For most of us, one-size-fits-all programs and programming have always been an undeniable fact of life. We had a coach, mentor, or teacher who followed a specific philosophy, recipe or process and simply hoped for the best.
After all, most systems are better than no system at all, so we quietly accepted reality and moved forward.
We intuitively realized that some coaches, mentors, teachers, philosophies and/or processes fit some individuals far better than others. Many have come to grasp the fact that such a universal reality will never completely go away. Perfect just does not exist.
That is the reason many of us are unconsciously in the constant search for a better “fit” for ourselves, our children, our family, our teams and/or our organizations.
But as far as physical training is concerned, technology and the evolution of thought behind training has evolved considerably in just the last 10 years.
We are just now fully grasping the incredible benefits of customization and hyper-personalization of our athlete’s training protocols. In fact, when we step back and look at it from a distance, such a process actually makes perfect sense. Instead of forcing each unique athlete to conform to a rigid choreography and a universal cookie cutter model of training, we go through a four-step process that, at the Ranch Consortium, we refer to as Assess, Categorize, Customize, and Prioritize.
Without getting too abstruse and deep into training methodology, here is why such a process is a gigantic leap forward.
The science behind this is good. Whenever we take a group of dynamic systems… such as a collection of baseball pitchers… and expose them to a strict process or protocol… such as a one-size-fits-all weighted ball program… the results are fairly predictable.
Some flourish, most show very little change, and some get injured or go backwards.
For a vast majority of the history of training athletes, this was simply standard operating procedure.
It was great if your athlete was on the “flourish side” of the bell curve and it was unfortunate if he happened to get injured or went backwards.
The authors of the particular “process” would champion and highlight their successes and for the most part ignore the failures. (By the way, that certainly included our early days at the Texas Baseball Ranch®.)
If you happened to be on the wrong side of the curve, you often went in search of the next process, hoping that this next one was a better fit.
This went on for years and years. Nothing to see here, simply keep moving forward.
But slowly things began to change. Technology improved. Thinking and understanding evolved. Some of us in multiple disciplines and arenas of athletic training and performance enhancement rejected the status quo, consensus, conventional thinking and group think. Thanks to works of Bernstein, Nyman and Bosch, we began to understand “Dynamic SystemsTheory” and how it relates to our athletes individually.
We started down the complex road of hyper-personalization and built training processes which were led not by efficiency, but by the individual constraints of each individual athlete.
In short, we wanted to assist each athlete in overcoming and/or reducing the specific constraint that was MOST limiting or interfering with his performance right now… currently… today! At the Ranch Consortium we refer to this by its Motor Learning equivalent: A Constraint-Led Approach to Motor Skill Development.
I wrote a whitepaper entitled, “The Case Against Weighted Balls?” We made it into a short book. If you would like a copy of it, please call or email our office and we will mail you a copy for free: Please let our Office Manager, Anna Dugger, know if you are a player, parent or coach.
Now to be clear, the title was intended to be provocative. We in fact believe that over-weighted and underweighted balls as throwing tools are exceptional. However, they are simply tools. They are not a silver bullet nor a panacea, and if used incorrectly, they can in fact place athletes at greater risk of injury.
The purpose of my paper was to share our 20-year relationship with the utilization of weighted balls in training so that players, parents and/or coaches would have a better understanding of how to maximize the benefits of weighted ball training while minimizing their risks.
If you are interested in utilizing weighted balls as part of your process, I believe the book is quite helpful and informative.
However, after reading it again for the first time in several months, I realized I omitted a very, very valuable piece of the puzzle and a critical influencer, and I wanted to correct that now.
A huge component of our success has been the assessment phase. No one single person has been more influential in that regard than Phil Donley. Not only is Phil one of my most favorite people in the entire world and a wonderful man, he was light years ahead of his time, helping us understand what sound structural assessment entails and how to interpret the testing information.
Today his influence is all over our processes. For those unfamiliar with Phil, here is a little about him:
Phillip Donley is a retired Colonel U.S. Army Reserve. He was Chief Physical Therapist at Akron City Hospital (1958-1960), Instructor and Assistant Athletic Trainer at West Head Athletic Trainer and Professor of Physical Education at West Chester University (1965-1991). He owned a private Sports Physical Therapy Clinic in West Chester in 1981 to 1995. Since 1997, he has served as a Consultant to the Philadelphia Phillies for 10 years and the Philadelphia Eagles for 5 years. He now treats patients part-time at the West Chester office of Optimum Physical Therapy Associates. He also performs research and clinical care lectures on shoulder and full body kinetic chain topics.
In closing, the primary reason so many people are often disappointed with their training is because their specific training is simply not a great fit. It may have been a better fit a year ago or it might be a great fit 6 months from now, but right now, there are things that are far more important. It may even be a great fit for your roommate or teammate, but it isn’t for you.
Getting the wrong plan will at best minimize your gains and at worst ruin or significantly sidetrack your career.
To have the BEST chance of your training having a large positive impact on your performance, you should:
Assess your current physical structure, mobility/flexibility, strength/strength balance, movements/mechanical efficiency, recovery/ability to bounce back and performance parameters (velocity, command, swing-and-miss stuff).
Then Categorize– from those assessments, guide each athlete to the exact area(s) and protocol(s) that they need most at this moment.
Then Customize– building a hyper-personalized, holistic plan for the next 8-12 weeks so that each athlete works on the specific areas they need most.
Then Prioritize– creating a hierarchy of our process to make certain we hit the most urgent things first.
The best news in all of this is that today in 2020, there is a viable, far more effective way to train than following a mail order program on the internet. And indeed, sometimes your very career may depend upon it.
Until next time, stay curious and keep fighting the good fight.
– – – – – – – – – – – –
Important TBR Updates
We have only 2 remaining Elite Pitchers Bootcamps on the summer schedule after this weekend. The August 7-9 is SOLD OUT but there are still spots available in our Labor Day Camp, September 5-7. Due to current COVID-19 state mandates, we have reduced the number of attendees to 2/3’s of out normal 45 cap. For more information on these popular events, please visit www.TexasBaseballRanch.com/events. We are also loosening up our cancellation/change policy so that people can be comfortable in making plans now in the face of current and future uncertainty. **We also have an option for you to extend you bootcamp weekend and stay for an additional week(s) and participate in out “Extended Stay Summer Developmental Program”.
