Control Problems on the Mound? It’s Not Always “Mental.”

How many times have you heard these lines?

  • “It’s a mental issue.”
  • “He has the yips.”
  • “He lost the ability to throw strikes.”
  • “It’s all in his head.”
  • “He’s mentally weak.”

They’re catch-all phrases that hope to capture the essence of why a pitcher like Daniel Bard can put up these kinds of insane runs:

It’s generally assumed that pitchers like Bard simply lose it mentally and can’t throw strikes because of some ephemeral issue that no one can pinpoint. Let me state for the record that this kind of thing DOES happen, but very often it’s actually an underlying physiological issue, not a mental/psychological one (or at least one rooted in those areas). Daniel Bard can still throw 95+ MPH – just like a handful of my pro clients who were throwing at their top velocities despite spraying the ball all over the place. None of them reported pain, soreness, or weakness – so it couldn’t be physical, right?

Unfortunately, that’s not how it always works.

First, let’s take a closer look at just how hard it is to throw strikes.

A Matter of Timing

Throwing a five ounce baseball with raised seams to a catcher at a target of your choosing is not exactly the easiest thing to do, yet the actual physics-to-performance marriage goes largely unexamined. Here’s two slow-motion videos shot from the side and overhead to capture the two main planes that the arm’s trajectory is on (capturing internal rotation, elbow extension, and trunk rotation). Aaron West is on the left, Taiki Green is on the right.

Aaron West vs. Taiki Green

The distal wrist of the pitching arm (and therefore, the ball) is on a weird curvilinear path around the body that is very individual to the pitcher in question. However, for simplicity’s sake to understand the basic geometry behind throwing strikes, we’ll make the arm path a simple circle below:

Tangent Arc

Imagine the black circle is the arm path and the blue line with points A and B is the ball’s trajectory. This is a line drawn tangent to the arc, and this is how a ball is thrown from the arm path. A line drawn tangent to a circle has only one point of intersection (inflection point).

So, now that the basic geometry lesson is over, here’s how it relates to throwing a baseball at a target – a baseball is ejected from the hand at a “release point” that has just one point of intersection with the hand (the moment of separation between the baseball and the hand, usually the middle finger). Now imagine that the circle above is rotating at something like 4500 degrees per second (internal rotation) but is also being deformed at up to 2500 degrees per second by increasing the radius of the circle (elbow extension), and you have a good idea of just how difficult it is to “repeat” your mechanics. (Take a look at an interactive display – change the point on the circle just slightly, and see how much the tangent line deviates.)

Actually, when you think of it that way, how is it even possible to repeat your mechanics? How is it possible that professional pitchers can hit their target on a somewhat regular basis? Mathematically, it seems to require superhuman reaction speeds and timing ability.

Physiologically, the body is one hell of a weapon.

Proprioception is Everything

Your body has the ability to automatically and unconsciously sense and control motor units in a complex way to perform incredibly difficult tasks – like ballistically ejecting an object at 90+ MPH towards a target with some degree of precision. Your body uses a set of levers (bones), pulleys (muscles, tendons, ligaments), and a central processing unit (brain, nerves installed in the muscles) to coordinate everything together to make minute changes that are impossible to consciously repeat. This is the genesis of the so-called “10,000 hour rule” as made popular by Outliers, and the MUCH better book by Geoff Colvin, Talent is Overrated.

Proprioception is the sense of the relative position of various body parts in relation to one another, usually while they are being moved. This is a generally automatic function of the body – you don’t think about firing the muscles of the upper leg in relation to the lower leg while you’re walking, nor do you think about expanding your chest manually when you breathe. When the body is damaged, there may be a temporary loss of proprioception, but the feedback given to the nervous system generally makes quick adaptations and allows for quick recovery.

For healthy pitchers, this is why we do a lot of overload/underload training using wrist weights, PlyoCare balls, and Driveline Elite Weighted Baseballs. By forcing the body to adapt to new stimuli through similar ranges of motion (and with vastly different ballistic profiles), the motor units of the pitching arm become more efficient.

However, for injured pitchers, it’s a completely different story – and that includes both pitchers who were previously injured and are now healthy in addition to pitchers who are injured but display no symptoms of injury.

Rebuilding Proprioception Through Rehabilitation – Early Intervention is Key

Rehabilitation of previously injured pitchers is far more complex than sending them to physical therapy after surgery and “returning to function” based on strength and skill tests. A pitcher who has had UCL graft/replacement (Tommy John surgery) will now have holes drilled in his arm plus a brand new tendon in place of the original ligament, not to mention severe cuts to the pronator/flexor mass that were required to get to the connective tissue in the first place.

Tommy John

Retraining the pitcher’s proprioceptive ability is similar to what we do with our healthy pitchers, though the focus is generally more on partial and constraint movements that get backchained into the full throwing motion. By using overloaded drills to help force the body to feel the proper movement patterns to more safely generate velocity, we can start the primary programming of the interval throwing program off with an accelerated pace. It is critical that when the athlete starts interval throwing that he immediately starts these simple and safe drills, because the minute a pitcher picks up a baseball, he will revert to primary programming – even if that programming is detrimental to his arm’s health. Furthermore, primary programming is not always applicable, because leftover proprioceptive sense believes the ligament is in one place, the forearm flexors have sufficient strength, the biceps work in a certain way…

Get where I’m going with this? Is it any wonder that a pitcher who seems “healthy” after surgery has ridiculous control problems? It may partially be due to psychological fear of getting on a mound and “cutting loose,” but often it is due to proprioceptive failure. Remapping the proprioceptive senses is incredibly important, and one that is often lost in the physical therapy world. Even if the PT uses Bosu Balls or other unstable surfaces to work on proprioceptive sense, these are not sport-specific and have little to no carryover to ballistic training.

Rebuilding and Regaining Control

For athletes who have microtears in their ligaments or otherwise damaged tissues that they cannot feel – ligaments have poor blood supply and innervation – this can have a serious negative impact on their ability to throw strikes. The proprioceptive mapping of how to throw strikes may be on one setting but cannot adequately adjust to the new situation of slightly damaged tissue that presents no symptoms to the central nervous system. This is why pitchers who have destabilization of the elbow tend to display control/command issues well before their UCL ruptures, even if their velocity does not significantly drop in the process.

