6.27.2012

Hip Flexibility for Pitchers

Hip range of motion is critical for pitchers to maintain the health of their throwing arm and to attain peak performance. Any pitcher experiencing shoulder or elbow pain should look toward the hips, and all higher level pitchers (say, over the age of 16) should sporadically check on a few key issues.

Pitching demands adequate hip internal and external range of motion on both sides. There are two moments where hip function particularly comes into play:

1. The moment of shoulder/pelvis seperation. This is when the upper half and lower half of the body are (very) temporarily rotating in opposite directions, effectively winding up stored elastic energy from the powerful hip and trunk muscles to be transfered to the scapula and shoulder.
If the trail leg (right leg on a righty) doesn't have sufficient hip external rotation range of motion, the pitcher will often appear to be "opening up" his torso too early. In addition, he may shorten his stride length because the trail leg simply cannot push off over a long distance as the upper body moves down the mound.

The player who is told to "quit flying open too early" may become frustrated when he struggles to correct his form. When he is finally able to stay "closed" longer, the extensive adjustments needed to make that happen come at the expense of velocity and accuracy. This pitcher may need to devote a few weeks or even months to some serious hip mobility work in order to sync everything up.

2. The moment of leverage and then deceleration off the front leg during and after ball release.

Adequate hip internal rotation of the lead leg is needed for the pitcher to efficiently block with the lead leg and "catapult" the force generated in the lower half to the throwing arm. Inadequate internal rotation will cause the pitcher to cut their arm path short and/or shorten their stride length.

Lastly, it's good to remember that even in an otherwise healthy person, pitching creates what pitching demands. Pitching is a high speed, asymmetrical activity that does create problems over a bazillion reps.

The lead hip that is internally rotated and flexed forward all the time gradually loses hip extension and often pulls that half of the pelvis into a posterior tilt. The trail hip that is extended and externally rotated all the time often loses some flexion range of motion and pulls that half of the pelvis into an anterior tilt. For this reason, many pitchers will create a situation where their dominant leg is functionally longer than their stride (forward) leg. This is usually an easy fix, as the pitcher basically stretches each hip into the opposite planes of motion that they go through when throwing.

Part II - Stretches and strengthening to gain and maintain adequate hip mobility.

6.21.2012

I carry all of my stress in my shoulders...

Clients with neck, shoulder, and head pain often explain their problem in these terms. I ask them about their stress because that's relevant. But the fact that someone relates their pain to psychological stress isn't very helpful from an orthopedic perspective.

I could lightly touch the shoulders and neck while uttering low pitched hmmmms between telling them their muscles are tight. And perhaps they are tight. But diagnosing and treating a chronically painful condition based upon tight muscles is misleading at best.

Ultrasound and topical creams like Biofreeze are rarely helpful for more than a few days. Massage has it's place. But Chronically tight and sensitive muscles are a symptom of something else, and I'm not willing to throw my hands up and say "oh well it must be fibromyalgia."

I won't deny the existence of myofascial pain syndrome. But please remember that health care providers diagnose fibromyalgia through a process of ruling out other issues.


While locking wayward daughters out of the house or punching annoying coworkers in the face may be legitimate short- and long term solutions to your stress, I can offer a few more practical suggestions. If you're looking for a confirmation of tight muscles and a massage, these are probably not for you.

1. Remember that psychological stress is, well, psychological.
Psychological stress absolutely effects the body in a myriad of ways. It's good to keep in mind that pain is purely a psychological event. While stress alters our perceptions, especially our pain perceptions, it does not literally bind our bodies in whack positions. Gravity, fatigue, and arthritis have that covered.

2. Your posture is probably bad.

In my 11 plus years of treating clients with headaches and neck pain (many of whom also have fibromyalgia), I recall very few who have had those symptoms with good posture. It's far more plausable to assume that poor posture causes pain and tightness that's exacerbated by stress than it is to say that stress causes tightness and bad posture.

When posture is poor, the head, neck, and upper back muscles all must work overtime just to hold the head up. The only thing stressful to the muscle tissue itself is the weight of your head! Thoracic kyphosis and forward tilted (protracted) scapula also work against you, as they give many of those same muscles a poorly positioned, unstable base from which to work.