Would you like to train at the Ranch for a longer period of time this summer? Our “Extended Stay Summer Development Program” is the program for you. We have one session remaining this summer. It is a two week mini session, August 3-13. More information is available at www.texasbaseballranch.com/events/tbr-summer-program/.
Response to our “Ranch Remote” training option has been exciting. It’s a program for people that would still like to get access to, and ongoing instruction from, the TBR staff but prefer to avoid travel due to the virus. Click here to get more information on this NEW, hyper-personalized training option. The number of participants in this program is limited to 36 so if you’re interested, don’t dealy.
Like many of you, we have heard the news that many Junior Colleges across the country have cancelled their fall season and in some cases, the entire 2020-2021 athletic season. This obviously is both disappointing and frustrating for many young men. At the Texas Baseball Ranch®, we have decided to put into place a fall training program for those young men who would like to take a ‘gap’ year, focusing on a structured developmental program that will best prepare them for college baseball when it finally does return. Please email info@TexasBaseballRanch.com if you would like more information on this option.
To become an elite throwing athlete, you need to throw … a lot.
Quick, off the top of your head, name me one skill in life where becoming elite at that skill involves …
NOT DOING THAT SKILL.
You want to be a great guitar player?
Here’s what you do …
Don’t play guitar too much.
Save your bullets.
Take three months off every year to give your body time to recover.
You want to be a great chemist?
Ok, listen up.
Whatever you do …
Don’t do too much chemistry
When you want to do something well, doing that thing a lot seems ridiculously self-evident.
Yet if you ask medical experts and baseball traditionalists about the key to preventing throwing injuries, that’s exactly what we hear.
It stems from what I believe to be a fundamentally flawed assumption — that all throwing injuries are due to OVERUSE.
When the assumption is that OVERUSE is the cause of injury, the natural course of treatment is UNDERUSE.
Limit pitch counts.
Control innings pitched.
Take 3 months off every year.
Those were the recommendations, and most of the baseball world fell in lockstep without question.
Programs around the country implemented the restrictions, but to the experts’ surprise, injury rates continued to rise.
When the data showed no impact on injury rates with rest and “overuse” avoidance, the experts doubled down.
“They’re not being obedient … not doing what we said they should do.”
Soon it became political.
Any coach at any level who allowed a pitcher to go beyond these arbitrary limits was labeled ignorant, irresponsible, reckless, and even abusive. Governing boards legislated limits that would lead to disciplinary action if breached.
Coaches and organizations complied. Yet injury rates kept climbing.
Let’s face it. We’ve been chasing pitch counts and innings limits for nearly two decades, and it doesn’t seem to have had any influence on slowing the injury rate. Yet, we continue to mandate draconian restrictions.
It’s mind-boggling, really.
It defies logic, and the laws of physiology.
Davis’s law in physiology states that all human tissue remodels and aligns itself to resist the stress under which it is place. Any tissue with a blood supply is capable of making itself more robust and resistant to injury. However, it must be is exposed to the right stress. The body will always adapt. For positive adaptations, we must add stress to vulnerable tissue. If we withhold stress, we’re sure to get unwanted negative adaptations.
Send an astronaut into space for 30 days. In the absence of gravity, his body adapts negatively. When he comes down to earth, his bones are brittle, and his muscles are weak because he hasn’t been exposed to stress.
The irony is apparent.
In our noble effort to prevent injury by reducing exposure to stress, we may be making our athletes more vulnerable.
We must add stress.
But, we must control that stress, adding it slowly, incrementally, over time.
If we add it too quickly, the tissue will fail. If we add it at high intensity for too long, the body will respond by laying down the most hardened tissue it can muster — bone. The result will be calcifications and/or arthritic spurs.
Please understand, I’m not saying workload doesn’t matter.
There is a reasonable limit to how much an athlete should throw. However, that limit should be determined on a case-by-case basis.
You see, managing arm health is far deeper and more complex than merely counting pitches. Arm health and performance involves optimizing what my friend Ron Wolforth calls The Six Types of Contributors To Sub-Par Performance and/Or Pain.
Here they are shown in their order of importance.
If types 1 thru 5 are right, the pitcher could (and should) throw a lot.
If types 1 thru 5 are wrong, 10 pitches may be too much.
At least 2-3 times per week, we get calls and visits from players whose loving parents are beside themselves.
“I don’t know how he got hurt. He never went over the pitch count.”
Most parents don’t let their son throw too much. However, in many cases, their sons simply aren’t ready to handle even the smallest amount of workload. They haven’t stabilized the first five types of contributors.
At the Ranch consortium, we want our students to throw a lot, but we also understand that workload mustbe individualized. Not everyone is ready to throw a lot. A couple of years ago, we realized we needed to create a process for objectively measuring and calculating an athlete’s readiness to tolerate high volume throwing.
At the Florida Baseball Ranch, we measure EVERYTHING. We enter all of that information into a database we keep on an app in our iPads on the training floor. Our analytics department has formulaically quantified and weighted each possible contributing variable.
We combine that information with ramp-up data, pain and recovery audits, and performance-related factors like velocity changes, strike percentages, and ball flight metrics. Then we run that data through an algorithm we developed that produces an on-going Arm Readiness Measurement (A.R.M.). This score ranges from 0 to 100 and allows us to individually predict the amount of work each player can tolerate.
Last fall, the father of one of our 17-year-old students approached me before a training session and said, “Hey, my son threw 90 pitches in a game with his travel team this weekend. Does that seem excessive to you?”
“Hold on a minute,” I replied. I typed the player’s name into our Ipad App and called up his A.R.M. “No.” I said. His readiness score is 88 out of 100, so he should be able to tolerate 90 pitches just fine.”
If the player had scored a 20 on the A.R.M. we would have had a reason for concern. More importantly, we would have needed to dig deeper into his assessment to determine why he had scored so low. Then we would have gotten to work on correcting his deficits so he could score higher on the A.R.M.