Close monitoring of these markers should be done by all professional teams, and athletes themselves should integrate proprioceptive remapping exercises into their training.

The next time you think your favorite pitcher has simply “lost his marbles” and has developed “Steve Blass disease,” consider that maybe he has a serious injury that is simply asymptomatic. Just because he doesn’t feel pain doesn’t mean he’s not hurt – and that’s one of the most frustrating things any athlete can go through.

The Reinvention of Casey Weathers – Restoring What Tommy John Took

Casey Weathers was the first round pick of the Colorado Rockies (8th overall) in 2007 after putting up incredible numbers at Vanderbilt – striking out 75 over 49.1 innings while allowing fewer than one hit + walk per inning pitched. Casey was throwing 95-97 MPH at the time with a wipeout slider, and was tagged as a fast-mover. In his first full season in Tulsa (AA), he was off to a good start, striking out a ton of hitters and getting very weak contact with his ERA hovering just around 3. He would hit 100+ MPH on several outings in the hot weather. He’d also throw in the 2008 Olympics for the United States, taking home the bronze medal for his efforts.

Casey Weathers - USA

Things were good, until his command started to desert him, and it finally happened – his elbow hurt after throwing a pitch. He had an MRI done on his arm by the team doctor, which led to the following report:

FINDINGS:
There has been interval development of increased signal and poor definition of the mid to
proximal fibers of the anterior bundle of the medial collateral ligament compatible with
ligament rupture. There is mild edema in the adjacent flexor digitorum superficialis
muscle compatible with mild muscle strain injury.

IMPRESSION:
Rupture of the anterior bundle of the medial collateral ligament as well as a mild strain
of the adjacent flexor digitorum superficialis muscle.

For those not aware what that means, it’s not good news. On October 20th, 2008, Casey Weathers had a follow-up meeting with Dr. Lewis Yocum to receive the official bad news, and eleven days later had his ulnar collateral ligament replaced. Tommy John surgery had struck yet another pitcher.

The Dark Side of Tommy John Surgery

Tommy John

On a late night rant about elbow reconstruction surgery, I said this:

Casey was one of the unlucky ones; the ones who don’t magically throw harder and have no problems after having major surgery on a body part that they lean on to earn a living. This is more common than you think – remember Kris Medlen? Ryan Madson? Jack Armstrong? Daniel Hudson? Andrew Brackman?

When you drill holes in the bone, cut into the soft tissue, and perform reconstructive surgery, serious complications can occur. We accept this as a fact of everyday life when it comes to major surgery on other body parts, like our heart or even rotator cuff, but many believe elbow surgery is this simple procedure that has no issues that come along with it. These people are wrong, and spreading this sentiment is very, very dangerous.

Casey complained of post-operative pain and obtained another MRI in March 2009, which found:

There is very mild bone edema along the graft tunnel in the ulna. Posterior to the intact graft there is a
small fragment of bone along the posterior inferior margin of the medial epicondyle
separated 2 mm from the condyle at the expected origin of the posterior band and in part
involving posterior bundle humeral attachment. There is surrounding granulation and/or
inflammatory tissue. There is adjacent remodeled sclerotic margin with mild deformity of
the adjacent tip of the medial malleolus again posterior to the graft. These changes are
best appreciated in entirety on coronal 17 sagittal 07/06. Linear band of soft tissue
inflammation and scar tissue extends along the posterior margin medial epicondyle as
well with elevation of the capsule 1-2 mm from the bone in this location, likely post-
surgical related.

Summary: Casey had a lot of post-operative problems with his elbow, primarily a bone spur that started to develop.

Throughout 2010, his rehabilitation continued to progress slowly. Casey would have a PRP injection in his elbow before the season, which did little to improve the situation. Casey wouldn’t throw in a game until late 2010 – nearly 20 months post-operation. And when he did, he would feel pain near the ball release phase of the delivery, and was walking a lot of guys despite his velocity nearly fully returning.

The list of pitchers who lose enough proprioception from elbow to fingertips is long and varied, yet Casey was – and others undoubtedly are – branded “mentally weak” for being unable to throw strikes.

However, research in the Driveline Sports Science lab shows that forearm fitness, endurance, and strength are strongly correlated with command. During elbow surgery, the flexor-pronator mass is sliced open, and during rehabilitation, it atrophies as the elbow is immobilized for months on end. Is it any wonder that so many athletes who have had Tommy John surgery return only to find their ability to throw strikes has completely abandoned them – despite the fact they may feel no different?

EMG Sensors

After pitching in 2011 and 2012 with ridiculous walk rates (including 53 free passes in 34 innings in 2012) and pain in his forearm, Casey had an MRI and exploratory surgery to confirm that the bone spur in his elbow was near the posterior aspect of the anterior bundle of the UCL, and though little to no damage was done to the UCL, this bone chip was causing serious issues in Casey’s arm. The loose bodies were removed and Casey would undergo rehab yet again, missing all of the 2013 season.

The Chicago Cubs notified Casey they would not be renewing his contract, and Casey signed with the San Francisco Giants for the 2014 season.

Teamless in Seattle – Work Begins

Though Casey took the 2013-2014 off-season seriously and trained very hard through his rehab period, he would show up to the Giants camp without his trademark velocity – throwing just 89-91 MPH and topping out at 92 MPH. His command wasn’t terrible but it wasn’t good either, and he was swiftly cut from the roster.

Casey’s teammate at Vanderbilt (Caleb Cotham, Yankees) had trained remotely with me over the 2013-2014 off-season and Caleb highly recommended that Casey email me for more information and to see if I could help restore his velocity.

