…

“While on the mound, about 20 pitches in, the pain begins and with it my arm starts to feel weaker”
“(Specifically the brachialis, bicep, and forearm muscles feel weak).” “(Specifically the brachialis, bicep, and forearm muscles feel weak).”

This is because you perform “intuitive forearm flyout” where the action produces the tendency towards Forearm supinated drives. The Brachialis is a secondary forearm supinator.

My velocity goes down and I slowly loose accuracy.

“I am a pretty strong kid, workout plenty,”

If you perform pathomechanically, strengthening only creates more joint stress.

“went through a throwing program”

Were you warned about forearm actions and their effect on you’re Elbow?

'PT pre-season in an attempt to resolve the pain”

From where I sit, I believe PT’s are going to be the ones that will give us a chance to make mitigating changes in the way throwing pacients leave the healing process. They must understand all these kinesiological cause and mitigations by actually going through mechanical live changes with the PT, not your local pitching coach who will extend you’re misery. Some are!

“None of the doctors have helped and nothing that I have done in my attempt to relieve the pain has worked.”

Par for the course. This is how it is currently done as in the past, let’s blame “pitch counts” in this way nothing is actually mitigated physically and then, repetition ignorance.

“Here were the doctor’s impressions from my most recent MRI:
Low-grade muscle strain of the lateral aspect of the biceps brachii muscle manifest by
mild intramuscular edema. No intramuscular hematoma formation. No tendon tear visualized.”

This is great information as told to him by his radiologist. What now?

“Any help is appreciated as I am legitimately considering giving up pitching because of this issue.
Thank you”

Kinesioanotimical cause:

When thrower/pitchers perform intuitive forearm driven supination where they centrifuge their arm action “outside of vertical” (forearm drive to the outside of vertical orientation) they fail to engage the Triceps to extend their Elbows ( break in Kinetic chain) because the brackialis is firing off first concentrically (while shortening) to supinate the drive, then it keeps firing off to keep the Elbow joint and forearm joint from crashing together ballistically (this is a whole other set of assults on the Elbow) and is now contracting to keep this assault from happening but in the end fails resulting in muscle failure at the Biceps and Brackiallis, with the Brachiallis taking the brunt.

Mitigation:

All throw types must be voluntarily forearm pronated during drive , release and recovery!
In order for this to happen you must learn how to bring you’re ball side forearm back by supinating it on the way back to ¾ of it’s range of motion simultaneously with glove side foot plant then immediatly raise you’re ball side Elbow so you’re triceps are facing the target, now they are in position to fire and extend your Elbow voluntarily with pronation and full length start inwards rotation of you’re Humerus. This cleans up the second break in the Kinetic chain of the traditional motion where if you supinate your forearm is traveling in the oppositwe direction of you’re Humerus!
Look for you’re Elbow to Pop up not pull down, coach Newton want’s you to throw across.
Fix this and watch pronation snap give you a velocity boost and more pitch types.

later,

Lon Fullmer

certified Dr. Mike Marshall pitching coach


#5

Thank you so much for the info!