Imagine you’re a college pitching coach, or you run a travel ball organization. You enter a weekend series or a tournament with 10 pitchers. Three have A.R.M. scores of 80 or above. Four are sitting between 50 and 75, and three are below 35. You’ll need to lean on the 80+ guys to handle most of the innings. The four in the middle can eat up a fair portion, but the 35 and below group will probably be limited to only a few innings each. After the series, you can address the discrepancies that led to the lower scores so they can handle more innings in the future.
If you want to improve your velocity, your command, or your secondary stuff, you have to throw a lot. But, before you do, you’d better be sure you’re ready to throw a lot.
Before you make another throw, or pitch in another game, call us at 866-787-4533.
We’ll develop a customized training plan that links your hardware to your software, and optimizes your warmup and ramp-up. We’ll write a strength and conditioning program that will aid in your readiness and turbo-boost your development. When you execute your plan, you’ll be able to throw safely and with enough volume to accelerate your progress at warp speed.
You’ll throw harder.
You’ll throw more strikes.
You’ll have nasty secondary stuff.
And, you’ll do it all without pain!
We’ll be with you every step of the way to guide you through your process.
As also mentioned in last month’s newsletter, I said this would be the year of injuries. Remember? I said it enough times that some people even said to me, “Yes, you did say that, and your point?”
Now, let me clarify something regarding all my talk about injuries. I may have written about it last month, but I’ve been telling everyone about it since APRIL. I’ve been screaming about this.
Does this make my predictions even more powerful given there have, in fact, been a number of injuries since the MLB season and youth travel ball began again? Maybe, but there was a rhyme to my reason.
The mind is so powerful; it can will us to do great things. The mind is also powerful enough to make us do things that can bring us pain and injury.
Ever since March, when every sport had been cancelled, players could not wait to get back to playing games and for good reason.
Schools had children staying home all day. People like Dr. Fauci, Dr. Ferrer, and others were telling us what we could and could not do. We were told “no” time after time. So baseball players quarantined, just like the rest of the nation, and became very sedentary and lethargic. Video games, Netflix, and television made us lazy. To be honest, I watched all nine seasons of “The Office,” which I’d never have done if we’d kept on going. But our emotions and thoughts around baseball never left our minds.
So when the state started opening up again, numerous coaches immediately had their travel teams start practicing up to three times a week, while other coaches took their teams to places like Arizona to play from 3 to 6 games over one weekend.
The coaches needed to coach, and the players were SO ready to play again. Mentally and emotionally at least, they were so ready to play.
But a funny, well not too funny, thing happened. Their sedentary bodies weren’t ready for the physical part of the game. Oblique injuries appeared, groin and hamstring tightness became very real, and, most importantly, elbows and shoulders got tired, hurt, and, in some cases, injured to the point where players are still on the mend.
It’s a sad state of affairs in baseball when injuries occur. But how could they not? Young bodies were not, and are still not, ready for the rigors these coaches are placing on them. It became a matter of, “Hurry up, because we have a game next weekend.” It’s shameful coaches had their teams playing game after game when their players weren’t anywhere near the level they needed to be at to play a game, let alone win.
I know of one coach who had one of his star pitchers throw for 6 innings so they could get to the championship game of a tournament.
It’s disgusting, and they wonder how a kid could get hurt. That coach said, “His arm should have been ready while we were all in quarantine.” Needless to say, I advised the parents of this player to immediately leave this type of environment. When the goal is winning instead of development at such a young age, then that coach is doing a great disservice to the entire family. In fact, you could argue it’s a form of child abuse, but that’s for another time.
When the MLB voted to play an abbreviated season, I told Warren at class that the injury bug was going to get those players. They only had three weeks of summer training, and in less than a week a whole slew of pitchers went down: Clayton Kershaw, Justin Verlander (as well as 8 other Houston pitchers, 7 of whom were called up and had never pitched in big leagues before), Cole Hamels, Dillon Tate, Noah Syndergaard, Chris Sale, Jose Quintana, Jordan Zimmerman, Mike Montgomery, Alex Wood, and Jimmy Nelson. The list goes on and on.
This doesn’t even include the Angel’s Anthony Rendon (out with an oblique injury). If you look at the MLB injury list, it must have at least 180 names. Some are COVID-19 related, but a vast majority are from injuries from training or from the first several games of the season.
My final point on this subject is to say that ALL players must be careful while getting back into shape. The MLB is different because these are grown men taking responsibility for themselves. However, we must take responsibility as parents, and myself as a teacher, to make sure our players are training accordingly and not just going out to the field at full speed.
When we began our summer training, our players weren’t allowed to use the radar gun if they hadn’t been throwing for a period of time. Fortunately, a number of our campers are players who had already been working with us so we had an idea of where they were with regard to their workload. But if I just had players throwing immediately to a radar gun, then shame on me. However, I had an idea of who had trained accordingly and who had not.
As schools go back online this month (on a personal note, I hate that the social development of young and healthy kids is being put at risk, including the isolation my daughter goes through every day), it’s going to be imperative that your player is getting in the repetitions he needs so as to be ready when games start up again. I constantly remind players that games WILL begin again, and they need to be ready.
Here’s where we can help:
Our weekly training sessions are ongoing. The 7:30pm Advanced Training Class (ATC) begins on Wednesday, August 12th. Our safety protocols are still in place and strictly enforced. Throwzone Academy is functioning with the safety of our players and their parents in mind.
Allow us to be part of your son’s development. In fact, we can be utilized as part of your child’s physical education portion of the day, and I can sign any paperwork you need as proof. Allow us to put your child in the best possible position to avoid the risk of injuries.
Not all injuries are alike and while we can never say players won’t get hurt, working with us WILL LESSEN the risk. We can proudly say that, and the proof is in our years of experience and in the number of players who have moved on to the next level, staying healthy and on the field all the while.
We have several opportunities available and can start working with your son today. Call us at 661-644-2147 and begin a journey toward getting your son to the level he expects and needs to be at in order to reach his goals in his baseball career.
One night last winter my friend, Alan Jaeger called me with a major concern about the current state of UCL reconstruction post-operative rehabilitation and throwing protocols. We talked for about an hour, and the discussion ignited a thought eruption that had been smoldering in my head for over 10 years.