On March 27th, Casey fired off an email to me stating his history, unsure of where to go from here. I responded that he was welcome to train here and that we just had two unaffiliated professionals leave our facility (previously with the Nationals and Phillies), so it was a good time to get some individual attention. After going over the training plans and fees, Casey committed to training here for an indeterminate amount of time with the minimum being around 2 weeks of full-time training. He expressed his fear of regressing back to having elbow pain once again, and I assured him that our program was first developed to help reduce short-term pain and hopefully ingrain long-term health, and through those methods, we believed velocity would be more easily developed.

So, knowing that he had two elbow surgeries – one just a few months prior – I naturally took it easy on him on his first day, right? Not exactly. Here’s what I said in an email to the Driveline Baseball Email List:

On day one, I had him throwing Driveline Elite Weighted Baseballs and Driveline PlyoCare Balls and took tons of high-speed video and radar readings of his throws. What the data revealed was obvious to me after thousands and thousands of repetitions of watching pitchers throw and marrying it to real research – Casey did not adequately control the direction, timing, and magnitude of extension of his pitching elbow. Further probing revealed that Casey had issues with hyperextension of the pitching elbow, which made total sense.

Yes, you read that correctly, I had Casey throwing one and two kilogram PlyoCare balls as well as 9 ounce weighted baseballs on the first day he was here. (After taking video of him in our biomechanics lab and showing him the lengthy warm-up / arm care protocol we have, of course.)

Driveline MegaKit

The look on his face after I told him to throw weighted baseballs as hard as he possibly could was pretty funny. Casey wasn’t argumentative, however, and he completed his first round of Ballistic Efficiency Testing, clocking a whopping 93 MPH on a maximum effort pull-down with a regular five-ounce baseball.

Not too impressive. But the spread of velocities told me something in addition to the high-speed video and four-camera synchronized video I shot – Casey was holding back. He was able to throw overloaded baseballs at a velocity far too close to a regular baseball, yet his underload throws were fairly standard. The arm strength was there – the reciprocal inhibition is what was killing him.

I showed him video of him in the Futures Game, of his draft video coming out of Vanderbilt, and the video we shot in the lab. I told him that he needed to be like the guy at Vanderbilt with just two mechanical tweaks that could be felt using our overload/underload training program using wrist weights and various weighted implements – so we started undoing all the “take it easy” programming he got in pro ball and started reprogramming his central nervous system using specifically crafted drills, including hundreds of throws at submaximal intensity of underload baseballs to develop the correct relationship between his throwing hand and his throwing elbow.

Casey Weathers - Vanderbilt

Restoring the velocity of a pitcher like Casey is a lot easier than it is to develop in a 16 year old high school pitcher. I told him on day one that I was extremely confident that we’d restore his velocity to close to what he was throwing at Vanderbilt, and if he continued to train using our methods, that he should be able to return to full strength while maintaining a healthy mechanical pattern. At this point, he was all for it.

He would throw a bullpen to one of my clients, Brendan Illies (Puyallup HS). In the bullpen, he sat 90-92 – not appreciably better than he was in Spring Training, but at least this was an indoor bullpen session and should expect to be better outdoors against hitters. Still, I wasn’t banking on it, and neither was Casey. He would show up 5-6 days a week to train individually and in a group setting with my other clients, many of them high schoolers. Every day he came in, he learned something new – rebounders to develop force acceptance, tons of use on the Marc Pro for electrical muscle stimulation, hundreds of reps using PlyoCare balls to develop proper mechanical patterns, and lifting a bunch of free weights to maintain his strength levels.

Then we’d evaluate and test, over and over again. Iteration is the key to success in our program, and Casey would be no different. His velocity began to pick up, and ten days after he began training here, progress was coming along:

Not satisfied with those numbers, we scheduled another velocity testing day four days after the +10 day marker to officially cap off 2 weeks of training, and breakthroughs started to occur:

Weathers Velo 14 days

That’s more like it – 98.7 MPH isn’t too bad at all. Casey was throwing more often and with more intensity and never once complained about significant arm pain. Sure, he’d have the tweak here or there, but I reminded him that’s when he was regressing back into a painful pattern, and overloaded implements helped him explore the limits of those mechanical issues. When Casey was at his best, he was ripping off near 110 MPH underload throws at my face:

Casey Weathers Underload

After a few indoor target sessions to work on his command – which was getting better all the time through proprioceptive improvement and virtually NO work on it specifically – I felt confident that he could throw to hitters and be successful. Through the gracious help of Coach Wiese at Puyallup HS, I arranged for Casey to throw to volunteers from Puyallup HS who were on their way to an undefeated season in the SPSL 4A league and earning themselves a top-25 national ranking in the process. I told Casey these kids could be a pain in the ass and that he should go right after them, after all, more than a handful of them had significant Division-I scholarships to schools like North Carolina, New Mexico, Washington, and Oregon State. He made some disparaging comments about the Pac-12 and ACC (being a former SEC closer, of course), but smiled and took the mound.

His command was significantly better than expected, and while his slider was a work in progress (watch the above video for one particularly nasty slider from the rear view – sorry, Adam Stump), his velocity had jumped up from the 89-91 MPH range he was at in Spring Training, touching 96 MPH.

Casey 96 MPH

We went back to work to develop arm strength and durability in addition to trying to eke out some more velocity gains. At this point, I emailed the various local scouts that I knew as well as some scouting directors I was friends with and told them about Casey’s resurgence. More than a few organizations were interested, and some fairly important people came out to see him at his last live hitters session (once again versus Puyallup HS) where his slider was incredibly sharp and he sat 94-95 MPH.

The End of the Beginning

Casey would return home with a parting gift in his travel bag – a full set of Driveline PlyoCare Balls, Elite Weighted Balls, and Jaeger Sports J-Bands for at-home training (all available in the Driveline Velocity and Arm Care MegaKit).

I sent him his remote training program so he could continue to work hard, and we stayed in frequent touch over a period of two weeks. I opened up a channel with his agent, Mark Pieper of Relativity Sports, as well as other scouts who previously expressed interest in Casey’s progress, until the inevitable happened – Casey would sign as a free agent on May 16th, 2014, with the Tampa Bay Rays – joining the organization that has treated his former Vanderbilt teammate so well, David Price.

