Elbow pain

mmac,

I'm not sure what you mean. Did the doctor say that he hyperextended it or that he overexerted it? Did he just start throwing for the season? Has he ever had this problem before?

I ask because I have been talking to 5 other guys (just this week) who are experiencing similar problems.

Given his age (>16), he could benefit from a conditioning program that strengthened the muscles around his elbow (e.g. iron balls and/or rubber tubing). You might want to buy Tom Seaver's book on pitching. In it he talks at length about his conditioning program.

I also believe that there are a few tweaks that he could make to his mechanics (and that won't hurt his velocity). One is an idea that I call Early Pronation.

I don't want to cross-post, so if you want to hear more about my recommendations, go on over to the Pitching Mechanics forum that I moderate in www.LetsTalkPitching.com (it's free). This morning I'm going to post an article that talks about this at length.

Feel free to e-mail me if you have any more questions.

Hope this helps,

Chris O'Leary
chris@chrisoleary.com

MMac did the doctor say he was fit to throw ?
Otherwise shut him down and get a referral to a sports doctor and determine if there is any damage.
A catcher I know ingnored the pain and is no longer playing.

thanks for your answers - he has been using a conditioning program with weighted balls and rubber tubing but dont know yet if it is helping, probably too soon to tell. I will check on your forum later today. I am seeing the Doctor ( he is a sports doctor ) today (for another son with bad knees!) so I will ask him again what to advise. Son is away at school (northeast) and really doesnt start training for another week so hopefully he has time to rest. Thanks

mmac

Rest may not be the answer-- he should see an ortho/sports doc IMMEDIATELY--- conditioning programs do not help if the damage has already been done

The college he is at should have a trainer or training staff. They are there to take care of these issues. Proper procedure would be to go to them first.

Listen to TR. Mmac said the doctor said it was hyperextended and that he was icing and resting. But then he says he's using weighted balls and tubing? Who told him to do that? The first doctor? If he doesn't like the diagnosis or treatment plan from the doctor, then go to another doctor for another opinion. A kids arm is too important to leave to Coach Chris's armchair pontifications. It's one thing to purport yourself as a pitching instructor, or guru, or anything else, but let's not speculate on injuries and offer that a specific training program or a book will heal an injury.

quote:

Stay away from inexperienced shaman.

This isn't just my idea.

The idea of pronation gained widespread attention as a result of the work of Dr. Mike Marshall (at least). Its effectiveness has also been independently validated by others including Glenn Fleisig and James Andrews.

On page 465 of the paper "Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers" by Stephen Lyman PhD, Glenn S. Fleisig PhD, James R. Andrews MD, and E. David Osinski MA., the authors make the following statement...

"In fact, two mechanical flaws, backward lean in the balance position and early hand separation, correlated with a decreased risk of elbow pain. Two other flaws, a long arm swing and arm ahead of the body at the time of ball release, correlated with a decreased risk of shoulder pain."

When the authors talk about the "arm ahead of the body at the time of ball release" they are talking about pronation. The only way to have the arm in this position at the Release Point is to be actively pronating at (and more importantly well before) that moment.

The reason that I use the term Early Pronation is that we have since learned that all pronation is not the same. Tom House and Will Carroll talk a lot about pronation, but as the experience of Mark Prior and many other profession pitchers with elbow problems demonstrates, pronating is not enough.

You have to do it at the right moment (which is while the arm is accelerating, not just at the release point) for pronation to protect the elbow.

If you want to learn more about this, below is a link to an article I wrote that discusses the difference between Early Pronation and Late Pronation...

http://www.chrisoleary.com/pitching/essays/pronateearlyandoften.html

Chris it becomes your idea when you pass it on just like it becomes your bullet when you pull the trigger.
This is why I called you scary. Its not like you are going to hurt yourself but rather some young player who needs medical advice from a proper source.

quote:

Chris it becomes your idea when you pass it on just like it becomes your bullet when you pull the trigger.

So do you have a problem when Will Carroll and Tom House talk about it?

What's scary is that they don't understand the subtleties involved; that if you don't do it soon enough, it won't have the desired result (but at least also won't have a negative result). It's also scary that they are lulling people into having a false sense of security.

