Muscle strain...any ideas?

quote:

Originally posted by Cutter:
Last year, my son, now 15, strained a muscle in his upper back, in the area between his right shoulder blade and the spine. He eventually saw his doc, took some time off, and went through physical therapy. Prior to playing again, he went through a graduated throwing program that took weeks to complete. The doctor, who specializes in arm/throwing injuries and does work with a MLB team, felt it may have been related to throwing (my son is not a pitcher), but he couldn't state what he thought may have been happening mechanically. At that time, my son was switch hitting, so he couldn't say that he didn't do this while swinging the bat.

Well, almost one year later, the injury has flared up again, and it this time it appears to be related to throwing. Through the last year, we made sure he rested and built up his throwing distance/strength through a long toss program and other exercises. He also had some off-time during the summer.

I know this is very vague in what is happening, but are there any ideas as to what may be going on mechanically? Have any of you had the same area affected? Again, this is between the shoulder blade and spine on his throwing side.

This sounds like one of the muscles that moves the scapula.

Do you know exactly what muscle was involved?

Do you have a video of him throwing?

Does he do any weightlifting?

quote:

Originally posted by thepainguy:
This sounds like one of the muscles that moves the scapula.

Do you know exactly what muscle was involved?

Do you have a video of him throwing?

Does he do any weightlifting?

I believe it was the rhomboid muscle. I don't have any video that is ready to be uploaded right now, but I can try and get some ready by the end of the weekend.

He did some weightlifting during the summer, but had to curtail it when HS started again due to academic workload.

quote:

Originally posted by Cutter:
I believe it was the rhomboid muscle.

The Rhomboids are involved in decelerating the arm. That means that your son could have a problem with his follow through. Possible, he's cutting his follow through short and/or wrapping his arm around his body, which requires the muscles to apply more force over a shorter period of time.

Andy Pettitte has had this kind of a problem, and I think it's due in part to his follow-through...



Your son could also have a muscle imbalance, which means that the muscles that accelerate his arm are stronger than the muscles that decelerate his arm. This can be caused by doing bench presses and push ups and not working the opposing muscles.

A video would help to pinpoint a problem with his follow-through.

My money would be on a muscle imbalance between the front side and back side shoulder muscles. There are more accelerator muscles on the front side than there are decellerator muscles on the back side. Kids who lift weights work the front side far more than the back side because it's what they see in the mirror. Did your son's rehab/throwing program involve anything to specifically strengthen the back side? It should have, IMHO.

it is probably not stretching enough or not being warmed up enough and then not following through enough. I am a pitcher and I had that same problem before I really started to extend.

Get another qualified DOCTORS opinion.

I'd like to thank all of you for your comments thus far. This last week, we spent lots of time massaging my son's back, having him take advil, and stretching quite a bit. All of this was in preparation for the Top96 event that was held in Southern California.

Well as things would go, he was able to participate in it without a hitch, and his arm (back) was fine. We went into the event very cautiously, and he worked up to the levels that he did. He actually got high marks in arm strength, and there were no real residual complaints. I am actually amazed about this, as I would have expected he would have been down for a few weeks.

Prior to the event, we visited his physical therapist, and he was not able to trigger any pain with manipulations.

My gut feeling about this, for what it's worth, is that my son, at times, abbreviates his follow-through, and that is what may have caused the aggravation of the old injury. He is actually pretty good about warming up, but I am thinking that, in addition to the above, that his back side muscles are not as strong as they should be. As such, I am going to be contacting an acquaintance of mine that is associated with Jaeger Sports to get him on a consistent exercise and throwing program.

While this may not be the ultimate answer, I think we will be off to a good start. Again, thanks for all of your help.

Input is always accepted and appreciated.

quote:

Originally posted by 3bpitcher:
it is probably not stretching enough or not being warmed up enough...

Stretching, if the goal is to increase the range of motion of the joint, is a bad idea. What you need to do is make sure that the muscles are warmed up properly.

I do this by having my guys start out throwing 20 feet apart and then, after they've thrown 20 throws, taking one step back every 3 throws.

This is what David Eckstein does before every game.

that is a good point Mr. painguy. You got me kind of interested so would you mind elaborating a little more. Thx for the info.

quote:

Originally posted by 3bpitcher:
that is a good point Mr. painguy. You got me kind of interested so would you mind elaborating a little more. Thx for the info.

Some studies have come out recently that indicate that certain forms of stretching can actually increase the risk of injury rather than lower it.

The difference appears to be whether the goal of the stretching is to...

1. Increase the range of motion of a joint.
2. Activate and warm up muscles.

The first type of stretching seems to be bad because it can take joints out of their most stable configuration (by lengthening the ligaments that hold the joint together).

The second type of stretching, as well as the long toss that David Eckstein does before each game, reduce the risk of injury by allowing muscles to gradually warm up.

The confusing part is that some people talk about "stretching" when they actually mean "warming up" muscles.

Someone clued my son into a warm up pattern that is consistent with what the Doctor was posting. I think he called it plyometrics - which involved small, and very rapid, movements to loosen up the muscles without stretching the ligaments. It looks funny, but it seems to work.

My son has had similiar issues. His problem was a range of motion issue. He currently is working with a therapist who beleives you need to develop a full range of motion before you work on strengthing the muscles. One check point we are using, have your son stand straight up (with the shirt off) and raise his arms up 90 degrees straight in front of him. From the back does your son look symetrical and do you see redness appearing in the back of his throwing shoulder. If there is redness than those are the muscles that need to be isolated and strengthed. We are finding that the the therapist is our new best friend and are following his routine in the off-season.

In response to the pain guy,
thanks for the inforamtion, i really learned something.

Google "dynamic warm up" and you'll get lots of hits explaining what pain guy described.