Outline. Training Interventions for Youth Baseball Athletes. 3 Rehabilitation Focus Points. What Training to Perform?

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Outline Training Interventions for Youth Baseball Athletes Tim L.

What are the focus points for training young overhead throwing athletes? 2. What are the training effects on baseball players? 3. What training should be performed when have limited time?

Shoulder Mobility Loss of Shoulder Motion risk factor for injury Wilk AJSM 2011 Shanley AJSM 2011 Correcting posterior shoulder tightness associated with symptom resolution Tyler AJSM 2010 3

1 Outline Training Interventions for Youth Baseball Athletes Tim L. Uhl PhD ATC PT FNATA Division of Athletic Training Department of Rehabilitation Sciences College of Health Sciences University of Kentucky 1. What are the focus points for training young overhead throwing athletes? 2. What are the training effects on baseball players? 3. What training should be performed when have limited time? 3 Rehabilitation Focus Points 1. Kinetic Chain 50% of ball velocity comes from leg and trunk Toyoshima Biomechanics IV Shoulder Mobility Loss of Shoulder Motion risk factor for injury Wilk AJSM 2011 Shanley AJSM 2011 Correcting posterior shoulder tightness associated with symptom resolution Tyler AJSM Rehabilitation Focus Points 3. Arm Strength & Endurance Pre season weakness in ER and Elevation are predictive of throwing related injuries requiring surgery Byram AJSM 2010 Strength training has positive effect on ball velocity & endurance Escamilla JSCR 2010 Carter JSCR 2007 Moore Sports Health 2013 Athletes presenting with shoulder pain often have shoulder girdle weakness Merolla Muscul Surg 2010 Cools BJSM 2004 What Training to Perform? Plyometric Ballistic 6 Carter JSCR 2007 Throwers 10 Escamilla JSCR 2012 Advanced Throwers 10 Wilk Physician & Sportsmedicine 2012 Core Training Saeterbakken JSCR 2011 Disabled Thrower Shoulder Kibler 2013 Youth Athletes Respond to Elastic Resistance 4 wks. training with Elastic Resistance 10 minutes of warm up 30 minutes of elastic bands 30 minutes of distance based interval long toss program 17 shoulder exercises (thrower s ten) 3 x 1 x reps Increased training group from 25 to 26 M/sec (4mph) Escamilla JSCR

3 forms of Training Produce Equal Results 68 HS baseball players involved in summer ball Throwers ten (18 ex) Keisper Pneumatic (16 ex) Plyometric (32 ex) Control 3 x wk for 6 wks Progressed from

9 Thrower 10 Keiser Pneumatic Plyometric Control Endurance Improves 14 High School Baseball players 20 week off season intervention emphasizing endurance and technique Improved Posterior Shoulder

Literature supports training program with relatively high volume exercises What if you don t have adequate time or supervision 1. Warm up: 4 6 minutes 2. Exercises: 5 8 minutes 3.

2 3 forms of Training Produce Equal Results 68 HS baseball players involved in summer ball Throwers ten (18 ex) Keisper Pneumatic (16 ex) Plyometric (32 ex) Control 3 x wk for 6 wks Progressed from high (12) to lower reps (6) to facilitate strength & power 12 8 Ball Velocity measured Pre Post Ball Velocity (MPH) Thrower 10 Keiser Pneumatic Plyometric Control Endurance Improves 14 High School Baseball players 20 week off season intervention emphasizing endurance and technique Improved Posterior Shoulder Endurance (PSET) Moore Sports Health 2013 Number of Repetitions Endurance Baseline (n =14) 4 wks (n=13) 8 wks (n=9) 20 wks (n=12) Integrative Program: In Season Literature supports training program with relatively high volume exercises What if you don t have adequate time or supervision 1. Warm up: 4 6 minutes 2. Exercises: 5 8 minutes 3. Stretching: 5 minutes Warm up Activity Coaching Point Time Wood chops No load Supine hip rolls Prone heel to butt (Scorpion) Squats Rotate torso x 2 Emphasize trunk rotation keep hips on ground keep knees apart and behind toes Warm up: Total time ~ 3 minutes Activity Coaching Point Time Burbees or Up/Downs Up and Down quickly Arm Circles Full Arc of motion forward/backward Jog Bases Face outfield to 3rd Start at Home Run to 1st Sid shuffle facing infield to 2nd Back pedal home X 2 Exercises 2 sets of 30 seconds progress to 60 seconds Stand in good posture.5 second concentric 2 seconds hold Increase motor recruitment of active muscles by 15% Cools AJSM 2007 Seitz & Uhl (in Review) 3 second eccentric return to start 7 elastic band exercises that activates multiple shoulder muscles Myers J. Ath Train

