Tim was a relief pitcher at a local high school, but wanted to work his way up to become a starter during his junior/senior years. He had several good pitches with control, but only slightly above average speed. Tim came to me because of a re-occurring, nagging shoulder problem. He explained that he never really had an injury or trauma, but there was just something not right about his shoulder. His parents had taken him to a couple of sports medical doctors, who did imaging studies, but nothing appeared to be wrong and therefore he was diagnosed with “over-use” syndrome and told to rest the shoulder and prescribed some PT sessions; neither of which did much good.
When I saw Tim, I was struck by the maturity of his young man and his compete and total commitment to do whatever was necessary to advance his potential career in baseball; he really wanted to go to college on a baseball scholarship and maybe even pursue a professional career.
After I competed a total examination, to include his lower extremities, I felt comfortable in my diagnosis. Tim did have an “over-use” syndrome, maybe because he was a year-round baseball player, but, in addition to using his arm too much, Tim had two other larger issues. First, he had a condition called scapular-winging. This is caused by weak muscles in the upper arm that causes the scapula to lift away from the rib cage, causing instability of the entire shoulder complex. But second, I found that Tim had very weak glut (butt) muscles. Anyone with any knowledge of sports knows that the majority of power, especially for pitching, comes from your lower extremities. Because Tim’s gluts were fairly weak, thereby not providing the power he really needed to pitch, Tim was over-compensating for this lack of power, by over throwing the ball with his shoulder/arm, contributing to his over-use syndrome.
Fortunately for Tim and his parents, I had treated this condition on many other patients and knew exactly what to do. First, he was prescribed some very specific exercises that re-train his scapular muscles in a way to eliminate his scapular winging. At the same time, I had a conversation with his Tim, his parents, coach and trainer and explained to all of them how to strengthen his weak gluts in such a way as to reactive them very quickly.
Because Tim was a competitive person with a desire to succeed, within about 6 weeks, Tim’s shoulder muscles had stabilized and his glut muscles had responded, beyond even my expectations. I have not seem Tim his my initial evaluation but his father called to tell me that Tim was going to be a started in his junior year, his shoulder felt completely normal and he had actually picked up 4-5 mph on his fastball. Enough it seems, that maybe his college dream might come true.