HSS Thrower's Manual Preview

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Thrower’s Manual Hospital for Special Surgery Rehabilitation Department Sports Rehabilitation and Performance Center


Developed by: Michael Levinson, PT, CSCS Clinical Supervisor Sports Rehabilitation and Performance Center Exercise photos by: Derrick Johnson Design: Violet Yuen

For more information contact: Hospital for Special Surgery Sports Rehabilitation and Performance Center 212.606.1005 Or visit our website at: http://www.hss.edu/sports-rehabilitation-and-performance-center.asp

Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


TABLE OF CONTENTS

Introduction

1

Upper Body Exercises

6

Scapula Strengthening

7

Shoulder Strengthening

10

Elbow and Forearm Strengthening

15

Flexibility Exercises

18

Lower Body and Core Exercises

21

Strengthening

22

Flexibility

29

Tips for Throwers

32

Interval Throwing Program

34

Resources

41


INTRODUCTION The Thrower’s Performance Program at the Hospital for Special Surgery (HSS) Sports Rehabilitation and Performance Center was developed to help the throwing athlete reach the next level. Whether recovering from an injury or looking to achieve full performance potential, athletes of all ages and skill levels have benefited from our expert and in depth analysis, training, and instruction. Now the Thrower’s Manual takes key elements of this program and brings them directly to you. Everyone throws differently, but from little league to the major leagues the basic building blocks of good technique and effective injury prevention are the same. This booklet offers the tools you need to build your skill set on a solid foundation. The exercises are broken down in detail, with easy to follow photographs and instructions. Many of them can be performed anywhere, but some do require basic gym equipment. Working with the clinicians and performance specialists at HSS as you use this manual is ideal, because it will allow you to maximize the benefits and ensure proper technique. Performing exercises correctly is important because:

 The risk of injury is reduced, as well trained athletes are less likely to be injured  The athlete who is well conditioned is likely to recover from injury or surgery more rapidly. Whether or not you have been seen at the HSS Performance Center, we recommend reading through the manual before you get started to familiarize yourself with the positions and technique. You can follow the complete series exactly as it appears here, or choose what you need and integrate it into your own fitness regimen. You will also find helpful tips and advice throughout the text, developed from years of experience training athletes both on and off the field. We are proud to be a part of your team as you reach for greater heights in your sport. More information on the Thrower’s Performance Program can be found on our website at: www.hss.edu/throwers-performanceprogram.asp.

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Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


INTRODUCTION The exercises found in this manual incorporate the following elements: Training and conditioning The throwing athlete that participates in a year round strength and conditioning program will have a significant advantage when beginning pre-season training. Training and conditioning may enhance performance. Throwing sports require upper and lower body strength, flexibility, coordination, power, selective endurance, balance, and core stability. Improved throwing performance or velocity, as well as the elimination of pain, are often a function of all of these factors. When performing a strength and conditioning program, it is important to understand that throwing is a transfer of kinetic energy from the legs and hips through the trunk to the arm. Any loss of energy in this kinetic chain can result in a greater chance of injury and/or diminished performance.

It is also important to understand that throwing is an explosive, high speed activity. The sports specific exercises presented in this manual are specifically designed to meet these needs. Warming up and stretching Prior to all exercises, a proper warm-up is necessary. An active warm-up consisting of a light jog, calisthenics or stationary cycling, functions to increase body core temperature, increase heart rate and increase blood flow to the muscles, tendons and ligaments. This in turn increases the elastic properties of the muscles and tendons, and prepares the body for high speed activities, such as starting and stopping, and change of direction. Flexibility of the entire body is critical to the throwing athlete. Throwing athletes frequently develop selective flexibility deficits which are often correlated with subsequent injuries. Stretching increases the elastic length of muscle tissue and increases range of motion, enabling the athlete to generate a greater amount of power. Stretching should be performed prior to and after strengthening and conditioning, practice and competition. As mentioned previously, stretching is most effective when the core temperature is elevated. Stretching should be done slowly and smoothly—there should be no

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Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


INTRODUCTION “bouncing.” Stretching should only be performed to the point of minimal discomfort, never to a painful range of motion. Stretches should be held for approximately 15 to 30 seconds. Stretching should also be performed following a workout as part of a “cool down”. This will reduce the chance of muscle soreness and improve the rate of recovery. Strengthening A strengthening program for the throwing athlete must address all portions of the kinetic chain—that includes the upper body, core, and lower body. The throwing athlete must establish functional strength where strengthening is specific to the throwing activity and follows the movement patterns of throwing. The throwing athlete is not “body building”. Bulky muscles may actually reduce flexibility and range of motion, which may in turn limit performance and increase the chance of injury. When strengthening, muscle balance must be achieved.