Now you are showing the dilusional part. How can you compare yourself to them and their advice would be see a qualified doctor. That is why House uses a docto (John Gleddies) for the medical issues in his books.
Did you read the ranting I posted on your Marshall thread ? Dosen't he sound similsr to you. The only difference is he followsw Dick Mills.

Coach Chris,

For someone who writes volumes, you have either a reading or comprehension problem here.

The kid has pain in the elbow. He saw a doctor. He doesn't need you and your pronation right now. He needs professionals in the medical profession.

Do you have an M.D. or any medical certifications? EMS training? Candy Striper ever? Beyond that, where have you coached? Did you ever play beyond Little League (or even in LL, if I use that as a measure because I've watched that mess of a video in your yard).

You're a little scary.

quote:

How can you compare yourself to them and their advice would be see a qualified doctor.

But mmac said she already went to see a doctor. Therefore, I'm not making a diagnosis.

She also explicitly asked for other suggestions.

BTW, she said "overextended" not "hyperextended" which is ambiguous.

Coach Chris,

Honestly, I'm having trouble with the "Coach" part of your name.

You are no different than a person practicing law without a JD or someone posing as a doctor with nothing more than a HS diploma.

You get scarier with every post you make.

The other advice is get a second opinion from a sports doctor. That is the only advice we are qualified to give.

quote:

Do you have an M.D. or any medical certifications? EMS training? Candy Striper ever? Beyond that, where have you coached? Did you ever play beyond Little League (or even in LL, if I use that as a measure because I've watched that mess of a video in your yard).

I answer this question (at length) on my web site...

http://www.chrisoleary.com/pitching/WhoIAmAndHowIGotHere.html

As I say there, one thing that I believe prepared me to do this type of work was a job (that I held over 3 Summers) working as a paralegal analyzing the medical histories of people who said they had asbestosis (99% didn't). To be able to do this job I first had to understand the physiology of the lungs and the pathology of asbestosis (e.g. Pleural Plaques and Mesothelioma). I analyzed somewhere in the neighborhood of 1,000 medical histories and in that time our client only lost one verdict (due to a clear-cut case of Mesothelioma).

I never pitched at the professional, college, or even high school levels. I did try out for my college team but ended up having to pull out due to the damage that I did to my shoulder when I was younger (which is a big part of the reason why I care so much about this).

The extent of my early experience pitching was numerous Indian Ball and pickup games during high school and later on in college. However, I am the batting practice coach for my sons' teams, which has forced me to learn to throws strikes and hit certain spots in the zone. I also work with the catchers and throw them balls all over in (and more importantly out of) the strike zone.

I have spent the past 5 years serving as my son's (11U) pitching coaching and the pitching coach of the teams he has played on. My son, who has been taught exclusively by me, was one of the top pitchers on his CYC team (he's a Greg Maddux type location and control pitcher). He has also never had any arm pain (or even soreness).

During my time coaching my son's teams, I have had to deal with pitchers who developed pain as a result of a mechanical flaw (e.g. supinating rather than pronating the wrist as they released the ball).

quote:

And, you just diagnosed it over the internet, issued a change in mechanics without monitoring it in person. How will he know if he is pronating at the right time? If he doesn't do it at the right time, is there a possibility he may cause further damage?

No I didn't. The doctor did. That's also why I asked for the clarification.

That's also why I gave her suggestions, which is what she asked for (and which is what she would get if she talked to Will Carroll and/or read saving the pitcher).

If he doesn't pronate at the right moment, then he will continue to damage his arm as before (but no worse). Pronating at the wrong moment won't hurt him. It just won't help him.

To summarize, you have very little playing experience, you never coached a kid older than 11, you're not a doctor and you researched for a lawyer as a summer job. It's like you stayed at a Holiday Inn Express last night and woke up as Leo Mazzone.

I hope everyone has a good understanding of your background before taking anything you say as good baseball advice. For their safety...

quote:

Now you are showing the dilusional part. How can you compare yourself to them and their advice would be see a qualified doctor.

First of all, it's "de"-lusonal.

Second, if you listen to Will Carroll, he is constantly talking about pronation (which is a good thing).