I couldn’t be more happy for Casey. He truly embraced the facility’s motto – Rest is Atrophy – and set a great example for our high school athletes. He was ready to discard everything he thought he knew about training and was very open-minded about the entire process, asking tons of questions along the way to further his own understanding of the material in addition to simply training very hard to get better.

Whether or not Casey succeeds in professional baseball – and I’m betting he’ll do just fine – he’s already proven that velocity can be developed and restored safely, despite the fact that few coaches and trainers in the professional ranks think it can happen. And even if they believe it can happen, they sure as hell don’t think “weighted baseballs” are the way to do it, especially with guys who have had arm surgery (two, in Casey’s situation).

I look forward to seeing Casey this coming off-season to continue to work, especially alongside our ragtag group of professionals like Trevor Bauer. The crowd will be bigger this time around, but the spirit of the facility always remains the same – and that’s the real reason our program works.

Casey Bullpen

Here’s what Casey had to say about his training time at Driveline Baseball – presented totally unedited:

I was nervous at first to start an intensive program like Kyle’s. After 2 elbow surgeries and Chronic elbow pain, how would my arm hold up to throwing weighted balls at maximum intensity? Within two weeks all of my concerns had been alleviated. Kyle has an advanced understanding of the research that is available in the biomechanics and pitching community. It impressed me even more how incredibly driven he is to continue to learn.

Kyle’s program brought me back from a guy scared to throw because I didn’t want to agitate my arm, to throwing with full intent every day and more volume than I had since 2007 in college. I spent the majority of my career protecting my arm and not using it. It felt great to actually practice with athleticism and purpose again. I really feel like Kyle gave that back to me and more.

He went above and beyond what a pitching coach could do for a player. I can’t thank Kyle enough for breathing life back into my career. I will continue to work with Kyle because I truly believe in the benefits of the program.

Momentum and Arm Action: Myths and Misunderstandings

Pitching mechanics is a difficult subject to talk about, and one that I don’t touch lightly on this blog. Covering the basics of pitching mechanics like stride length, stride speed, hip/shoulder separation, and even pronation are generally not the topics I tend to discuss – at least not without a significant amount of data. With this post, I’d like to talk about the concept of momentum as it exists in the baseball pitching delivery compared to the generally-accepted definition of the term in the world of physics (classical mechanics, to be precise).

Momentum’s real definition – long before deep analysis of pitching mechanics ever existed – is simply:

…a quantity expressing the motion of a body or system, equal to the product of the mass of a body and its velocity.

Its formula is p = mv; momentum is equal to mass times velocity.

Momentum and Arm Action

Stephen Strasburg

Paul Nyman described the ultimate goal of developing pitching velocity as connecting momentum in the delivery, that connective tissue are springs that are to be loaded and unloaded. Nyman’s general descriptions of intent and momentum in the delivery were (and remain) breakthroughs in understanding how velocity is really developed.

In the physical world, we are bound to the law of Conservation of Momentum, which states:

…a body at rest remains at rest and a body in motion continues to move at a constant velocity unless acted upon by an external force.

This is also known as the Law of Inertia, Newton’s First Law.

However, the fact that momentum is conserved has been twisted when it comes to baseball pitching mechanics. Nyman and others have posited that a constant flow of momentum being connected from proximal to distal is ideal for developing elite fastball velocities.

Let me be clear about this: I agree with the overall modern day understanding of the kinetic chain (proximal to distal, largest to smallest), but not with the idea that momentum is conserved in such a manner. What is being described is simply efficient sequencing of body parts, not the “elastic storage” of energy necessarily.

Summation of Speed

Taking a Look at the Data

When American Sports Medicine Institute (ASMI) studied Dr. Mike Marshall’s throwing technique in 2008, they released data that showed bucketed ranges for their “elite” and “mediocre” group pitchers to compare the “torque” group with.

If you have never seen a Dr. Marshall pitcher, then you should probably watch some of this high-speed clip of Mike Farrenkopf throwing at ASMI’s labs:

Leaving aside the unorthodoxy of Marshall’s technique, several major points arise from the data provided by ASMI.

1. Hip rotation velocity is simply not that important.

Comparing the Elite Group (85-89 MPH in lab settings) of pitchers with the Mediocre Group (74-77 MPH in lab settings) of pitchers reveals that the elite throwers have a mean maximum pelvis rotation velocity of 598.5 deg/sec while the mediocre group was at 532 deg/sec. A delta of 66 deg/sec was less than one standard deviation (522 to 675, SD of 76.5) in the elite throwers’ group for hip rotation velocity.

Other existing research corroborates this finding. In Kinematic comparisons of different pitch velocity groups in baseball using motion model method (Takahashi, Fujii, et al ISBS 2002), researchers found that peak hip rotation velocities showed no appreciable difference between high and low velocity groups, but rather timing was far more important. In fact, the high velocity group tended to reach peak hip rotation earlier than the low velocity group, which runs counter to what most modern pitching coaches teach (rotate the hips as late as possible).

Kinematic Comparisons

Those pitching coaches that preach hip rotation velocity is important should probably review the research literature on the subject to re-evaluate their claims.

2. Momentum into Shoulder External Rotation was unimportant

When asked to describe connecting momentum into the arm action phase of the delivery, many modern pitching coaches assert that the speed of the distal wrist entering shoulder external rotation creates a greater elastic stretch of the internal rotators and “stores” energy in connective tissue. (OK, most don’t describe it with that terminology, but that’s what they mean.) This seems to make sense. Ever watch the NFL combine high jump test?

What do you see? The jumper makes an immediate countermovement (squat) and explosively drives off of the flexed knees to create the maximum amount of ground reaction forces (GRFs) to propel himself skyward.

Since shoulder internal rotation velocity is highly coupled with ball velocity (throwing a ball is mostly shoulder internal rotation + elbow extension), we should seek high angular velocities of shoulder external rotation, right?

Perhaps not. Consider that the shoulder-scapular complex is not necessarily designed to externally rotate to 170-180 degrees as shown below:

Billy Wagner at MER

Can you get your arm in this position without throwing a ball or other object? I didn’t think so.

