Check out Arm care part one here
The second half of our two-part “Armcare” series features a Q&A with two of the foremost experts on shoulder and elbow injuries.
Why do you think we haven’t seen a pronounced spike like this in injury rates before?
Michael Ciccotti: Part of it might be that we didn’t understand these injuries quite as much at the time as we do now. Ballplayers today, with the way they’re recruited into high school, college and ultimately professional baseball, it almost necessitates that they start focusing on exclusively baseball at incredibly early ages. Arguably, they have more mileage on them than the elite level ballplayers decades ago, and more mileage on them than multi-sport athletes today.
Up until college and sometimes through college, players used to play multiple sports; there was a broad balance of stress throughout the musculoskeletal system, rather than years and years of competitive stress in the same areas of the body. It’s like having two beautiful cars; one of them has a thousand miles on it and the other has 50,000 miles on it. They look the same, they’re both beautiful, but the car that has 50,000 miles on it is more likely to have problems than the other car.
What can coaches do to mitigate the occurrence of arm injuries with their players?
Ben Kibler: Coaches are very observational and analytical. They can pick out a lot of things and compare them to the standard that they’ve developed. We need to look for the cause of the observed motions: the elbow dips because the shoulder is tired, the shoulder blade is slumping down or the legs are weak. Arms are slow because of hip weakness, resulting in the arm being behind. If you look at the legs, you can find most of the problems associated with the hand, you can find hip weakness or a tight back. It is possible to observe these things, so coaches and doctors need to work together to agree on what is happening.
I worked with the Houston Astros for several years, and we got the point where the coaches and I were talking the same language, talking about the same things. Now I’m working to make that happen with the Kansas City Royals. The point is that sitting down across the table from each other is the best way to do it- ‘this is what I see, what do you see?’
Ultimately, it’s our goal to provide information through research to the coaches, allowing them go get the best players possible on their teams programs. The players benefit because things are getting done right and the professional teams are benefitting because in general, they’re getting a higher-quality product with less miles on it. It’s a big win all the way around if we can do this right.
MC: One of the things that coaches can provide has to do with mechanics of throwing. Some coaches are brilliant with that and other coaches are novice, but I think the majority of coaches have a sense of [the mechanics of throwing] and how to optimize mechanics. Number two is encouraging athletes to be well-conditioned from the ground-up. We’re focused on the shoulder and the elbow, but coaches can help make sure these athletes are involved in some sort of conditioning program that involves the legs, hips, and core along with the upper extremities.
When you’re a collegiate coach, it’s really hard; you’re there to win and your job security is often dependent on winning with 18, 19, and 20-year olds. You want the best players and you want them to be available.
How would you explain these injury rates in Latin American countries?