3. Your poor posture probably begins in your thoracic spine.
Stretch his neck? The neck
has nowhere to go!

Pretty much everyone who sits for any length of time aquires some degree of tightness through their thoracic spine. The thoracic spine is the base of the scapula, cervical spine, head, and about a zillion muscles. All efforts to stretch and correct the neck aren't going to work until your thoracic situation is improved.

4. Your trunk and back muscles are probably weak.

Your back muscles have likely suffered misuse and neglect. Due to postural changes noted above, they don't have the right line of pull to do their jobs effectively. The muscles that transition the upper back to the head take a pounding, which tends to cause them to heighten their tone. Viola - tight muscles! Massaging those rocks does help for a time and there is value to that, but it does little to correct the problem.

5. You're not being nagged enough about your posture.

Impossible, you say? Well, did you know that stretching doesn't fix poor posture? Neither does joint manipulation or strengthening. While those give you the potential to improve your posture, the only thing that improves posture is constant attention to your posture. Wiring the brain into a new habit of sitting tall and standing tall and moving tall is definitely a lot more difficult than exercising. Go ahead and try it.

So, the moral of the story is "mechanical treatment for mechanical problems."

And stress? I'm no expert on that, but I've found that Luke 6:28 seems to work a lot better than punching people.

 - - - - -

6.14.2012

purpose -> fun -> fitness -> purpose


It's undeniable - exercise is uncomfortable. And very, very good for you.

bodybuilding =  inverse mooning ?
Physical activity tremendously benefits our mental health. It's the only way to steer clear of one modern self destructive road, the wide road that leads to disuse atrophy and heart disease, cancer, diabetes, and on and on. Exercise helps you do things, real things, not just run 26 miles or flip tractor tires or stand on a stage in front of strangers looking un-pretty in a speedo.

I apologize if bodybuilding is your thing. I just never was a fan of, "Hey look at me standing here." My bad.

The less healthy you are, the less opportunity you have to experience this world, to play and work and serve others. Research shows that those who are active and fit don't live much longer than those who are not, but the quality of life is radically different (as are health care expenditures).

So why do people choose not to be active? [It is a choice for the far majority of us.]

While physical activity reminds people that they are hurting and out of shape, sitting on the couch or computer chair doesn't. And even children have learned that exercise is boring and painful. And who wants to do that?

Young or old, it needs to be fun. Note that I didn't say easy or pain free. The best type of exercise is absolutely what you find fun. And one of the best ways to make it fun is to set specific, performance based goals and train toward them with purpose.

Feeling good about how you look in jeans and being able to eat human sized portions of normal food without getting flabby and being able to roll and tumble with your children are meaningful goals. But they're not performance based goals that make hard training fun.

Justin over at Synergy Fitness recently posted on of those e-card things.

One of the greatest things in life is when you realize that 
your body just achieved what it couldn't have done two weeks ago.

True That! The pushing, striving, achieving, that, THAT REALLY IS FUN.

Maybe you want to dunk a basketball. Or walk a 5 k race in less than one hour. Or cycle a century or be able to pull twice your body weight right off the dead ground. Whatever the goal, you cannot afford to haphazardly drone through the motions. Forty five minutes of elliptical trainer here, a set of bicep curls there, a set of machine lateral shoulder raises if you feel like it...how boring and miserable!

Just like anything else in life, you have to do more than just show up.

For those of you interested in looks (And who's not?), please remember that form follows function. You cannot mold your body into the appearance of a cut, resilient warrior by doing random cardio and the seated ab twist machine. Aim at fit, you you'll get "hot" thrown in. Aim at "hot," and you'll get neither.

Train with purpose. You won't always feel like it. But choose to, and then go make it count. Plan, work, achieve, plan again. Have fun!

- - - -

Purpose looks like...