However, knees were designed to be flexed and extended like the high jumper in the above video, which makes that movement optimal.

The data seems to support this line of thinking, too. In the aforementioned ASMI data set, elite pitchers generate an average peak angular velocity of shoulder external rotation of 1578.5 deg/sec (1291 to 1866 +/- 1 SD 287.5). The Marshall pitchers generate an average peak value of just 405 deg/sec.

This is astronomically different – you are talking about a four standard deviation difference between Marshall pitchers and elite traditional pitchers. This is a massive outlier, and in itself it is proof that Marshall’s pitchers more or less do as he asks (minimize reverse forearm bounce, as he calls it).

Since Marshall’s pitchers have such terrible countermovement into shoulder external rotation, their ball velocity must be massively different, right? Well, this is a complicated question. The short answer is “yes,” because Marshall pitchers threw an average of 77 MPH compared to the 85-89 MPH range of elite pitchers. But mediocre pitchers threw just 74-77 MPH and their average peak angular velocity of shoulder external rotation was 1530 deg/sec. What? Read that again, and look two paragraphs up. Note that mediocre pitchers had statistically insigificantly lower countermovement into shoulder external rotation than elite pitchers!

This statistic alone should be enough to bust the idea that the speed at which the forearm lays back into external rotation is important, but it goes further than that. The faster the arm lays back in external rotation, the faster the arm must rebound into internal rotation to drive the ball to the plate. This creates a ton of torque and plyometric stress at the elbow (dynamically stabilizing the joint against valgus stress) and the shoulder.

What’s more is this astonishing statistic – Marshall’s pitchers generated elite levels of peak shoulder internal rotation angular velocity (7899 deg/sec vs. 7547 deg/sec) AND peak elbow extension angular velocity (2509 deg/sec vs. 2413 deg/sec). Remember, these are not accelerations – they are velocities, meaning their arm was moving just as fast as the elite pitching group’s! Why didn’t this translate into better ball velocity? I covered this in another blog post titled Reviewing ASMI’s Biomechanical Analysis of Dr. Marshall’s Pitchers, where I posited the following theory (referencing the forced activation of the flexor-pronator mass in the Marshall pitching mechanic):

This is what is happening when you powerfully contract the pronator muscles in the forearm: You are very likely protecting the ligaments in the ulnar collateral ligament (UCL) while simultaneously generating equivalent IR Velocity, Elbow Extension Velocity, and related torques (which are just derivatives of acceleration of body parts; this is typically done using inverse dynamics as outlined by Zatsiorsky) – but you’re getting much lower final velocities of the baseball due to this “stiff” portion violating the kinetic chain. Additionally, due to the rotating forearm as the arm is accelerated forward, the wrist is not laid back for the final acceleration into ball release.

3. Kinetics and Joint Loading Numbers Don’t Tell the Entire Story

A biomechanics researcher occasionally opines to me, wondering why the field of baseball biomechanics is so in love with joint torques and loads. He explains that nearly all other mechanical fields do not view these numbers as absolute, but merely guiding numbers – and connections between joints and structural integrity/strength is far more relevant in their research.

Such are my feelings about absolute joint torques and loads. For example – it is well-documented that Marshall’s pitchers rarely hurt themselves while pitching (I suppose a few would find objection with this statement, but it is more or less true if you’re not being pedantic – Jeff Sparks’ UCL rupture cannot reasonably be blamed on the Marshall technique) despite throwing 2 – 10 lb. iron balls and training with up to 25+ lb wrist weights, all on top of throwing to maximum effort every single day. Yet in ASMI’s study of their pitchers, they concluded that Marshall pitchers generate equivalent torques on their shoulders and elbows as the elite pitchers did, which only makes sense given their internal rotation and elbow extension angular velocities were so high (and accelerations must have been higher given the lower rates of maximum shoulder external rotation).

Joel Zumaya

How is this possible? As stated multiple times before on this blog (this long article on Joel Zumaya’s elbow is a good start), the flexor-pronator mass dynamically stabilizes the elbow against valgus force and is thought to provide additional protection to the UCL during baseball pitching. Additionally, the lack of rebound from shoulder ER to IR may be a relevant factor that was not quantifiable at the time of the study – a theory that holds some merit, since we know that bone is sensitive to loading rate when it comes to pitching mechanics.

From Whence Arm Speed Comes From

If the speed at which the arm lays back isn’t relevant to creating fastball velocity, but internal rotation angular velocity (mediocre: 5873.5 deg/sec, elite: 7547 deg/sec) and elbow extension angular velocities (mediocre: 1978.5 deg/sec, elite: 2413 deg/sec) are massively important, then how do we create a faster arm? (For lack of a better term.)

The first answer is a cop out but unfortunately a very real one: A better genetic profile. If you were lucky enough to be gifted with faster-firing muscle fibers in the relevant areas of the body (internal rotators, elbow extensors), then you will probably “naturally” throw harder than your neighbor. Since we can’t control that factor, let’s acknowledge it but ignore it.

Javelin Throw

Power and speed-strength can still be developed in the pitching arm (despite what you hear from traditional pitching coaches who think velocity is god-given), which is why weighted baseballs make up a large part of our training in the Elite Pitcher Program at Driveline Baseball. Yes, their mechanical autoregulation cues are good (and important), but developing speed-strength using under/overload training has scientific merit dating all the way back to the Soviet Sports Science projects of the early 20th century.

Additionally, a better understanding of the agonist-antagonist relationship of the pitching arm (and its surrounding musculature) can help us develop velocity indirectly. By strengthening the decelerators and improving recovery of the pitching arm in the delivery, the arm is free to move faster without inhibition; your subconscious motor control is often better than your conscious brain at determining what movements will injure the human body. This is the theory behind using wrist weights, heavy plyometric balls, and sport-specific lifting exercises in the weight room to not only increase endurance of the muscles that help protect the arm, but to increase the contractile strength of them and possibly unlock fastball velocity in doing so.

