A great series on the elbow

Eric Cressey, of Cressey Performance, published a series of posts on his personal blog over the past two weeks that takes a fairly comprehensive look at the elbow. His series progresses through anatomy, pathology, and injury before discussing how to go about protecting pitchers.

The first three parts are factual in nature, heavy on scientific facts but without beating you over the head with mumbo-jumbo.

Part 4 of Cressey's series builds on the information from the first three. He uses a 4-category approach to make general suggestions for keeping a pitcher healthy. The last three categories are spot-on, but I have a few issues with his ideas about injurious pitching mechanics.

To kick it off, Cressey shows a photo of a 5' 7" pitcher and a 6' 7" pitcher standing side-by-side and says, "Anyone who thinks these two are going to throw a baseball with velocity and safety via the same mechanics is out of his mind."

This is a very interesting statement to me, since Cressey seems to be suggesting that "safe" mechanics for a tall pitcher are different from "safe" mechanics for a short pitcher. I may be out of my mind, but that's just plain wrong.

Now, in real life, dealing with two different pitchers, yes, safe mechanics for one pitcher aren't necessarily safe for another pitcher, but height has as much to do with it as a pitcher's choice in footwear. The basics of functional anatomy do not vary with a person's height.

Things that will cause variations in "safe" mechanics are long-term training and congenital joint laxity. Long-term training is a very general term that I am using here to refer to how the body has adapted over time to throwing a baseball. This encompasses principles involving conformational changes in the skeleton (i.e. humeral retroversion), increased bone density, changes in muscle contractile force, and changes in tensile strength of ligaments. Congenital joint laxity can be thought of as natural flexibility, and it varies from person to person.

Cressey might as well have included a photo of any two pitchers standing side-by-side.

Kinetically speaking, shorter people have shorter levers, so an equal amount of force applied at a given joint results in less torque for a shorter person than for a taller person. This, however, is unavoidable.

The safest mechanics for an individual will be the same no matter how tall or short that person is. There is no height at which certain mechanics become safe and others become unsafe.

Cressey then discusses two biomechanical studies that correlate horizontal shoulder adduction and external rotation, respectively, to elbow valgus stress. Neither study supports his proposition, but the points are well taken, if somewhat incomplete.

My chief complaint about studies like these is that they focus mainly on peak torque values instead of the loading rates of those torques (i.e. How much time did the joint tissues have to adapt to the stress?). This is a topic for another day, though.

He follows this up with a discussion about balancing health-risk with performance as it pertains to deception and pitch movement. This is an excellent point, but it's one that I think far too many young pitchers fail to understand. This is also a topic for another day.

Cressey has two more posts in this series, and if you aren't already a reader of his, I highly suggest you become one. Click here to visit Eric Cressey's blog.