High to Low Row Bend Elbow Shoulder Extension Elbow

arm Squeezing Scapula muscles together Keep elbow

fully flexed arm Start with arm at 90 and elbow

across body Control eccentric phase of activity

90 and forearm parallel to ground stable elbow good

straight Thumb up Deceleration of finger tips Start

band back to a 90/90 position Scapular retraction

eccentric phase of exercise Scapular Punches Elbow

3 High to Low Row Bend Elbow Shoulder Extension Elbow straight Resistive Band at height of fully flexed arm Squeezing Scapula muscles together Keep elbow straight Acceleration Resistive Band at height of fully flexed arm Start with arm at 90 and elbow flexed at 90 Go through throwing motion with arm across body Control eccentric phase of activity External 90 Start with arm abducted to 90 and forearm parallel to ground stable elbow good scapular control Shoulder Flexion Elbow stay straight Thumb up Deceleration of finger tips Start with arm slightly forward and elbow straight Pull band back to a 90/90 position Scapular retraction with shoulder motion Control scapula during eccentric phase of exercise Scapular Punches Elbow stay straight Reach out far Control scapula during eccentric phase of exercise 3

Core & Legs Lunge with Trunk Rotation Hold a 5 10 lb dumbell near chest Step into a lunge Rotate Torso

control Increase speed of rotation Lengthen arm away from torso with weight Core & Legs Shoulder

Speed of rotation with good control Cross body stretch for posterior shoulder tightness Stabilize

a stretch Sleeper Stretch for posterior shoulder tightness adjust elbow down to avoid painful position.

Adjust elbow position based on level of stretch and symptoms, instruct patient to squeeze scapula

flexed to stabilize proximal attachment, incorporate trunk rotation.

4 Core & Legs Lunge with Trunk Rotation Hold a 5 10 lb dumbell near chest Step into a lunge Rotate Torso 3 times Step back Lunge with opposite Rotate Torso 3 times Hold lunge position Focus on balance and control Increase speed of rotation Lengthen arm away from torso with weight Core & Legs Shoulder Flexibility Ball Rotation Toss a 5lb medicine ball Full torso rotation Focus on balance and control Speed of rotation with good control Cross body stretch for posterior shoulder tightness Stabilize shoulder blade against wall and gradually pull arm across body Add towel under elbow to create more of a stretch Sleeper Stretch for posterior shoulder tightness adjust elbow down to avoid painful position. Shoulder & Trunk Mobility Doorway stretch for tight anterior musculature. Adjust elbow position based on level of stretch and symptoms, instruct patient to squeeze scapula together and step forward until feel a stretch across front of shoulder Latissimus Dorsi Stretch hips flexed to stabilize proximal attachment, incorporate trunk rotation. Can use bench or chair to increase stretch Leg Mobility and Balance Can perform classic static stretch or as part of dynamic warm up Youth athletes develop tightness due to growth 4

Kinetic Chain 2. Shoulder Mobility 3. Arm Strength and Endurance 2.

5 Summary Thank You 1. What are the focus points for training young overhead throwing athletes? 1. Kinetic Chain 2. Shoulder Mobility 3. Arm Strength and Endurance 2. Supervised training can have a positive effect performance 3. Less is known about injury prevention 4. Suggested an integrative program that address primary shoulder muscle for limited time 5

D: Doorway Stretch E: Towel Stretch for Pectoralis Minor Blackburn Exercises: 6 Positions A: Prone Horizontal Abduction (Neutral)

D: Doorway Stretch E: Towel Stretch for Pectoralis Minor Blackburn Exercises: 6 Positions A: Prone Horizontal Abduction (Neutral) D: Doorway Stretch Bring your shoulder into a horizontal position out to your side (abduction) and flex your elbow 90û Place your elbow against the edge of a doorway Lead forward and downwards with your