Hardly the End Story

While few of you have made it this far into the blog post, I’m afraid to say that this is just a very topical review of one small segment of pitching mechanics. Further research and experimentation is required to get the best out of our athletes, which is why research in the Driveline Sports Science lab never stops. I’m excited to see what additional research using EMG sensors will bring (we already have a lot of neat data), especially in combination with force plates and our existing biomechanics lab with high-speed cameras.

Let me give you something to think about that we recently discovered 4-6 months ago that became vitally important in how we train our athletes. Take a look at this graph of elbow extension/flexion angular velocities from the aforementioned paper by Takahashi et al – and try to grasp the importance of the slope, magnitude, and timing of the graph when comparing high vs. low velocity pitchers. The answer may just shock you.

Elbow Comparison

Releasing Tommy John’s Grip on Pitchers

It’s about that time, isn’t it? The short period of time where we notice the rash of elbow and shoulder injuries to pitchers and look for answers in the usual places, like Tom Verducci’s columns (never mind that the Verducci Effect has been thoroughly debunked) where the “experts” are interviewed and say some variation on the following:

  • Travel ball is evil
  • Showcase ball will cause you to kill your arm, damn those people at Perfect Game
  • Latin players grow into their velocity
  • Americans put too much focus on velocity
  • etc

Let’s not forget: If a pitcher is going to be injured, it is most likely at the beginning of the year. The reasons for this aren’t necessarily clear, but as Dirk Hayhurst pointed out in his latest book, when he hurt his shoulder in the gym, he was tempted to nurse it to the beginning of Spring Training and hope to blow it out on the mound there so medical insurance would be picked up by the team. It is not inconceivable that this is a significant contributor. Additionally, players are often allowed to do whatever they want in the offseason by their teams, and are not given specific workouts to train their arm. I’ll always remember Matt Diaz doing P90x in the 2008-2009 offseason, which is probably one of the worst possible “training” (I use the term loosely) methods you can employ for a baseball player. A lack of a sound throwing program with specific prehab exercises probably contributes to both the velocity drop at the beginning of the year (in addition to weather of course) as well as increased risk of injury in the early months of the year.

So, with all that out of the way, let’s cover some major talking points.

Youth Pitchers are Overused

Tim Lincecum - Young Age

This is a trope that generally covers the “showcase baseball is more risky than Little League” as well as the “pitch counts / adequate rest is important” line of argumentation. Most of these arguments lately are based off of a longitudinal 2011 study done by the University of North Carolina (pdf, web) which indirectly surveyed youth, high school, and college pitchers across the country from 2006-2010 (HS players 2007-2010, college players 2008-2010).

ASMI also released a ten-year longitudinal study (pdf) in 2006 that concluded that pitching more than 100 innings in a calendar year increased the risk of serious injury to the pitching arm. However, like most longitudinal studies, sample size and retention rate dropped off very quickly:

ASMI Sample Size

The University of North Carolina study was cited by many publications, including USA Today, which concluded:

The study found the primary cause of such injuries is overuse.

Researchers went on to say that curve balls were not more likely to hurt a pitcher’s elbow than any other type of pitch based on the data from this study. Fortunately, they published their summarized data for review:

Pitch Data

Er… overuse is the primary injury factor here? Like Russell Carleton concluded based on statistical analysis of MLB pitchers, it’s actually prior injury that best predicts future injury. And furthermore, the second-highest risk ratio was throwing sliders, according to the data! Higher innings pitched and showcase pitching both fall below use of the slider AND the curveball (thrown at a later age).

Now, pitch counts seem to be effective at reducing injuries to youth athletes, and that’s certainly a cause I can get behind. It is my opinion that pitch counts need to be instituted at the youth level to avoid abuse by parents, even if these pitch counts are overly conservative.

So, is overuse a real problem? I have no doubt that some coaches and parents out there abuse their kids by leaving them in games too often. However, the 30th pitch of the inning and the 30th pitch of the game in the third inning aren’t the same stress-wise, and this is a factor that should hopefully be understood by coaches and parents alike. But outright blaming showcases and select teams for the rise in pitching injuries is irresponsible, considering none of these studies controlled for the ability of the pitchers in question – of course the pitchers who throw hard and are more effective tend to do more showcases, and this effect can be very large.

Which brings us to our next point…

Kids Throw too Hard

Lance McCullers

In Tom Verducci’s latest article in Sports Illustrated, he talks at length about how youth pitchers are overused and how velocity is at a premium, which leads to more injuries to the pitching arm. He quoted an anonymous international scouting director, who said:

Latin American pitchers are allowed to grow into their velocity. It’s a common story to sign a guy throwing 84, 85 [mph] who eventually winds up throwing in the 90s. Michael Pineda is one. You’re looking for someone with a good, athletic body who can throw the ball around the plate and has a feel for spinning the ball. The velocity comes in time, with training and better nutrition and physical growth. Here? The statistics don’t lie. We need to look elsewhere around the world to learn a better way. It’s time.

Really? The same Michael Pineda who missed three months in the minors during the 2009 season with a non-specific elbow injury and later had invasive labrum reconstruction surgery, requiring him to miss all of 2012 and most of 2013? The same Michael Pineda who averaged just about 95 MPH with the Seattle Mariners and has now “grown into” an average velocity of 92.5 MPH with the Yankees?

Verducci continues the cherry-picking, noting:

Go back to 2002, which featured a strong first-round high school draft class that included Zack Greinke, Cole Hamels and Matt Cain. None threw harder than 94 mph as seniors. All of them have thrown more than 1,500 innings in the big leagues.

Greinke never threw harder than 94 MPH as a senior? Perfect Game shows he threw 94 MPH during the winter after his junior year of high school, and John Sickels noted something entirely different in his ESPN column during the 2003 summer season:

Greinke is an excellent overall athlete, who was mostly a position player before his senior year in high school. He moved to the mound full-time a few months before the ’02 draft, and showed stunningly quick development. Greinke’s fastball has been clocked as high as 96 mph, though it’s more usually in the 90-93 mph range. He hits spots with it, and isn’t afraid to throw inside. His curveball and changeup are already above-average pitches.