Cort, training for strength-endurance (and continued awesomeness) as he prepares for the Spartan Race. This was the finisher, a little somethin' we like to call "30 ROCK" done between bouts of Farmers Walks with 170 pounds:




30 Rock = ~55 lb rock for 30 reps: 10 over heard presses, 5 step-ups each leg, 10 "goblet" squats

             - - - - - -

6.06.2012

Muscle Memory is Real (And Important)

Everyone from medical experts to casual sports fans has used or heard the term muscle memory. It's often brought up in the context of a trained athlete or fitness enthusiast having time off from physical activity due to an injury, scheduled rest, or off-season.

"He has the muscle memory to make a quick come-back."

cross section of skeletal muscle
Everyone nods their head with the understanding that an athlete who is currently deconditioned but has invested time in training and competition will recover his or her physical abilities much faster and to a greater extent than a relatively untrained person.

And it's true! But how do muscles remember? If you ask them to do anything more than shorten, they'll just sit there all jacked, with a blank stare on their face. Although it sounds 14% less cool, muscle memory is technically motor memory. The key player in motor memory is, of course, the brain, which can't do a darn thing for itself but is great at shooting orders. 

What exactly does the brain "remember?"

1. Desire. First of all, trained people often want to regain their physical abilities. They have tasted and seen what life is like as a solid force of a person and usually have great motivation to avoid the alternative.

2. Previously trained brains have learned how to suffer. They are willing to put up with the misery, even embrace it, because they realize the triple pay off. They know that "no pain, no gain" is a half truth, and can easily discriminate between physical damage and beneficial discomfort.

3. The brain remembers the circuitry of skilled movement. Riding a bike is, well, like riding a bike. The neurological motor plans of lifting, running, jumping, throwing, etc, last much longer than the actual physical ability to perform them. Deconditioned athletes reap the rewards of having worked through thousands or tens of thousands of well executed repetitions in the past. The body may be soft and weak, but the brain hasn't forgotten.

4. On the more technical side, through consistent and regular training, the brain learns how to signal the muscles more efficiently. Through rate coding (bundling nerve signals in the most efficient manner), motor unit synchronization (getting various muscles and parts of muscles on the same page and working together), and reciprocal inhibition (getting opposing muscles to relax and even contribute through improved stabilization), the brain literally knows how to get more out of the body.

5. When a muscle is exercised, nuclei are added, and they're not lost when muscles atrophy. Some scientists think this is an additional reason why previously trained people do bounce back more rapidly than untrained folks.

In summary, muscle memory is a brain skill, earned through years in the training trenches, that's not easily erased by a little time off. Go out and get you some!

Bonus: Muscle memory can be "built" quicker and to a greater extent by getting powerful and efficient in a few basic exercises rather than switching your program every other week. Muscle confusion is like, so 2007.

6.05.2012

Adrenaline Withdrawal

A quick update on the pectoral muscle tear.

I elected to have it surgically repaired, and this happened less than two weeks ago. The right shoulder is tight but not painful. I have a right arm pit again. I can work and get by, filling sippy cups, tying shoes, carrying buckets of tadpoles and catfish, and I'm thankful for that.

I'm playing more wiffle ball with the boys, getting good at throwing left handed.

Today Dr. Deluca (at OIP) told me that the surgery took one hour and forty five minutes, not forty five minutes as I had thought. After he opened me up, he spent 20 minutes draining fluid and blood from the area before he could get moving.

There was significant tearing of the muscle tissue and a complete rupture of the pectoral tendon from the humerus (upper arm bone). His first attempt to unwrap the muscle tissue and pull it back resulted in greater tearing, so he sutured that baby up. He scraped the bone and periosteum (connective tissue covering) of the humerus to cause bleeding and pinned the pectoral tendon to that point with two small staples. He sewed up an inner layer and glued my skin together.

I woke up from surgery feeling groggy. I've had little to no pain since.

Dr. Deluca kindly reminded me that healing of a tendon-bone interface cannot be rushed. 

I've quickly gone from being thankful that I can work and function well to being anxious for a fix. For at least 8 weeks there will be no back flips. And no front flips. Not even any side flips. No squats or anything that involves climbing or hanging.

Nothing fun or awesome and nothing that makes you awesome. I simply cannot afford to fall toward my right arm. I can ride a bike like a civilized human, but what fun is that?

So here's to the fear of falling! And not doing something stupid that pulls those staples off the humerus!