Shoulder Strain


#1

My son had to leave a game yesterday due to a shoulder tendon strain. I videotaped his first few pitches. Is there anything in his mechanics that anyone can point to that shows stress on his shoulder? Thanks in advance.


#2

Look at the position he gets into at the start of 15s mark. Then look at his head position at the end of the 15s mark.


#3

he has a really weird relase


#4

not sure if that comes into play with a shoulder strain


#5

How much has your son thrown over the past several years? Has he taken time off from throwing? Arm injuries are commonly caused by overuse. See Prevention of Arm Injury in Youth Baseball Pitchers.pdf (145.0 KB)

That said, mechanics can also cause injuries. In this regard, Chris O’Leary has interesting theories on the relationship between the Inverted W, a late arm, and injuries. Your son appears to have the inverted W, as seen below in my first screenshot. Your video is too fast and jumpy to get a good screen grab of his foot plant (a slow motion video would help), but what I captured in the second screenshot below might indicate a late arm too. O’Leary is controversial and has his detractors, but his theories are not without basis. You can read up on them here (look for Inverted W and timing articles).

Also, I would take your son to an orthopedic surgeon trained in sports medicine for the best course of action.


#6

South Paw,
To answer your question about overuse - he has pitched since he was 9. He took winters off to play basketball. He had some shoulder pain last year near the end of his baseball season - the middle of summer. He was advised by his physical therapist to not throw until this season started - March. So he didn’t start throwing until then.
After seeing the screenshots, I can see the stress he is placing on his shoulder. I don’t know when he developed the inverted W, because that is something relatively new - maybe an attempt to throw harder.
He has an appointment to see his doctor today, so we’ll see what he suggests.


#7

My comments in bold:

[quote=“Drakes_Dad, post:6, topic:19971, full:true”]
South Paw,

To answer your question about overuse - he has pitched since he was 9 [No problem with that]. He took winters off to play basketball [Very good]. He had some shoulder pain last year near the end of his baseball season - the middle of summer. He was advised by his physical therapist to not throw until this season started - March. So he didn’t start throwing until then. [Good advice]

After seeing the screenshots, I can see the stress he is placing on his shoulder. I don’t know when he developed the inverted W, because that is something relatively new - maybe an attempt to throw harder [The Inverted W is said to increase velocity, but also risk of injury]. He has an appointment to see his doctor today, so we’ll see what he suggests. [Great. Let us know. I would also recommend that he follow closely the pitching guidelines recently issued by MLB for youth pitchers, called Pitch Smart <— Click on this link. As you will see, MLB’s Pitch Smart includes recommendations to take 4 or more months off each year from all throwing. After researching the youth of the great pitchers, I have my son take 5 months off each year from all throwing. It does him wonders, physically and mentally.)[/quote]


#8

Inverted W…otherwise known as an M. LOL sorry couldn’t resist that one, inverted W sounds so much cooler though.


#9

Here are a couple of counter thoughts-

I don’t really see an inverted W. I see an arm cocked at an extreme angle as the shoulders begin to rotate. The jury is still out on the inverted W. As was mentioned, it is more likely the angle of the arm (forearm below parallel with ground) when the front foot is weighted that causes whatever is caused by this position…

As for ASMI- I don’t buy their whole lay off throwing thing. When you look at countries where baseball is player year round, those athletes don’t have any more arm injuries that the general baseball population. There certainly are players who at times need to rest. But, and this is my experience over 7 years of baseball with my son- the only time he ever had a problem was when he took the fall and winter off. I have a good friend who’s an OS and he and I have discussed pitching/throwing many times. He, and he is the one that got me to thinking, is of the mindset that it’s not necessarily that year-round pitching that’s the problem as much as it is that the pitchers are throwing too many innings at a time, are getting into long innings with high pitch counts, have poor mechanics, are pitching without enough rest, and aren’t doing any conditioning/strengthening outside of baseball. How to quantify those criteria is virtually impossible to do. My son is now 13, pitches and catches, and throws pretty hard for his age. At age 10 we took the fall and winter off from baseball. When we started that spring, we did the usual ramp-up over a couple of weeks. Early into the season he developed LL shoulder. An MRI revealed no structural damage. We rested and started the Thrower’s Ten program. He returned to play and has never had any other arm issues. He maintains the Thrower’s Ten routine 3-4x/wk. We start playing in mid-January and play through early July. Then take a couple of months off and pick back up in mid-Sept. for fall ball and play through mid-November. Even during the non-playing periods we still pick up the gloves and throw once or twice per week (just some light catch with a dozen or so hard throws) just to stay limber and keep the shoulder and elbow in shape. We will continue to follow this routine until I can read conclusive proof to the contrary.


#10
  1. If you don’t see an Inverted W, you must not want to. It’s a textbook case of an Inverted W.

  2. It’s not just ASMI that - based on scientific studies - recommends laying off throwing for at least 4 months per year. Major League Baseball, on the advice of its Pitch Smart Advisory Committee, which is made up of the top Tommy John surgeons in the country and the orthopedic surgeons of MLB teams, see here, recommend it too. But you obviously know more than those guys. You need to contact them and tell them they’re wrong!

  3. Keep throwing year round!


#11

I’m just going by what a very good friend of mine who happens to have been a practicing orthopedic surgeon since 1988 says. That, combined with my own personal experience. All of these studies failed to tease apart many of the uncontrolled variables and they lump the results together and make a proclamation that is a broad brush. If year round throwing is bad, why aren’t all of the Caribbean kid’s arms falling off.