Hamels broke his humerus bone his junior year of high school, which limited his velocity and dropped his draft stock to the middle of the first round. So even if he was topping out at 94 MPH, there would have been extenuating circumstances on why he didn’t throw harder considering he missed an entire year of development. But Verducci was verifiably wrong once again according to mlb.com:

Hamels returned to go 10-0 with an 0.39 ERA his senior season, impressing the Phillies with his 94-96 mph fastball and plus curve and change.

By the way, all the experts that say playing multiple sports is good for an athlete may enjoy this bit of anecdotal fun:

Apparently the 18-year-old would run through a truck to play for the Phillies — a parked car to be exact. Hamels smacked into the back of one playing street football with friends. He injured his arm then but did nothing about it. Three weeks later, he broke the humerus bone in his throwing arm while pitching in a game.

(I happen to think playing multiple sports is a good thing, too – but for psychological reasons and not “scientific” ones that are trotted out there all the time.)

Matt Cain did not, in fact, throw over 94 MPH as a high school senior – reportedly topping out at 92 MPH. However, once he was allowed to “grow into” his velocity in professional baseball, he fractured his elbow while pitching in 2003, just one year after the draft.

Jonah Keri’s post on the topic at Grantland started off a bit more realistic, quoting some solid research presented by Dr. James Andrews:

“The big risk factor is year-round baseball,” Andrews said. “These kids are not just throwing year-round, they’re competing year-round, and they don’t have any time for recovery. And of course the showcases where they’re pitching for scouts, they try to overpitch, and they get hurt.”

I can’t disagree with that – playing games and pitching competitively year-round is ridiculous and should be immediately stopped. I advise all of my warm weather clients to tell their winter ball coaches to kindly stuff it while they rest, recover, and train hard in the weight room or play a second sport.

But then Jonah quotes another anonymous AL executive who seems to be totally clueless about cause and effect:

“The rise of Perfect Game baseball and other summer travel baseball has dramatically decreased the off time for younger players. Kids are traveling all over the country from 8 years old on, and playing year-round. Colleges are recruiting younger and younger, and kids feel like if they don’t compete in every summer or fall event, they will lose their chance for exposure. That kind of exposure also leads to kids absolutely airing it out at max effort. When the section behind the plate is loaded with recruiters and scouts, kids absolutely take it up a notch and try to throw it through the backstop. The damage that is being done early can’t be undone by managing workloads once pitchers get into pro baseball.”

So… how is this Perfect Game’s fault, exactly? College and professional teams are the ones sending scouts to these events! If they were so concerned with keeping kids healthy, they would decrease the incentive to attend the events by not sending representatives of their teams. PG is only responding to market forces by providing events, and it’s a stretch to blame them specifically for decreasing the amount of time off, anyway.

PG - WWBA

Look how much we care about these kids’ arms!

Dr. Andrews goes on to say:

“It used to be that we didn’t see these injuries until they got into high-level professional baseball. But now, the majority of the injuries are either freshmen in college, or even some young kid in ninth, 10th, 11th, 12th grade in high school. These young kids are developing their bodies so quickly, and their ligament … isn’t strong enough to keep up with their body, and they’re tearing it.”

It’s true that the majority of the injuries happen early in the year as well as early in a pitcher’s developmental cycle, but to say that it’s wholly because their bodies are developing so fast ignores a whole host of other variables we’ll get to later in this article – such as massive ignorance of training principles amongst amateur baseball coaches.

Dan Jennings – GM of the Miami Marlins – said:

“Back in the day, you’d be pitching melons in a field, doing things with your hands — that’s how you built strength, from your elbows to your fingertips. Because of the new strength and conditioning programs, that’s been taken out. By the 10th grade, you’re told to focus only on football, or only on baseball; kids no longer play multiple sports. You get these specialized regimens where you build large muscle groups, but not the small muscles around the rotator and UCL. The large muscles get developed so large that when you try to decelerate, you can get badly hurt.”

Of course, Jonah interviewed a strength and conditioning expert in the field of baseball like Eric Cressey, Ron Wolforth, or if those two were busy, maybe me, right? No. Not a single interview appears in the article with an athletic trainer that is well-known for training amateur players with a good record of health like the aforementioned people I listed. I highly doubt we were all so busy we couldn’t be reached via email or phone call – I know that I didn’t get pinged before this article went up!

Our field got thrown further under the bus with no chance for rebuttal by an anonymous executive, who said:

“I think what has happened is that, due to improved training and instruction, pitchers throw harder. Joints and related connective tissue are put under greater stress from the increased velocity. Many claim that they can reduce injury with ‘their program.’ There is no evidence to support those claims. I am afraid, in fact, that many of these programs — several of which are well designed — actually increase injuries. The conundrum is that they also improve performance.”

First of all, this is a completely ridiculous statement with no evidence presented in favor of it – unfortunate, consider Jonah Keri used to write for Baseball Prospectus, a website that highly values falsifiability and thorough research.

Secondly, I have done internal studies on our training program of our amateur and professional talent, and when comparing our data with longitudinal studies and surveys done at appropriately matched levels, Driveline Baseball athletes are far less likely (2+ SD) to suffer a major arm injury (defined as missing competitive baseball for 8+ weeks; usually surgery) than your average athlete. I am sure that the athletes at Cressey Performance training under Eric Cressey and Matt Blake have similar – if not better! – records at keeping their athletes healthy, yet at least I was not contacted to give my side of the story, and I highly doubt Eric or Matt passed up on a chance to chime in with their experiences on such an important subject matter.

