The Rubber Arm: Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury

By Dr. John R. Mishock

Dr. John R. Mishock’s dreams of playing beyond college were eliminated following injures to the wrist, elbow and shoulder. The setbacks led him to his true calling; being a physical therapist and chiropractor now helping athletes of all ages enhance their athletic performance, prevent and recover from injury. Coaches, parents and baseball players alike realize that in order to be an elite level pitcher they must throw with high velocity and control. The excess amount of throwing, poor pitching mechanics and inadequate physical training has led to shoulder and elbow injuries seen in baseball players. Dr. Mishock draws upon his experience as a baseball player and coach along with his high level understanding of anatomy, functional movement, and physical training to lend a unique perspective on baseball pitching. Whether you’re a coach, parent, or baseball player serious about reaching the highest levels of pitching or throwing success, this book is a resource in enhancing ones baseball performance.

• Language: English
• Publisher: Lulu Publishing Services
• Release date: May 4, 2017
• ISBN: 9781483465067

Book preview

THE

RUBBER

ARM

Using Science to Increase Pitch

Control, Improve Velocity, and

Prevent Elbow and Shoulder Injury

Dr. John R. Mishock

Copyright © 2017 Dr. John R. Mishock.

All rights reserved. No part of this book may be reproduced, stored, or transmitted by any means—whether auditory, graphic, mechanical, or electronic—without written permission of both publisher and author, except in the case of brief excerpts used in critical articles and reviews. Unauthorized reproduction of any part of this work is illegal and is punishable by law.

All images within the book, unless they are anatomy illustrations credited to artist Sebastian Kaulitzki from Shutterstock.com, are by Dr. John R. Mishock.

ISBN: 978-1-4834-6507-4 (sc)

ISBN: 978-1-4834-6506-7 (e)

Library of Congress Control Number: 2017901729

Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

Any people depicted in stock imagery provided by Thinkstock are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

Lulu Publishing Services rev. date: 04/05/2017

Contents

Acknowledgements

A Note: Pronoun & Grammar Usage

Introduction

Chapter 1 The Culture Of The Rubber Arm

Chapter 2 The Grip And Pitch Type Risk

Chapter 3 The Balance Point

Chapter 4 The Drive

Chapter 5 The Acceleration

Chapter 6 The Deceleration

Chapter 7 Highlights Of Pitch Mechanics

Chapter 8 Review Of Key Specific Muscle Groups Essential For Muscles Responsible For Throwing Velocity

Chapter 9 Optimizing Pitch Velocity And Control

Chapter 10 Fundamental Throwing Mechanic Drills To Increase Velocity, Control And Prevent Injury

Chapter 11 Guidelines To Prevent Shoulder And Elbow Injuries In Youth And Adolescent Baseball Players

Chapter 12 Pitcher Fatigue: The Warning Signs

Chapter 13 A Pre-Season, In-Season, & On Field Resistance-Tubing Throwers’ Exercise Program

Chapter 14 Baseball Interval Throwing Program

Chapter 15 Flexibility And Range Of Motion Training For Baseball

Chapter 16 Conclusion

ACKNOWLEDGEMENTS

Dedication: To my loving supportive wife Michelle who has stood by my side through our life journeys. To my kids, Ty, Zach, Hunter, and Madelyn who were the models for the countless pictures we took for this book. I love you all.

A NOTE: PRONOUN & GRAMMAR USAGE

For the sake of less problematic grammar in writing about a single baseball player of focus, and since plural language is not always simple with a topic like this, male pronouns are used in this book. If a gender-neutral singular pronoun in the English language existed to accommodate being more all-encompassing, it would have been used here. This book is written with the idea in mind that readers know baseball as well as softball can be and are played by both men and women, to varying degrees. But again, to keep everything as grammatically correct as possible, male pronouns are used for consistency and also in knowing that men generally play baseball in much higher percentages than women do.

