Recently, I had a minor leaguer in for a Precision Strike, One Day, One-On-One Evaluation and Training Session. Since he’s currently in extended spring training with a pro team, he had to come in under the radar on a Sunday morning. So to maintain confidentiality, I’ll just call him “Lefty”.

As I always do with minor leaguers, I asked Lefty what he thought were the biggest constraints keeping him out of the big leagues.

He reported that since being drafted out of college as a 91-93 mph guy, he had been losing velo and had developed a shooting pain with associated numbness and tingling into the last 2 fingers of his throwing hand.

This cluster of symptoms usually indicates aggravation of the ulnar nerve.I wrote a blog on ulnar neuritis a while back.

Lefty said he was a big fan of our work and had studied everything I had written. “That article on the inverted iron pyramid was one of the best things I have ever read. I’ve been working all winter on getting into my glutes, but it seems like whenever I try, it, my lead leg kicks out in front of me and I lean backward and kind of fall off the mound. I was doing that one day and I felt the twinge in my elbow so I stopped and went back to my old way. ”

(If you’d like to review that blog, go to

As per norm, we started with a physical examination. I checked Lefty’s scapular mobility and stability, his shoulder mobility, thoracic mobility, trunk stability, hip mobility, and ankle mobility, and performed a functional movement screen.

As I looked at the results of the physical assessment, I could almost predict what his video analysis would be.

Of particular interest were my findings that he had significant deficits in ankle dorsiflexion (toes toward head), and tight quads, which made his deep squat test look really bad.

When we looked at the video, the first thing that jumped out was his lack of glute load. He never got his butt behind his heel. This caused him to become quad dominant, bending his back knee in a manner that projected his knee forward of his toe and his weight onto the ball of his foot, guiding his ride/stride to be toward his arm side (headed toward the first base on deck circle). To find a way back toward home plate, he adjusted by opening his lead leg early and arching his back into a postural disconnection.

Over the winter, he noticed that if he didn’t lead backwards, it didn’t hurt, so by the time he checked in at the Florida Baseball Ranch he had modified his posture to more of an “eyes level/shoulders square” approach. Unfortunately this move had resulted in 2-3 mph loss of velocity, and occasionally (1 of 10-20 pitches) he would feel the tingling briefly.

Lefty asked that I not show screen shots of his video, because he doesn’t want his current coaches –who  have offered no remedy to date — to know he was visiting us.  Instead, I asked one of our new students, Corey Stump to pose for some pictures to demonstrate the concepts.

corey glute load differencescoery landingcoreyelbow bangcoery posture

So you see, the problem started with Lefty shifting his weight to the ball of his foot and becoming quad dominant with his first move (just like I described in the Inverted Iron Pyramid article). That one move created a cascade of compensatory adjustments, including a postural disconnection, that led to a bang on the elbow and ultimately inflamed the ulnar nerve.

One would think all we would need to do is to get him off his quads and onto his glutes and his problem would be solved.

But wait…

It goes a little deeper than that…

Because of Lefty’s limited ankle mobility, and hip mobility, he was UNABLE to engage his inverted iron pyramid and get in to his glutes.

He had developed his throwing pattern based on his individual physical attributes.

The entire problem might be the result of a series of events that began with something as seemingly benign as a lack of ankle dorsiflexion.ankle DF:PF

Lefty’s, body had organized itself in the most effective way possible, given his physical adaptations.When he tried to change his throwing pattern by simply “thinking” about getting more into his glutes, without adjusting his physical constraints to prepare his body for the change, it led to a compensatory postural disconnection and irritation of the ulnar nerve.

This is a massively important concept to understand when working with throwing athletes…

Physical and biomechanical constraints are intimately interwoven. Often one spawns the other.

Some guys throw the way they throw because they’re tight or have motor control issues. Some guys are tight or have motor control issues because of the way they throw.

Changing pitching mechanics is a serious undertaking.

Even the most minor change in a movement pattern could produce significant effects — both positive and negative.

As a pitching instructor, if you’re going to try to change a movement pattern, you had better address the athlete’s physical constraints simultaneously (and oh by the way…his preparation and warm up habits, his conditioning, his workload ramp up, his recovery plan, and his sleep, nutrition and hydration routines).

And that certainly can’t be done by sitting on a bucket and shouting commands while trying to avoid getting hit in the forehead.

You can beat a guy over the head as much as you want with verbal commands and drills. If he isn’t physically capable of making the changes, you won’t modify his movement pattern — not without potentially disastrous unintended consequences.

And if you miss something important, those consequences could be dire.

If you’re experiencing arm pain or struggling with your performance, I want to help you!

Call my office at 813-655-3342 and ask Amy to schedule a Precision Strike One-on-One Session.

If you want a more elaborate stem-to-stern look at everything we do, get signed up for one of our weekend Arm Care and Elite Performance Training Camps.

Click here to learn more.

See you at The Ranch,

randy clinic headshot

Randy Sullivan, MPT

CEO, Florida Baseball Ranch

Sullivan Rehab Services