Four Camera System

Let me take a moment to state that at Driveline Baseball, injury prevention is the NUMBER ONE most important lens that all training is filtered through. Our private training facility has some of the most sophisticated equipment you can possibly find, and I can absolutely guarantee you that no other private pitching development facility in the world has the scientific tools we have to evaluate pitchers. We use multiple high-speed cameras in a markerless biomechanics laboratory that can calculate both kinematics and joint kinetics, a four-camera synchronized system to subjectively evaluate pitching mechanics, a database of major league pitchers with correlated planar kinematics and injury histories to compare our pitchers to, wearable athletic EMG sensors to measure muscle activity under the skin during maximum effort throwing with no degradation in performance/velocity, and force plates to measure ground reaction forces of various activities – not to mention high-end EMS recovery tools like the Marc Pro, equipment from Oates’ Specialties, and custom-manufactured and designed implements like Driveline PlyoCare Balls.

So while I can’t speak for others (though I have a good feeling that the aforementioned people care a LOT about preventing injuries), I am doing a whole hell of a lot to analyze and study the pitching delivery to help cut down on injuries to our pitchers, and I don’t really appreciate the blanket statement handed out by baseball executives hiding behind an anonymous snippet throwing the strength and conditioning community under the bus like we’re a bunch of idiots who don’t care about the future health of our clients. Furthermore, it’s quite irresponsible of Jonah Keri to not get this side of the story from noted representatives of our field, a fact I have pointed out on Twitter which garnered no response.

The real problem is probably a bit more involved, but what’s clear is that teams are not electing to draft weak arms and hope to develop them – they still go for the hardest throwers possible in the top rounds. Of course, they’re absolutely correct to do so, considering that fastball velocity is the number one best predictor of strikeout rate and success at the MLB level:

Being able to bring the heat is a very important factor in a pitcher’s success. Being able to crank it up a notch typically improves a pitcher’s run prevention abilities, and losing a notch hurts his effectiveness. Starting pitchers improve by about one run allowed per nine innings for every gain of 4 mph, and relief pitchers improve by about one run per nine innings for every gain of 2.5 mph.

ASMI’s Risk Factors for Shoulder and Elbow Injuries in Adolescent Baseball Pitchers (Olsen, Fleisig, et al AJSM 2006) was heavily cited in Verducci’s article to damn fastball velocity. The study had numerous flaws, including self-reporting of injury factors for control groups and injured groups (groups who are hurt are FAR more likely to report negative things about their coaches and previous throwing programs, and this factor was not controlled for) but was still a mostly well-designed study with very interesting data. Using a multivariate analysis of the data yielded far more interesting conclusions than the cherry-picked conclusions from the abstract:

Multivariate FB Velo

So despite the fact that Verducci (and Fleisig, to a lesser extent) blamed fastball velocity as a huge factor, it is actually in fact the least important factor in the multivariate analysis. And where did the 85+ MPH marker come from? It seems to have been subjectively chosen as a “high-velocity” marker.

Regardless of the origin of the “velocity limit,” if we simply accept the number given, throwing harder is fourteen times less relevant to predicting injury than pitching with arm fatigue on a regular basis, and half as relevant as pitching year-round (greater than 8+ months per year, a good number considering winter ball is the usual culprit here).

Uneducated, Ignorant, and Malicious Coaches are the Real Problem

HS Pitching Coach

If you play baseball, let me ask you a question: What would your pitching coach say if you asked him to cite his favorite research paper on pitching injuries?

Let me guess: Nothing. Or you’d be benched.

This is the real problem. Coaches at all levels simply don’t care about educating themselves on thrilling topics such as kinesiology, biomechanics, and research. The gold standard for coaching at higher levels of baseball is the fact that the coach played professionally or at a high college level, as if this is some good way to evaluate someone who will have a large role in keeping your arm healthy. It is, of course, the best example of falsely appealing to authority.

Let’s just pick a random well-known article on baseball pitching that is fairly important, such as Comparison of shoulder range of motion, strength, and playing time in uninjured high school baseball pitchers who reside in warm- and cold-weather climates (web). This paper by Kaplan, Elattrache, et al (AJSM 2011) talks about the soft tissue differences in pitchers who reside in warm weather climates compared to cold weather climates, concluding that athletes who competitively pitch year-round in warmer climates tend to have increased shoulder range of motion (ROM) and poorer shoulder external rotation strength. It’s fairly basic stuff to most decent trainers and coaches out there, but even a concept like this requires a coach to:

  • Read the paper
  • Understand the implications for increased total ROM of the throwing shoulder (perhaps GIRD?) and decreased ER strength (deceleration weaknesses?)
  • Figure out the best ways to counter these negative adaptations (specific stretching? passive external rotation strengthening? more time off?)
  • Deploy it effectively with his pitchers
  • Monitor the changes in soft tissues and ranges of motion
  • Evaluate his corrective exercise program and follow up with improvements

Keep in mind that this is for a SINGLE well-understood adaptation that happens with throwers of all ages and has wide-ranging implications on keeping arms healthy (let’s not even get into the elbow, hips, core, etc), and understand that the vast majority of pitching coaches (95%+?) don’t even do this. Your average pitching coach has never heard of Eric Cressey, Ron Wolforth, Lee Fiocchi, Matt Blake, Randy Sullivan, Jim Wagner, Kyle Boddy, or any other progressive baseball coach out there who cares about sports science, and expecting the average 14 year old to keep up on graduate-level kinesiology isn’t exactly fair.

Anti-Intellectualism is the Real Issue

Moneyball

Of course, this is nothing new in America – the dislike for intellectual behavior is well-established in this country and is perhaps most strongly present in the sports world. Consider how long it took Bill James and Pete Palmer to have their ideas adopted by most of professional baseball and you will come to the stark – and sad – realization that true player development (and injury prevention) is even further behind today than where James and Palmer started decades ago.

Since amateur coaches aren’t going to reverse their trend any time soon, it is unfortunately up to the athlete and parent in question to educate themselves and to fight back against disruptive and dangerous behavior by baseball coaches at large. Coaches that do not understand kinesiology and the importance of a proper training and throwing program must have kids taken out from under their wing; parents (and kids, sadly) must stand up to them and refuse to let their arms be abused, even if it means being labeled “uncoachable.”

Stop blaming velocity, pitch counts, and other weakly relevant factors. The number one issue is and will remain uneducated and willfully ignorant coaches that allow these things to continue. Focusing on the symptoms rather than the cause won’t solve anything.