INTRODUCTION

It is the middle of the youth travel baseball season, and Jimmy, a 10-year-old baseball player, arrives for an appointment at one of my six physical therapy clinic locations. His parents scheduled the visit because he’s been experiencing right shoulder pain for two straight weeks. The father and son are seated, attentive, as I gather the details of Jimmy’s history of shoulder pain. I inquire about how the shoulder pain developed. Jimmy says that he noticed the pain off and on since May, however, it grew much worse when he pitched in a baseball tournament last weekend. I ask him how many pitches he threw. He does not know. He does say that he pitched in 4 of the 5 games and that he pitched one complete game—6 innings to win the championship. His father states that there were no pitch limitations in the tournament and that he thought Jimmy would be fine to pitch as his team needed. I ask if he typically throws this frequently at tournaments, and his father explains that Jimmy is the best pitcher on the team. The only way they can win tournaments is for Jimmy to pitch, and a lot, he adds. As I examine Jimmy, it becomes clear that he has an acute severe shoulder injury. His range of motion is markedly limited, and his rotator cuff muscle strength is weak due to agonizing pain. Palpation around the biceps and supraspinatus tendons reveal significant pain and soreness, only reinforcing these symptoms which are so common with young baseball pitchers who throw too much, from my experience in seeing patients going through exactly what Jimmy is dealing with right now. Jimmy has rotator cuff and bicipital tendonitis. With rehabilitation and rest, hopefully Jimmy will be ready to pitch in 4 to 6 weeks. Jimmy finished physical therapy 6 weeks later with no pain, a full range of motion, and good strength. When I evaluated his pitching motion using a slow-motion video on my iPhone, I quickly noticed evidence of mechanical flaws in his movements, which could have led to poor efficiency and risk of injury. His pitching motion needed rebuilding, restructuring. Jimmy was able to resume baseball, but he was not able to pitch for the rest of the season. I put him in an off-season arm care and throwing program in hopes that he can return next season and pitch again.

Mike, a 17-year-old high school baseball star pitcher, had been referred to one of my clinics by a local orthopedic physician. Mike heard the diagnosis of a right partial tear of the ulnar collateral ligament. The surgeon wanted to try rehabilitation before considering Tommy John surgery, knowing that the surgery would require Mike to avoid playing baseball for a year, in addition to months of rehabilitation. Mike sits with his parents who have hopes of a college scholarship to be earned from his skills at the pitching mound. I question, Mike, how long have you had the pain in your elbow? He answers, For the last year, off and on. I ask, How many innings did you pitch last year? He takes a second to think about this. Not sure, Mike admits. Do you monitor your throwing with inning or pitch counts? I ask. Mike tells me that he usually tracked his pitching numbers since high school but not during his earlier years in travel baseball. His parents inform me that Mike excelled at pitching as a youth baseball star. They say that he threw pretty constantly during team practices and games. Have you had elbow pain before? I ask. His parents point out that Mike feels pain in the elbow off and on since long ago in his youth baseball days. They note that he would often throw through the pain, you know, the no pain no gain perspective. The rehabilitation for Mike consisted of 8 weeks of manual therapy to the elbow and forearm muscles, strengthening of the hips, core, shoulder, and forearm muscles, and a progressive interval throwing program. He was able to return to baseball and pitch during his senior season. But in his first year of college, he completely ruptured his ulnar collateral ligament, and this required surgery. Mike was never able to return to his college baseball team and gave up the game entirely after his junior season.

Cole, a 20-year-old Division I college catcher, visited one of my physical therapy clinics following his second Tommy John surgery. Cole served as a star pitcher throughout his young baseball career. He was highly sought after by college and professional scouts, with a good size frame and a fastball which could reach speed in the mid-nineties; he was a can’t-miss star of the field. Unfortunately, he blew out his elbow as a college freshman. He tried to return to pitching after his first Tommy John surgery but could not. He could never reach the pitch velocity which he once had. To still be a part of the game he loved so fiercely, Cole resorted to becoming a catcher. He had hopes of fulfilling his professional baseball dream but in the role of a catcher. Discouragingly, those dreams were dashed by the complex effects of the second Tommy John surgery. Cole never received a call or letter saying he’d been drafted. He ended his college career as a platoon player at first base and left field.