At the Florida Baseball Ranch® we train and develop high-caliber throwing athletes, improving velocity, command, secondary stuff, and arm health. This past summer, 161 high school and college baseball players made the trek to Lakeland, FL to begin their own relentless pursuit of excellence in our Complete Game Summer Training Program, They trained up to five hours per day, five days per week and they stayed anywhere from 2-10 weeks. The energy, intensity, and focus was palpable and he the results were incredible.
It has been our honor to assist players in achieving performance levels they have heretofore only dreamed of. However, we also serve as the rehab wing of the Baseball Ranch consortium. Like our sister company, the Texas Baseball Ranch®, hyper-individualization of multifaceted training is the keystone of our process. At the Ranch, we frequently advise our students, “If you find yourself involved in a training experience where everyone in the program does the same thing all the time, RUN!!! If you “google return to throwing programs” the first 10 pages (notice I said “pages”, not “articles).”
I believe it’s time for UCL rehabilitation to undergo a radical change.
At the core of any rehabilitation process are 2 fundamental laws of physiology:
1) Wolff’s Law states that bone grows and remodels in response to the forces that are placed upon it in a healthy person.
2) Davis’s Law is a physiological principle (the corollary to Wolff’s Law) stating that soft tissue continually remodels and heals according to how they are mechanically stressed.
Rehab Protocols Must Adhere To Known Principles of Tissue Organization
Many esteemed members of the medical profession appear to ascribe to the idea that nearly all throwing injuries are due to “overuse” and that “you only have so many bullets in the gun, so you have to save them.” Those who do so are either denying or ignoring Davis’s law which applies to all human connective tissue that has a blood supply. While the UCL, Labrum, and rotator cuff aren’t the most highly vascularized tissues, they do receive some blood flow, and therefore under the right conditions, they are capable of remodeling themselves to resist the stresses under which they are placed.
I’ve had the privilege of scrubbing in for surgery with Dr. Koko Eaton, the Tampa Bay Rays team physician, who during a few different UCL reconstructions lifted the fragment of a torn UCL and said, “look at how thick this ligament has gotten. This injury has been coming on for a long time.” My thoughts immediately turned to Davis’s law. “That confirms it,” I thought. “A thickened ligament indicates that it was attempting to remodel itself to resist the stress.” Unfortunately for this guy, it wasn’t able to remodel fast enough to keep up with the pace of the stress.
During one particular surgery, Dr. Eaton had harvested an exceptionally long portion of the patient’s palmaris longus tendon (to be used as the replacement UCL). He drilled four holes in the in the bone and wrapped the tendon through in 3 full figure 8’s. Next, Dr. Eaton tested the stability of the graft with an aggressive valgus stress maneuver. I mean, he really popped it hard. I almost fell over from the startle reflex. I was shocked. In physical therapy, we had always treated our post-UCLR patients with kid gloves, gingerly handling the elbow and avoiding all valgus stress. After I had regained my senses, I said, “Wow. That looks like a pretty stable repair (I know. Brilliant, right?).” Dr. Eaton nodded and stated, “You know, Randy. This new ligament isn’t really the main stabilizer of the elbow. It’s just the lattice for the scar tissue. As it forms around the ligament, the scar will become the primary stabilizer.” He added, “Whenever we have to go back in for a second repair, “It looks like a grenade went off in the guy’s elbow. There is just this massive blowout of scar tissue.”
Well, that really got me thinking.
In physical therapy, we’ve used the same universal UCL rehab program for as long as I can remember. A surgeon might add a few nuances, or choose a preferred brace, but early physical therapy is pretty much a one-size-fits-all approach that involves minimal motion – even bracing – for the first several days/weeks. We progress through isolated, guarded ranges of motion in unidirectional planes (flexion and extension, supination/pronation), avoiding any valgus stress for at least eight weeks. We don’t begin any movement that simulates the kinematics of throwing until at least 16 weeks post-op. During that time, the stabilizing scar is forming without any guidance. If you’re not interested in the biological processes in the body, skip the next section. If this kind of stuff interests you, here’s how the scar is formed:
The Physiology of Tissue Healing
Immediately (within seconds or minutes) after the surgery there is a brief constriction of blood vessels followed by rapid vasodilation. Vessels that were shut down are re-opened and widened as the tissue is infused with fresh blood – blood that contains many of the necessary healing agents for recovery and the ever-important undifferentiated mesenchymal cells (UMCs) that begin forming the scar. UMCs are like over-the-counter stem cells that run in the platelets of the blood. They have no real job until tissue is injured. When they receive what is assumed to be a chemical signal about tissue injury or death, they have the miraculous ability to morph themselves into whatever kind of cells they need to become to replace the injured or dead cells. UMCs are the same cells involved in the PRP (platelet-rich plasma) injection procedure that has become popular in the last 8-10 years.
After this period of vasodilation and infusion, the rate of blood flow diminishes. This increases the hydrostatic pressure which causes fluid to leak out of the blood vessels and into the surrounding tissue. The fluid that leaks out is called transudate, and it consists of fluid, scant amounts of protein, but it no intact cells. The migration of this watery fluid out of the vessels increases the viscosity of the blood. This condition is known as haemoconcentration (thickening of the blood).
If the flow slows to a crawl or even stops, endothelial cells that make up the inner lining of the blood vessels begin to die for two reasons: 1) the roughness of the blood due to increased viscosity which scrapes the cells off the inner wall, and 2) hypoxia (lack of oxygen) as they are physically separated from blood cells carrying much-needed oxygen.
When endothelial cells die or become dysfunctional, a critical process for evacuating cellular debris is disrupted, and constipation or backflow occurs. This is a primary reason we believe ice to be contraindicated immediately postoperatively. Ice causes vasoconstriction and impedes blood flow. Continued or enhanced blood flow will avoid the traffic jam that could result in permanent damage to endothelial cells and could cascade into more widespread necrosis (or cell death). For more problem with icing as a therapeutic modality, see the works of Gary Reinl, the author of Iced: The Illusionary Treatment Option.