Do you have a problem when he talks about it?

Here's a recent example of Will Caroll talking about pronation in the context of the Gyroball...

http://letstalkpitching.com/phpBB2/viewtopic.php?t=287&start=12

Just for the record, the Gyroball makes me nervous. I don't know if there's a safe way to throw it.

quote:

BTW, when you throw BP for the eleven year-olds, what distance do you throw from?

My 11U guys throw from 47'. Since I'm 6'1" I either throw from my knees (less and less often -- it's getting dangerous) or from about 55'. That way the ball comes in on a plane that resembles the path of a ball thrown by a 10 year-old.

If I throw from 47' my release point is too high and the guys have a hard time hitting the ball since it has so much vertical movement.

With my 7U guys I either pitch fast underhand or from my knees (less risk due to softer balls, not necessarily weaker swings).

quote:

deleted by me! This has become a ridiculous thread.

For the record, I never said that I was trying to throw at in-game speed. That would be stupid since I took the video in the middle of the off-season (due to my quirky shoulder I have to be very careful to warm up) and on flat, wet ground.

Instead, I was just trying to show people what the motion looked like.

In fact, I slowed down the first part of my motion a bit so that people could see more clearly what I was doing with my hand.

I don't understand. Who deleted all the posts?

quote:

Originally posted by Baseballdad1228:
To summarize, you have very little playing experience, you never coached a kid older than 11, you're not a doctor and you researched for a lawyer as a summer job. It's like you stayed at a Holiday Inn Express last night and woke up as Leo Mazzone.

I hope everyone has a good understanding of your background before taking anything you say as good baseball advice. For their safety...

I agree 100%. However, mmac did come on asking for advice, and you all know when you ask for advice around here you will get tons of it.

I do also believe that many posters have many agendas. Coach Chris' is for you all to follow him to a website page.

WOW! I guess it goes to show, you can't believe everything you see on the internet.

quote:

I do also believe that many posters have many agendas. Coach Chris' is for you all to follow him to a website page.

Your logic is flawed since I'm not selling anything.

My motive is to help people.

No more, no less.

quote:

Originally posted by Baseballdad1228:
,..... It's like you stayed at a Holiday Inn Express last night and woke up as Leo Mazzone.
...

lol. Actually in mid Jan, I stayed at a Holiday Inn and listened to Leo the next day. Yes, it was Cherry Hill 05 & 06.

Chris is attempting to share his learned information, which is in some respect, honorable. Chris posting of his pitching video actually does resemble the characteristics of Marshall's teachings. (ie pronate out of glove, linear upper and lower half, pronate throwing arm to plate)

Many could agree (as discussed at several winter clinics over several years), early pronation of the foreman is a part of a Marshall training program. A program requiring 12 months of his arm strengthing and flexibility as recommended by his $3K program just outside of Tampa.

The other side of the debate, like many 'new baseball ideas', is a lack of current professional parent clubs that have adopted the 'pronation' throwing approach as recommended by Marshall.

What many are unable to come to terms with is Marshall just may be ten years ahead of his time....(or behind). I have not heard of any arms from Marshall's program who has a blown elbow.

With that said, something must be done to reduce the number and severity of arm injuries.
Having TJ surgery, as a preventative elective approach, just does not make common sense, even though the success rate of surgery with extensive rehab is increasing. The operative word their is extensive and sucessful rehab (following elbow surgery). Shoulder surgery, however, has not been as sucessful.

Arm injuries occur with the arm is over-used, hyper-extended, over-exerted, and over-extended.

Several believe that baseball players should throw as often as desired (to train their craft) yet efficiently.

When mentors teach players to learn to throw w/o max effort, and pitch with great command and control, they become pitchers which seems to them, as if almost overnight!

Chris, keep up the 'Community of Practice' (CoP)!

OBTW: Marshall has said 'Jobe is a silly man."

Regards
Bear

Coach Chris,
Sorry but in the last few days you have been on a pitching philososphy frenzy with links.