Baseball has been a passion of mine since the time I was a small boy. My dreams of playing baseball at the highest level never came to pass. A labral tear of the right shoulder, elbow injuries to the medial collateral ligament, and a carpectomy (2 bones removed, the scaphoid and lunate) of the right wrist were all blessing in disguise. Instead, I fell into my true calling of being a chiropractor and physical therapist. My love of baseball has come full circle, though, through my occupation. Once the injured athlete, I now have the opportunity to help players reach their ultimate goal, unencumbered by injury. I wrote this book in hopes of providing reputable, in-depth research describing the most practical ways to prevent injury and optimize sports performance. With this resource, I hope the coach, parent, or player will glean the best chances of reaching the baseball dream without arm injuries dictating their fate on the field.

CHAPTER 1

The Culture of the Rubber Arm

In baseball circles, the term rubber arm represents an arm of a valuable pitcher who throws and throws with continual success and seemingly without injury or fatigue—he is always available to step up and pitch when the team is in dire need of a victory. His pitching arm is strong, flexible, and dependable. With a near epidemic of shoulder and elbow-related throwing injuries developing while pitchers are at the mound, the baseball player of today is often searching for the elusive rubber arm. My goal with this and future writings is to equip the modern baseball player with a state-of-the-art approach, based on sound research, in order to enhance pitching performance and prevent injury in attempts to create that rubber arm.

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Baseball is one of the most popular sports in the world, with an estimated 40 million individuals participating as amateurs and pros across the globe¹. The ability to pitch a baseball is potentially the single most important component at all levels of baseball. In Major League Baseball, the pitcher may be the most valuable commodity in all of professional sports. MLB spends $1.5 billion on pitchers’ salaries annually. That is 5 times more than the combined salaries of all the NFL’s starting quarterbacks. In what they earn, MLB pitchers exceed the top 200 NBA salaries combined².

The ability of the pitcher to throw hard and with accurate control is essential at all tiers of baseball. High-level college coaches and professional baseball scouts are not looking for pitchers who can throw a ball only 80 mph. The pitcher who throws in the mid-eighties range with good control is a minor college prospect. And the player who throws at a speed in the mid-nineties with good control is a mid-round or better professional draft pick. One must not underestimate the value of the pitcher who can throw strikes, hit spots, and change speeds. However, velocity is king. If you look at MLB statistics from 2003 to 2015, the average fastball went from 89 mph to 92 mph. In 2002, less than 50 percent of MLB pitchers had an average fastball greater than 90 mph. Contrast that with 2015, when 75 percent of MLB pitchers had an average fastball over 90 mph. The number of pitchers who average over 93 mph has gone up from 12 percent to 32 percent³.

Possibly of greater importance than the player’s ability to throw hard with good control is his ability to remain injury-free. From youth to professional leagues, there are more than 50,000 injuries per year. Most of the injuries in baseball involve a pitcher’s throwing arm, with nearly 50 percent of all pitchers experiencing significant shoulder or elbow pain which prevents participation in the sport at some point in their careers⁴.

Injuries are a major problem in MLB. In 2014, MLB spent $665 million on injured players who were on the disabled list. Tommy John surgery has become so widespread that it is often referred to as reaching epidemic levels in baseball players. Tommy John surgery is a surgical graft procedure in which the ulnar collateral ligament in the elbow is replaced with a tendon from elsewhere in the body. In 1974, Frank Jobe completed the first-ever surgery of this kind on Tommy John who pitched for the Los Angeles Dodgers at the time. The surgery was a success, allowing Tommy John to finish his professional time on the mound with a total of 288 career victories, ranking him seventh all-time among left-handed pitchers.

In MLB, from 2008 to 2014, the number of days players spent on the disabled list from elbow-related injuries went up from 5,000 to 8,000. In 2014, there was a record of 101 Tommy John surgeries performed in MLB. Of those who had the surgery in 2014, 37 percent were having the surgery for the second time. Overall, 25 percent of MLB pitchers have a history of Tommy John surgery⁵. There is popular belief in baseball circles that Tommy John surgery should be done to enhance pitching performance. Thirty percent of coaches, 37 percent of parents, 51 percent of high school athletes, and 26 percent of collegiate athletes believe that Tommy John surgery should be performed on players who have no existing elbow