When epithelial cells are preserved, the clean-up can begin. White blood cells (also called leukocytes) roll along the inside of the epithelial cell wall adhering transiently to form what looks like white brick pavement along the edge of the vessel wall. The white blood cells that manage to stick to the inner wall then shoot out little “pseudopods” that become what are known as polymorphs. These polymorphs lift up the endothelial barrier and squeeze through to produce holes in the membrane. At this point, white blood cells migrate through the holes and secrete a protein that locks on to a corresponding protein on the pseudopod on the outside of the endothelial wall. The process of passing through the vessel wall is called emigration. When the protein bond is complete, emigrated white blood cells/pseudopods begin to move toward the injury site for cleanup. Remarkably, they travel against the concentration gradient, like a salmon swimming upstream, in a process known as chemotaxis. When healthy cells are injured, they release 3 chemotactic agents (C5a, C3a, and C567). These agents send a powerful signal to the white blood cells that attract them to the site of the injury. This reaction is facilitated by magnesium and calcium ions.
When the white blood cells (also known as phagocytes) arrive on the scene, they don’t strike right away. They gather in a process called aggregation, then they recognize and engulf any unwanted debris, wrapping the garbage in a well-contained cellular trash bag before being passively transported into the lymphatic system for evacuation.
The lymphatic system can be thought of like the waste management service of the body. It’s like the trash man, hauling off and disposing of unwanted garbage. But, the lymphatic system is passive. It doesn’t send trash men out to pick up the trash; it waits for the phagocytes full of dead debris to wander near the lymph nodes. As they diffuse into the lymph system, they are evacuated through the kidneys. The passive nature of the lymphatic system is why early movement and muscle pumping such as that produced by Marc Pro® electrical stimulation and the pressure gradient created by Rocket Wrap® a both valuable parts of our rehabilitation and recovery programs.
Once the clean-up is complete, the road is clear for the UMCs to do their thing. They morph into the appropriate replacement cells and, like fresh recruits on the battlefield, assume their new position.
However, there is one more step they need to achieve an optimal outcome – a mechanical signal to direct their alignment. Following Davis’s Law, if we don’t provide a mechanical signal, by adding controlled stress to the new tissue, it forms in a disorganized fashion, like a plate spaghetti noodles left out in the sink all night. Disorganized tissue is unstable. Disorganized tissue is vulnerable. Disorganized tissue adheres to anything it can cling to, including, in the case of UCL reconstruction, the tendon graft that serves as the lattice for the newly forming scar.
In the current universal UCL rehabilitation protocol, we wait at least 16 weeks before we expose the elbow to any stresses that even remotely resemble the demands of actual throwing. During the entire process, in nearly every case, we fight a common enemy – scar tissue. Fearful of imparting any level of valgus load, we attempt to eliminate functional stress and try in vain to manage the scar from the outside with modalities like cross friction massage, instrument-assisted soft tissue mobilization (IASTM), and a collection of vaguely defined manual therapy techniques commonly known as “soft tissue work.” Please don’t get me wrong here, I’m not averse to these modalities, I’m certified in IASTM and use it sparingly as a pain management intervention and in cases where we might a have a gnarly, adherent scar. Nonetheless, in my opinion, those who believe we can impart order on tissue from outside of the body are sorely mistaken. That’s not the way Davis’s Law works. We might be able to break some of the superficial fibers loose, but even then, without internally activated stress created by movement, we can never achieve optimal scar tissue organization.
When I teach physical therapy continuing education classes on UCL rehabilitation, one of the slides I post is the image of a guy looking like he’s stressed and about to vomit. I call it “the moment.” The message is that as therapists and coaches we should prepare our players for an inevitable moment that nearly every recovering UCLR experiences. It usually happens at about 7-9 months post-operation. As the player begins to ramp up his throwing program toward more game-like intensity, he/she feels that dreaded and infernal “pop”! The immediate and terrifying thought is that they’ve re-injured the elbow, but more times than not, it’s just scar tissue breaking free. After about 7-10 days, the elbow starts feeling better, and the throwing program may be resumed. Why does this occur? I would suggest that the reason we fight scar tissue like this is that we allow it to become severely disorganized during our first 16 weeks of rehab.
Could it be that the for the lucky athletes, the frightening “pop” represents the tearing of tissue that is not directly attached to the graft? But, for the unlucky ones, the story is different. When a scar is allowed to heal unchecked and unguided, it adheres to anything upon which it can find a foothold — including, in many cases, the tender new tendon graft. If the scar happens to anchor tightly to the graft site, when the athlete begins adding the stress of throwing, it could cause the disorganized, randomly-oriented repair to explode into the “grenade” scene described by Dr. Eaton.
I believe we could be making a colossal mistake by eliminating all valgus stress and by avoiding any movements that mimic throwing in the early stages of rehab. Our efforts to protect the surgical repair by practically immobilizing the arm could be setting the stage for tissue failure. Within the limits of repair site integrity, establishing and maintaining scar tissue order should be the first order of business in any legitimate UCLR or Labrum repair rehabilitation. This can only be accomplished through controlled variable movement that adds the low-grade stress necessary to align the newly forming tissue effectively.
Rehab Programs Must Address Tissue Physiology AND Motor Control Simultaneously
What we’ve talked about so far is the physiology of the process. But, we haven’t yet discussed the impact of the extended rest and protection on motor control and coordination. As Dr. Eaton explained, the scar is an important stabilizer of the post-UCLR elbow. But, the number one stabilizing component of the system is dynamic motor control. The passive restraints provided by to the labrum and the UCL are the last line of defense. If your labrum and UCL are the points of primary stability, you’re probably already in trouble. The timing, sequencing, and synergy of surrounding musculature must be optimized to attenuate the stress on the UCL and labrum. Just like any other physiological system, the motor control system adapts precisely to the neuromuscular coordination demands it experiences. Lack of demand equals no adaptation. No coordinative demand equals no motor control. And, according to the SAID principle of rehab and training (Specific Adaptation to an Imposed Demand), the system will adapt directly in accordance with the stresses under which it is placed. When rehabilitating our players, the training experience we choose in every phase of recovery must keep tissue integrity paramount, but that experience must also be specific to the adaptation we are trying to elicit. It must mimic, as closely as possible, the parameters of the conditions our players will face in life and when they return to games.
And, one thing we know for sure is that the stress our players must handle in life and in games will be largely unpredictable. To bulletproof our players against the variability and unpredictability they will eventually face, we must introduce incrementally increasing variability, or unpredictability as early and as safely as possible. When introduced slowly and within the limits of tissue integrity, variability will allow physiological and neurological self-organization of coordinated movement to progress simultaneously.
