Solutions to the Epidemic

1. Improving throwing efficiency

2. Reinforcing the muscles that support the ligament

3. Proper intensification

 Improving throwing efficiency is a personalized process, starting with an assessment. The baseball or softball athlete's throwing motion is analyzed for weaknesses and points of improvement. They then target these inefficiencies. Adjusting the natural throwing motion to take a more optimal shape as they lock it in as a habit for the athlete to use going forward. 

It is exciting to be at the forefront, but working through the adoption process can be excruciating. We must reinforce the areas and muscles transmitting the greatest energy. This is crucial for injury prevention. The viscoelastic nature of muscle contractions when throwing requires training at low velocity to preserve and build tissue tolerance. Low velocity gives the body the stimulus to adapt, at the right intensity to not get hurt in the process. We need to develop more robust dynamic stabilizers around the elbow and shoulder to minimize the wear and tear of the primary stabilizers. A slow, and methodical approach, prioritizing high repetitions at low intensity will build this needed strength in a dependable way.

I could devote a couple of articles strictly to this topic, but today, we want to look at the efficiency of how we use energy, specifically high intensity. Traditionally, the main component of intensification is an interval-throwing program. One of the crucial aspects of a interval-throwing program is the long toss. A recently published paper, “The science and biomechanics of long-toss,” says, “Long toss is a highly variable training supplement that is used in throwing programs at all levels of baseball competition.” In my view, this article is representative of much of the current strategy across the sport. So, there are three words I would like to pick apart. "[H]ighly variable" are the first two. At first glance, this should make our ears perk up. We don’t want to be highly variable; we want to be highly consistent. Variability has its place, but we need a highly stable pattern for introducing high intensity. The second word is "supplement". Most people blindly use long-toss programs as a piece of their training because they heard it works. Though, it's critical we should recognize the genesis of the long-toss program. Typically, most long-toss programs are prescribed in a RTP (Return To Performance) context for guys recovering from ulnar collateral ligament surgery. This protocol is used to condition the arm slowly to the forces of higher speed pitching. Long toss can be very beneficial to a wide range of athletes, but it requires a precise use case to unlock strength beyond just a therapeutic context. Long-toss is an integral part of intensification, but it so often lacks this critical intentionality.

 

The last time I checked, I didn’t see many pitchers intentionally strengthening their fingers, even though we now know these muscles provide the only dynamic stability for the medial elbow.