By the way, that throwing hand is not in the inverted W position. It also appears to that the forearm is pretty much parallel to the ground although we don’t know exactly where the foot is at at this point. The mechanics are poor for a pitcher. The hand is in a position that would be more typical of a catcher throw. It is scrunched up by the shoulder, not down and away from the body.


#12

That’s a myth. Latin America and the Caribbean are very poor, and the kids do not throw year round like the American kids do. Year round play requires lots of money for travel, coaching, equipment, etc., and the Latin America/Caribbean kids simply don’t have it. More, they play soccer much of the year. Like Mariano Rivera, who was mainly a soccer player in his youth and didn’t pitch until he was 20. Poor Mariano, he could have been a better pitcher if he had only played rear round as a youth, right?

Finally, there’s a reason why a couple years ago when 35 MLB pitchers succumbed to Tommy John surgery, 34 of the 35 were born and raised in the American travel ball system. Only 1 was foreign born. Gee, I wonder why?

Keep on keeping on year round! Because you wouldn’t want your kid to grow up to be a lousy pitcher like Mariano Rivera! LOL


#13

From a former college pitcher and current pitching coach-

Your son has what they call hyper-angulation or arm drag. As his chest is opening at the .02 second mark his arm is positioned way behind his scapula. This arm drag places tons of stress on the front shoulder and can also stress the elbow as his arm accelerates in front of his face. Concentrate on getting proper hip to shoulder rotation and proper leg drive without early rotation of the back knee that can cause it to collapse. There is a pitching device that is on the market that many MLB and college teams use to help with proper leg drive and helps reduce arm drag that causes shoulder and elbow pain. The pitching device is called " King of the Hill". I am not affiliated with them nor do I sell their products. I just have experience working with pitchers that have had the same problem as your son and this pitching device helped with their proper leg drive and hip to shoulder rotation. www.trainwiththeking.com

I am not endorsing this product nor am I saying anyone should buy it. What I am saying is that it has helped many of my younger pitchers with hip to shoulder rotation and proper leg drive.

Hope this helps -


#14

It looks more like a horizontal w. Also, an inverted w is usually judged at foot strike (if you believe it’s the demon).

Are these Inverted Ws?


#15

First, you must not have read up on O’Leary’s theory about the Inverted W. O’Leary’s point is not that the Inverted W is in and of itself dangerous, but that the Inverted W often leads to late timing at foot strike. It is late timing at foot strike that, according to O’Leary, increases strain on the arm and increases risk of injury. The boy in the original post clearly has late timing at foot strike, which is preceded by an Inverted W, and he has a shoulder injury. Hmm.

Second, as for your photos, many clearly are Inverted Ws; some are not. For example, your first photo is of Tom Glavine, who O’Leary identifies as having had an Inverted W, but who avoided injury because - despite his Inverted W - he did not have a late timing problem at foot strike. Again, it’s all about late timing at foot strike. And the Inverted W often leads to late timing at foot strike - as it does with the injured boy in the original post.


#16

My point is you didn’t show where he was late at foot strike in the frame you posted. You just posted the W. Inverted w’s or horizontal w’s are made by many many successful uninjured pitchers. (The frame you posted of the pitcher in question is a bit more of a Horizontal W IMO.)

Also see:
http://journals.sagepub.com/doi/full/10.1177/2325967115581594
"Consensus between investigators was achieved for 99% of players for inverted-W positioning (248 players) and in 97% of players for early trunk rotation (243 players) for videos reviewed independently.
The inverted-W throwing position was not associated with significantly greater risk of upper extremity injury requiring surgery in MLB pitchers."

The frame that topgun821 posts does look more concerning to me, just in terms of shoulder strain. Dragging his arm through…


#17

The doctor gave Drake a good report. He said it was a muscle strain - and should come around in a few more days. The pain has subsided considerably since the day of the injury. The doctor told him to keep icing and to rest until he sees him again on Monday. He wants to reevaluate him at that time.
In the meantime, we’re going to work on his mechanics and try to work on his hip/shoulder separation with less drag on the hand. No throwing, but just going through the motions in slow motion for now.


#18

[quote=“mcloven, post:16, topic:19971”]My point is you didn’t show where he was late at foot strike in the frame you posted. You just posted the W.[/quote]You must have a lousy screen or you didn’t maximized the photo. Click on the maximize arrow in the lower right of the photo. It clearly shows his late arm at foot plant. Here it is again:

Thank you for confirming that it is a W, a classic Inverted W. Here is an even better view earlier in the windup - a perfect Inverted W:

Finally, that link you provide is to a summary of a study on the Inverted W by Wiemi A. Douoguih. Here is what Douoguih said about his study in his communications with O’Leary:

Our data showed an increased injury rate requiring surgery in pitchers who exhibited the inverted W, it just didn’t reach statistical significance. Because it did not reach statistical significance I can’t make the claim that the inverted W increases injury risk.

My hunch is that it does.

I appreciate your pioneering efforts… I do hope that you don’t get down on yourself when people want to shoot down your effort to shed light on a complex subject. It usually means that you’re on to something.

Read more here: http://clients.chrisoleary.com/Pitching/The-Science-Behind-The-Epidemic/Douoguih-Study-of-the-Inverted-W


#19

Inverted W is a timing issue. Looks like he lunges toward the plate late in the stride. Is this done purposefully? Notice how his stride foot is higher off the ground after the lunge. I’m not saying this is the cause of a timing issue but could be.


#20

Exactly. As I wrote above:

O’Leary’s point is not that the Inverted W is in and of itself dangerous, but that the Inverted W often leads to late timing at foot strike. It is late timing at foot strike that, according to O’Leary, increases strain on the arm and increases risk of injury. The boy in the original post clearly has late timing at foot strike, which is preceded by a clear Inverted W, and he has a shoulder injury.