As healing tissue organizes to withstand stress, it presents new coordinative demands. If we help an athlete develop the capacity to handle a given level of physiological stress, but we don’t also incorporate a motor control plan to keep the movement within the boundaries of safety, yet highly resistant to perturbation, we may be dooming them to failure. Connective tissue, whether healthy or healing, must remain physiologically and neurologically organized at all times.
Return-to-throwing protocols that feature mindless adherence to a pre-scripted regimen of throws ignore many of the factors that contributed to the injury in the first place. It’s vital that we employ a thorough multi-faceted assessment process to identify possible contributors. When deficits are noted, we must incorporate training strategies that influence the athlete to achieve efficiency in all 6 types of contributors to sub-par performance and/or pain.
Rehab Programs Must Be Individualized
As stated frequently by Coach Ron Wolforth, our mantra at the Florida and Texas Baseball Ranches® has long been, “One-size-fits-all fits none.” Training plans must be customized to meet the individual needs of every player, and they must be changed as the condition of the athlete changes. Cookie-cutter recipes for rehab will never be adequate for optimizing outcomes. Rehabilitation protocols should should illuminate overall principles and goals, and they should serve as general guides and . But, they should never be viewed as a governor, and they should never replace or limit the sound professional judgment of an experienced and qualified rehabilitation professional or coach.
Additionally, rehab protocols must be remain contemporary and should be changed and updated with the times.
As new information emerges, our approach to rehabilitation should be modified to reflect the most current training concepts. The current approach to rehabilitating injured throwing athletes is based on a program first introduced in the late 1970s. It is antiquated, ineffective and it stifles the creativity and adjustability necessary to achieve consistently positive outcomes.
We believe it is time for a change.
As soon as intra-operative bleeding is curtailed, remove the bulky dressing and eliminate all post-operative icing.
Start Marc Pro for at least 16 hours per day to assist with exudate evacuation, thereby creating a more optimal healing environment.
Add multidimensional low amplitude oscillations and gradually increase intensity as early as tissue integrity will allow.
Begin early progressions of functional range of motion including active movements in multiple planes and in “throwing-like” exercises performed within pain limits. High-frequency, low-intensity motion should begin the day after surgery.
Challenge all non-throwing arm attractors with light perturbations, variability and unpredictable loads ASAP after surgery.
Incrementally challenge the Throwing Arm Attractor as soon as tissue integrity allows. use low grade
Integrate variability/unpredictability early in the rehab process and influence more efficient movement patterns using self-organization techniques.
Utilize technology such as MOTUS® and MuscleSound® to measure stress and fatigue objectively, but teach our patients/players to become intimately familiar with how their arms feel. Let that be the ultimate guide for the process.
Design return to throwing and rehabilitative processes that allow each player to modulate his training experience based on how his arm and body feel on any given day, at any given moment.
Use pain as the boundary marker, but allow each athlete progress as quickly, or as slowly as his body prefers. Be prepared to adjust the plan daily based on each athlete’s subjective report on the status of pain, weakness, tightness, fatigue, etc.
Before publishing this article, I shared it with three trusted friends and colleagues, FBR Director of Player Development, Wes McGuire , Dr. Stephen Osterer, and Alan Jaeger. They added some important thoughts.
Wes McGuire: “We need to reconsider the value and potential corruptive nature of the initial throws in the traditional return to throwing protocol. Having experienced my own UCL recovery in high school, I am certain that the mechanics of a 50% effort throw are completely alien and might contribute to disconnections later in the rehab process. So many people (me included when I was recovering from a UCLR) develop some degree of ‘The Yips’ during UCL recovery. Could it be that these super-low intensity post surgical throws are offering disrupted sensory information that result in bad movement patterns?”
Dr. Stephen Osterer: “Something that would interest me in writing would be going into a bit more depth on how tissue loading directs directionality and composition of tissue, how all connective tissue is interconnected (van der Waals continuum), collagen deposition & type, and provide just a bit more insight into the importance of loading in general.
I’d love to explore the concept of how variability in stress can lead to robustness, and that robustness is critical to resiliency – all from a rehabilitation standpoint. Consider how the majority of ‘return to throw’ is repetitive drill work, repetitive exercises, etc. Narrow bandwidth of solutions = narrow bandwidth of tissue resiliency. This includes restoring joint range of motion (and proprioception) to increase the space of the elemental variables (a la UCM hypothesis) & that variability of load within that space may enhance the size of that space.
Another interesting topic would be inducing fatigue on purpose to drive physiological adaptation, but in controlled frequency and duration.
Interested in the pain science component?
The effect of fear and tight coupling / freezing of degrees of freedom and how variability and novelty in task ‘free’ that?
Kinesiophobia would be an interesting avenue to walk down – not sure that I’ve found or read much about it elsewhere in baseball.”
I’d like to invite and welcome Ron Wolforth, Stephen Osterer, Wes McGuire, Alan Jaeger, Dr. Ed Fehringer, and anyone else who wants to join us, as we investigate the current state of injury risk management, post-surgical rehab, and return to throwing programs in baseball.
When the current universal UCLR protocol was written, it was still ok for guys to smoke cigarettes in the dugout. I think it’s time to take another look. I think it’s time for a change.
I read a quote from Eric Cressey the other day, “The most important preparation for a successful OFF-SEASON is an effective IN SEASON training plan. You’ll never make optimal long-term progress if you struggle once a year to get back to the same initial starting point.”
He is inferring that the best way to make continual gains in strength during the off-season is to not regress during the season from the gains made in the previous off-season.
At the Texas Baseball Ranch, we believe the same is true when it comes to throwing, but in a little different sense… taking time off during the off-season.
If we take a significant amount of time off from throwing completely in the off-season, like it often is suggested, then it is going to be extremely hard to continually make gains from one year to the next.
For example, if a pitcher takes 6 weeks completely off from throwing, it’s going to take him at least 6 more weeks (if not longer) just to get back to where he was before. This is now 12+ weeks (3+ months) until the player is ready to try to improve upon his velocity, command, secondary stuff, etc.
Because of that, he has drastically reduced or even eliminated the amount of time he has to get better before the next season starts.
Rest is not the same as recovery. Rest causes atrophy.