I have read your bio. I am not a pitching coach, and I do beleive strongly (just like everyone else) that proper mechanics is important to staying injury free. That is not NEW news. That is a subject that has been discussed here frequently on the HSBBW and in baseball circles. You don't have to be a rocket scientist to know that Greg Maddux remained injury free due to his sound pitching mechanics, loose arm and natural throwing ability. It also doesn't take a genius to know that remaining injury free is very difficult in general because most really good young pitchers are not protected by parents and coaches from too much pitching. And their flaws are not corrected early. Pitching year round doesn't help the cause either. BTW, if you read Boyd Nations report of pitcher abuse points you will find that Mark Prior most probably threw too many before he reached pro ball. I can't debate whether his mechanics were a cause of injury, but I could debate his overuse as a young pitcher.
You are entitled to your opinions and your theory.
However, diagnosing why a pitcher has elbow pain on a website and making suggestions without ever seeing the pitcher throw is a no no as far as I am concerned.

I have been a nurse for 33 years and at no time would I ever attempt to diagnose a problem over the internet...I assume the initial MD examined the elbow and offered the treatment of ice and rest in an attempt to alleviate what he considered to be tendonitis...further pain upon movement is indicative of a more serious underlying problem which warrants further investigation by an Orthopedic MD particularly one experienced in the treatment of sports related injuries...but once again I am not the expert...I take my direction from the MD...
Having said all of the above...I have sat behind the back stop of hundreds of games for 14 years now...I have read many an article and book on the semantics of catching..have watched my son take catching lessons for years from the Red Sox catching coach...I, as a nurse, do not expect any non medical person to instruct me on how to start an IV, insert a foley, administer a GT feeding etc but by the same token does the fact that I have watched my son for many years now make me proficent in the semantics of catching...absolutely NOT...I have my profession and would not question a coach in his unless I felt it was blatantly destructive towards my child...Coach Chris, I believe you are suffering from delusions of grandeur... you are a Dad who has coached your sons... a computer whiz... I read your bio....you somehow think, based upon your own admissions, that you are qualified to give advice...not in my book...you are a Dad who coaches and has made himself somewhat knowledgeable in the sport of baseball specifically pitching...you are not qualified to lend advice to anyone especially in the area of elbow pain IMHO

Coach Chris

Could you tell us your background that gives you liberty to be dispensing this "info".

Being a "pitching coach" for your young sons tells me nothing--all dads are their sons coaches,

Please enlighten us tou your background and source of your "knowledge"

One other note for all on the internet, especially newbies to sites such as this--do not believe eveything your read--know who the "knowledge" dispenser is and what is credentials are

quote:

I do beleive strongly (just like everyone else) that proper mechanics is important to staying injury free.

The problem is that my study of pitchers and injuries is giving me the sense that some of what people advocate as "proper mechanics" are the very things that are causing injuries.

This isn't just my opinion, others have said it as well. For example, see "Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers" by Stephen Lyman PhD, Glenn S. Fleisig PhD, James R. Andrews MD, and E. David Osinski MA. On page 465 of this article, the authors make the following statement...

"In fact, two mechanical flaws, backward lean in the balance position and early hand separation, correlated with a decreased risk of elbow pain. Two other flaws, a long arm swing and arm ahead of the body at the time of ball release, correlated with a decreased risk of shoulder pain."

When the authors talk about the "arm ahead of the body at the time of ball release" they are talking about pronation (and more importantly something that I call Early Pronation). The only way to have the arm in this position at the Release Point is to be actively pronating at (and more importantly well before) that moment.
One thing to keep in mind when reading this paragraph (and article) is that the use of the term "mechanical flaw" is unfortunate (if not a bit misleading). I believe that the authors do not mean that doing these four things will hurt your velocity or control. Instead, I believe that they are just saying that these four things differ from what they believe are ideal mechanics.
Of course, that makes me wonder about the veracity of their model of the ideal pitching motion.

quote:

BTW, if you read Boyd Nations report of pitcher abuse points you will find that Mark Prior most probably threw too many before he reached pro ball.

People much smarter than me, namely Bill James, have pointed out that there are serious problems with the whole logic behind the current formulation of Pitcher Abuse Points (PAPs).