Throwers often develop muscular imbalances which may predispose them to injury or impact performance. The clinicians and performance specialists at HSS can identify these imbalances and assist in designing the correct program for the throwing athlete. Strength training for the thrower should include efficiency and endurance as fatigue is often a factor in injury and loss of performance. When performing strengthening exercises, larger muscle groups and multiple muscle exercises should be performed at the beginning of the workout to maximize efficiency. Smaller muscle groups should then be exercised toward the end of the workout. While muscle soreness is not uncommon when beginning a strengthening program, exercises should not consistently increase joint pain. When following a strength and conditioning program, the athlete should follow a seasonal progression of training.

Remember Spring training is not a time to establish a strength base; it is a time for fine tuning. It is not a time to lift heavy weights.

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Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


INTRODUCTION This training progression can be broken down into 5 phases: Phase 1: This is a period of active rest when throwing activities are avoided. Low-to-moderate intensity activities are performed to help the athlete maintain conditioning while recovering from the previous season. Phase 2: During this phase, a muscular strength base is established. The volume of strengthening increases and the intensity of training becomes moderate. Phase 3: During this phase, maximum strength is attained. Intensity of training becomes higher; speed agility and sport specific drills are introduced. Phase 4: This is a transition phase that leads into pre-season. Training becomes more explosive and more sport-specific activities are introduced. Quality of exercise and skills are emphasized. Phase 5: In-Season Maintenance. During this phase, the volume of work is reduced. Exercises are continued to maintain conditioning and fine tune certain components. A sharp decline in physical strength and soft tissue breakdown must be avoided.

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Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


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Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


UPPER BODY EXERCISES A significant function of the upper body musculature (shoulder, scapula, elbow, forearm and wrist) is positioning the arm in the kinetic chain. Although there may be some role in power production, a prime function is protection and injury prevention. Fatigue often is a contributing factor to injuries. Therefore, the upper body musculature must be trained for speed, endurance and efficiency. During throwing much activity takes place as the muscles lengthen. This lengthening often functions to decelerate or slow the arm down. Strengthening the muscles as they lengthen should be incorporated into the program. However, heavy weights, especially for younger throwers, are not indicated. Tubing or elastic resistance can be used for many of these exercises. Also, exercises that replicate specific movement patterns of the throwing motion should be included. A key anatomic component of the upper body is the scapula (shoulder blade). The large muscles attached to the scapula play a significant role in the throwing motion. The scapula is pivotal in transferring the large forces from the legs and trunk to the throwing arm. The scapula also provides a stable platform for the shoulder. Scapula muscles often become weak and stretched in throwers. These types of muscular imbalance of the scapula can result in a loss of energy leading to a greater chance of injury and loss of performance.

Another key anatomic component of the shoulder is the rotator cuff. The rotator cuff is a group of four muscles which drape over the shoulder joint. They function to help stabilize and rotate the shoulder joint during the throwing motion. The rotator cuff muscles are stressed a great deal when throwing; they are not large muscles and are easily inflamed. Rotator cuff exercises should be performed cautiously and should not cause pain. As mentioned previously, muscular balance is a goal of the strengthening program. Throwers often develop muscular imbalances of the shoulder; i.e. muscles in the front become much stronger. Strengthening activities for the muscles in the back must therefore be emphasized. This type of imbalance can be assessed and addressed by the clinicians and performance specialists at HSS. Flexibility deficits of the shoulder are common to throwers. A typical deficit is a loss of flexibility in the back of the shoulder, predisposing the thrower to injury. A general loss of shoulder flexibility can reduce the amount of energy stored and result in a loss of power.

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Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


UPPER BODY EXERCISES SCAPULA STRENGTHENING

Rowing with tubing: Pull back and pinch your shoulder blades together.

Rowing machine: Pull back and pinch your shoulder blades together.

Shrugs with tubing: Step on tubing with both feet. Keep elbows straight and shrug shoulders straight up. 7

Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


UPPER BODY EXERCISES SCAPULA STRENGTHENING

Shrugs with weights: Hold weights at side. Keep elbows straight and shrug shoulders straight up.

Serratus punch: Lie on back. Hold weight and keep elbow straight. Punch up toward the ceiling.

Wall push up with a plus: Place hands on wall. Slowly bend elbows bringing face towards the wall. Push away from wall and arch upper back at the end of the range.

Copyright © 2011 by Hospital for Special Surgery. All rights reserved.


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