We are not saying a pitcher should pitch year-round, throw bullpens, or do a Velocity Enhancement Program for the entire off-season, but we do believe that a pitcher should continue to throw year-round while cycling in an active recovery period of throwing for a few weeks after the season.
This is a period where he continues to throw, just not in a max-effort or high-volume manner that could cause trauma. Instead, in a manner that is working on connection and restoring proper throwing movements.
An example would be playing catch or throwing in the Durathro™ Sock using drills that limit your degrees of freedom, like Marshall 1 and Walking Torques, for a few weeks.
This way, the ramp up back to where he was beforehand should only take a few weeks.
Now he has added 6 extra weeks or more to make improvements before he has to go into preseason mode and start getting ready for the next season.
So, if you are struggling to make optimal long-term progress in your throwing, then making sure you maximize your off-season training is critical. And the best way to do that is to continue to throw.
If you did stop throwing completely, don’t panic! Just start back up ASAP and allow your ramp up to be at least as long as your time off was. We see a lot of injuries happen because the ramp up time in the off-season is too short to be ready for the season.
Until Next Time… Keep Getting After It!
– – – – – – – – – – –
There are some very specific ways for you to get involved with us at the Texas Baseball Ranch over the next couple months. We’d love to have you join us for one of them…
For Catchers:(Yes, you read that right!) We’re excited to announce our first Elite Catchers Boot Camp for catchers ages 14 & up. The camp is full but you can be added to a wait list should someone cancel.More information on this event and the amazing group of instructors can be found at: https://www.texasbaseballranch.com/catcher
For Coaches:Order the DVDs for our upcoming (December) Ultimate Pitching Coaches Bootcamp. The event itself has sold out but you can still purchase the DVDs at the regular rate until Oct. 31st (Save $100). This event is known as the Gold Standard in the industry and this year’s lineup of speakers is incredible! Check it out at www.coachesbootcamp.com
In the span of 30 days, we at the Texas Baseball Ranch® had conversations with two DI pitching coaches, two DII head coaches, one DIII head coach, and an NAIA pitching coach, all about the exact same phenomenon.
I thought it might be a perfect time to address this issue.
Here is a synopsis of what they all said:
Their team has historically done a very good job avoiding arm issues and surgical interventions.
The last couple of years they have seen a definite upswing in the number of their pitchers coming to campus with a weighted ball throwing program and all the requisite paraphernalia.
These young men with the choreographed throwing programs end up getting hurt, having extended periods on the shelf, or need surgery at a rather alarming rate that far exceeds the rate of their other pitchers.
While they certainly don’t want to micromanage or forbid their pitchers from seeking outside help, they really can’t afford to lose any of their top guys to injury, and they are seriously thinking about limiting or forbidding their pitchers from such programs.
They really wanted to hear our perspective on this phenomenon.
Success Leaves Clues- The Unsuccessful Leave Debris Scattered Across the Landscape
Here is a synopsis of our discussions with these men:
For starters, let’s take this completely out of the baseball realm for a moment. For the ailment of high blood pressure, an MD has dozens and dozens of different medications in his/her tool box that he/she can prescribe. What the doctor tries to do, based upon the patient’s histrionics, assessments, and tests, is prescribe a regimen including dosage, frequency, and duration that best fits their patient. They then schedule a follow up appointment and retest and reassess to see how the prescription worked, and if needed, change the medication (choose a different tool) or modify the dosage and frequency.
Next let’s look at world class strength coaches such as Eric Cressey or Lee Fiocchi. Eric and Lee have dozens and dozens of different options in their strength development tool box that they can prescribe. What they do, based upon the athlete’s histrionics, assessments, and tests, is prescribe a specific strength regimen including intensity, volume, and frequency that best fits the current needs of their athlete. They then closely follow the athlete’s progress and retest and reassess to see how the prescription worked, and if needed, change their program or modify the intensity, volume, and frequency.
Far too often in the medical community, some doctors get stuck or are courted by and/or financially incentivized by pharmaceuticalreps to prescribe a specific medication for a certain ailment. Thereby often giving a ‘stock solution’ to otherwise very unique individuals with similar symptoms. As we all can imagine, this rarely goes well. In the medical profession, there is a very appropriate mantra, “Diagnosis and prescription without assessment can lead to malpractice”.
Likewise, in the strength development community, some trainers prescribe a ‘one size fits all’ ‘stock solution’ to strength development. In essence, they have, in their opinion, one very, very good tool and they prescribe it to every one of their athletes. Over the years I have seen first-hand the negative repercussions and unintended detrimental consequences with homogenized strength programs. This is in large part what separates Eric and Lee. They are meticulous on performing their due diligence for the benefit of their individual clients.
In our opinion, we private instructors, pitching coaches, and head coaches should hold ourselves to the same high standard.
The Problem Is Real and It Is Not Going Away Any Time Soon
Returning now to the question surrounding the college and high school pitcher: “Should we then be surprised when an athlete shows up with a ‘stock’ weighted ball or throwing program and becomes injured or has arm issues?” Answer:I don’t believe so. In fact, I’m personally surprised more aren’t injured. ‘One size fits all’ programing, even those that are sound, will of course often have very uneven results when applied to a universal population.
By the way, I’ve learned this the hard way. In 2006 we had one regimen that we THOUGHT was extremely good. It worked very well for some, it didn’t help others at all, and some it actually took backwards. It was a very humbling lesson for us. Today, in 2019, we have literally dozens of paths an athlete can take, and we use the diagram to below as our foundation. I think it is a great guide for most people who work with groups of athletes.
#1 First we assess to find out where the athlete is currently.
#2 Then we place the athletes in the most appropriate training
category based upon their most pressing personal needs.
#3 We then customize and hyper-personalize as much of their training process as possible.
#4 We prioritize their work to make certain the main thing remains the main thing.
The Good News: There Are Things You Can Do…
A Third Option
Now let’s return to the main issue: Pitchers showing up on campus with a stock weighted ball throwing program.
Option #1-We could simply let them do their thing and HOPE they will be ok. The problem with that approach is that if this guy is supposed to be one of our key contributors this season, can we really take the risk of him being healthy and available to us when the anecdotal evidence suggests that those guys get hurt more often. Is that fair to the rest of the guys who bust their humps every day in search of a championship?