You can see this just by looking at the career pitcher abuse points and seeing who's at the top of the list: Roger Clemens. If Pitcher Abuse Points were preditive of injury, then someone with as long a career as he had wouldn't be at the top of the list.

quote:

diagnosing why a pitcher has elbow pain on a website and making suggestions without ever seeing the pitcher throw is a no no as far as I am concerned.

I didn't diagnose him. The MD did that. If I was only interested in diagnosing him, then I wouldn't have asked for clarification of the MD's diagnosis.

What I'm trying to do is identify the root cause(s) of the problem and then point out ways to keep people from doing those things.

quote:

Character cannot be developed in ease and quiet. Only through experience of trial and suffering can the soul be strengthened, vision cleared, ambition inspired, and success achieved

This is exactly why and where we differ.

While I am a big believer in the idea that "That which doesn't destroy me makes me stronger", and that suffering can build character, it is our responsibility and our obligation as parents to identify and eliminate unnecessary suffering.

Having never seen the young man's mechanics nor even read a description, I would not presume to begin identifying root causes. But perhaps that doesn't stop others.

quote:

Could you tell us your background that gives you liberty to be dispensing this "info".

As I said before, I answer this question at length on my web site...

http://www.chrisoleary.com/pitching/WhoIAmAndHowIGotHere.html

Since learning about Dr. Mike Marshall's ideas 9 months ago, I been spending pretty much every lunch doing extensive research into the physiology of pitching. That includes reading hundreds of journal articles.

I have also been studying the injury rates of sports like Water Polo, Cricket, Handball, and the javelin.

One thing that I believe prepared me to do this type of work was a job (that I held over 3 Summers) working as a paralegal analyzing the medical histories of people who said they had asbestosis (99% didn't). To be able to do this job I first had to understand the physiology of the lungs and the pathology of asbestosis (e.g. Pleural Plaques and Mesothelioma). I analyzed somewhere in the neighborhood of 1,000 medical histories and in that time our client only lost one verdict (due to a clear-cut case of Mesothelioma).

During my time coaching my son's teams, I have had to deal with pitchers who developed pain as a result of a mechanical flaw (e.g. supinating rather than pronating the wrist as they released the ball).

My opinion on you is that you have no foundation for your opinions - no medical background, no playing experience, no coaching experience beyond little league. The fact that you like Dr. Marshall's teachings is great - leave them to Marshall! He has years of experience and advanced degrees that correlate with the mechanics of pitching. You don't. That that you can cut and paste pitching sentences and throw out SAT words on a baseball website are your only talents. I just hope that you are well-meaning in this dillusion you have of yourself as a baseball person.

quote:

The fact that you like Dr. Marshall's teachings is great - leave them to Marshall! He has years of experience and advanced degrees that correlate with the mechanics of pitching.

I prefer to think of it as a Kosher Dill-usion.

There are two reasons why I am doing this.

First, Dr. Marshall is not the greatest communicator in the world. He is incredibly smart and knowledgeable and doesn't realize that most people don't share his knowledge. My hope is to try to translate his ideas into a more plain-English form and get them out to a wider audience.

Second, my concern with Dr. Marshall's approach is that it is very much my-way-or-the-highway. I don't think it's realistic to expect people to adopt all of his ideas overnight. Instead, I think it's far more likely that people will first want to experiment with parts of his ideas. What I am trying to do is identify the parts of his ideas that can be incorporated into the traditional pitching motion.

Chris you are a delusonal man. You don't listen to the experts who spend far more time and are far smarter than you. My wife would get along with you . There has never been a doctor who knows what she/he is talking about. She has that medical book that diagnosis every ailment know to man.
I think we have a case of a little knowledge is a dangerous thing.
Yes it is you against the world. Like all great men holding on to their vision agaist all those who challenge them.
The truth is Chris that all pitchers are subject to injury even with good mechanics. Good mechanics and proper conditioning help to reduce the risk.
When you read an article you are reading it with a tainted logic based on your rediculous assertions.

Wow, I started quite a discussion here! for what its worth I talked to my son's doctor last night and he said the elbow is hyperextended, not serious. He said therapy, ice and a gradual easing into light exercising of the arm (rubber tubes and weighted balls) would help. My son is seeing the trainer at school, hopefully it will heal soon.

Great news MmacHope and I hope he has a great season.