Bill Hartman 21:24–24:20
I've got some really, really good friends in baseball and I will trust in them to help me understand it better and we will move forward in that regard. I apologize for the bias and the strong opinion, but I believe it needs to be said so we can progress. Regarding Nick's question: instead of the typical I's, T's, and Y's, are there other ways to challenge the rotator cuff for a baseball player? Of course there are. The rotator cuff does not behave in isolation; it is involved in any movement that utilizes the upper extremity, whether supportive or active. But you do raise an interesting point. I plan to create a video on the I's, T's, and Y's because I think they are prescribed one, too often, and two, incorrectly. It's applied as a blanket exercise when, in reality, if you prescribe it to the wrong person at the wrong time or in the wrong context, you're creating a problem. Let's return to the original question: should arm care be aimed at increasing the dorsal rostral space? Maybe, if that's the specific need of the individual. There are two extreme archetypes of pitchers, and some will benefit from increasing dorsal rostral space more than others who may already have it. So, under certain circumstances, the I's, T's, and Y's are a great exercise for a specific type of pitcher with a particular structure. For others, it is the worst possible thing you could do because it actually steals the expansion element they need to position the ball. When we talk about the cocking phase of throwing a baseball, if I lack dorsal rostral space, I have to create a compensatory strategy to cock the ball, which is generally not the best choice. Again, if I am already compressed in that area and I prescribe the wrong exercise, such as an I-T-Y for that individual, I have just magnified the compensatory strategy they will use to throw. Now, perhaps it appears that you have enhanced performance in some cases. For instance, some people actually increase their velocity when using a compensatory strategy. If that is your goal—to amplify that capability—then you are successful. But we must understand the secondary consequences. If you risk other body parts, are you promoting the possibility that the pitcher will now have to pitch through lower back pain, elbow pain, or shoulder problems? There are any number of such factors, and that is what makes this so complex. While we want to be right and it is easy to preach opinions about arm care and physical structure, when we look at the individual, we have to make decisions about what we are trying to achieve and what outcome we desire, with the understanding of the secondary consequences. That is something I cannot predict, nor can you; it is something we have to assess based on the individual's experience, bringing us back to the n-of-one, within-subjects design model. This is how we must proceed, but we must do so with great care and concern, avoiding large leaps of probability. We must work within a framework that allows us to provide ultimate protection while we pursue performance. Again, this is very difficult; there is not one single right answer, but many possible right answers. However, I love that you asked the question because it raises significant concerns about how we often prescribe exercises blindly and simply cannot do that. We have to start viewing people as individuals.
baseball performancerotator cuff trainingdorsal rostral spacecompensatory strategiesindividualized assessment