Option #2- We could put our foot down and not allow outside programs whatsoever. The problem with that approach is that it immediately creates a rift between the player and the coaches, and really places a stain on trust, rapport, and team culture. Always keep in mind that the player has consciously invested his time and money into his program, and you refusing to respect or honor his investment is a confirmation that you feel that the athlete is either incompetent, inept, or incapable of making sound training decisions on their own.
Option #3- Or you could do this. Ask the player the following questions:
Ask the player to bring you his weekly process. (If he doesn’t have one, it’s on one sheet of paper, or on a laminated card, you know immediately it’s a stock program and what you are dealing with right away.)
How many days total are they throwing each week in addition to your team practice?
How many throws or how much time is spent on each segment outside of your team practice?
How many ‘push’ days a week outside of your team practice does this process call for?
What do they do for a wake-up, warm-up, and arm preparation outside of your team practice?
What do they do for post throwing and recovery outside of your team practice?
Did they previously have any assessment completed with regards to their physical structure or alignment which shaped their current process?
Did they previously have any assessment completed with regards to their mobility/flexibility which shaped their current process?
Did they previously have any assessment completed with regards to their strength/stability which shaped their current process?
Did they previously have any assessment completed with regards to their mechanical efficiency which shaped their current process?
Have they previously had any pain, arm issues, or difficulty in recovering?
Is their current workload using this system more, less, or the same as they trained in previous seasons?
Can they adequately explain, to your satisfaction, the specific purpose of each of their drills?
Again, I learned the importance of these questions the hard way. For the last 12 years I have roamed the facilities of the Texas and Florida Baseball Ranches, continually asking players those exact questions. While our coaches and players have improved exponentially in their ability to answer those questions over the past 12 years, some players just don’t quite grasp the concepts and/or the full magnitude of their personal training process.
The reason this is important is we obviously can’t assume just because an athlete ‘generally’ knows how to perform a specific drill and carries with him a laminated card and training paraphernalia, he therefore is a master at managing his own process over the course of the season. Subsequently, such a person who is clearly not intimately knowledgeable would, in our opinion, need and benefit from our continued guidance, mentorship, and support.
Remember: You Lead People…
You Manage Systems & Processes
Based on how each athlete answers these questions, the answers give us great insight into how we should proceed.
If indeed this is a ‘stock’ and ‘homogenized’ throwing program in which there is little or no personalization, cycling, or periodization, then we suggest you as his coach should intervene.
One of the biggest weaknesses of choreographed throwing programs is a complete lack of a ramp-up for soft tissue. Soft tissue pliability, resilience, and robustness takes a gradual increase in intensity and volume over time.
Tell him to take his prescribed throwing program and cut it in half for the first 2 weeks.
Tell him that if his arm is completely healthy after the first 2 weeks, for the next 2 weeks (weeks 3-4) to increase the volume to 60% of the suggested throwing program workload.
If his arm is completely healthy after weeks 3-4, tell him for the next 2 weeks (weeks 5-6) to increase the volume to 70% of the suggested throwing program workload.
If his arm is completely healthy after weeks 5-6, for the next 2 weeks (weeks 7-8) increase the volume to 80% of the suggested throwing program workload.
If his arm is completely healthy after weeks 7-8, for the next 2 weeks (weeks 8-9) increase the volume to 90% of the suggested throwing program workload.
If his arm is completely healthy after 9 weeks, he may add ONE velocity push day or one max long toss day and adopt his full program as long as you are not scrimmaging. If you are scrimmaging, pitching in competition becomes his push day. By all means long toss on a regular basis but trying to set personal all-time best distances is not recommended in our opinion during your competition phase.
If at any time he experiences any sort of arm discomfort, he immediately reverts back to the previous week’s volume and intensity, and refrains from any velocity push days or maximum distance long toss.
The steepness of season, training/practice, and game time ramp-ups are absolutely critical towards arm health and durability. Get that wrong at your own peril.
There is a third option for dealing with ‘stock’, ‘one size fits all’ weighted ball throwing programs and it not only helps with the ramp-up and arm health, it also builds rapport and trust between the coaches and the player as they work together to build a healthy, more durable, more electric throwing athlete.
Until next time,
Stay curious and keep fighting the good fight.
– – – – – – – – – –
If you know a young man that doesn’t need more innings this summer, but instead needs to improve either his velocity, command, secondary offerings or arm health & recovery, please encourage him to join us at The Texas Baseball Ranch for our “Extended Stay Summer Development Program”. He will leave with a hyper-personalized plan to help him with HIS specific needs. More information is available at www.TexasBaseballRanch.com/events.
(This is Part 2 of a 2-part series. Part 1 gave an overview on the subject and presented the first two of six training options. If you missed Part 1, CLICK HERE to access to it. In Part 2, the remaining four training options are covered.)
The Variable Distance is designed to work on making adjustments from pitch to pitch or to blend movement patterns into a full distance pitch.
Place 3 targets at varying distances, 4-6 feet difference. (Pictured here, the use of the Command Trainer. It can be found at OatesSpecialties.com/TBR)
This can be done on 3 separate mounds or can be done on 1 mound.
How to Perform:
Start at the first target and deliver a pitch or perform a drill if blending.
Then move to the next target and deliver a pitch or if blending, perform the next drill in the blend.
Finally, move to the last target and do the same.
The purpose of the V-Flex is to make your brain have to create a three-dimensional image of the strike zone.
It provides spatialinformation for the brain, so the strike zone is created inside the brain instead of as an external hard target outside the brain.
This allows for more cognitive feedback.
Place the small V-Flex frame at home plate with the black back drop directly behind it.
Then, when ready, add the next size frame about 15-20 feet in front of the small frame to create a visual tunnel from the mound.
Finally, you can add the third size (largest) frame about 15-20 feet in front on the middle frame.
How to Perform:
Just make pitches from the mound, executing inside and outside the strike zone.
Start with all 3 frames, then you can subtract a frame and so on.
Also, take a frame away for a few pitches then add it back, and go back and forth.
If you want to make it easier to track command in a bullpen or whenever a pitcher is throwing to a catcher, like in a flat ground or short distance work, use a string set up: