The question of whether or not baseball/softball players should do overhead lifting has been around likely since lifting weights became popular. It’s a hotly debated topic and there are conflicting opinions all throughout the baseball and performance training industries.
I’ll go on record as saying I do believe overhead athletes (baseball/softball players) should perform overhead work. However, it’s imperative to understand that there are a number of prerequisites that should be accomplished prior to advancing into overhead work, and that not all overhead work is created equally.
I discussed this topic with our Physical Therapist/Medical Advisor Cindy Caudy, PT and we put together our thoughts on how overhead lifting should be approached with these athletes.
IF YOU HATE READING HERE’S WHAT YOU NEED TO KNOW:
- Having sufficient mobility is critical before beginning overhead work. Areas of emphasis include: Scapula Upward Rotation, Shoulder External Rotation, Thoracic Extension and its impact on Glenohumeral Joint Rhythm. This is by no means a comprehensive mobility checklist, but provides a solid foundation for observation.
- Evaluate the bicep tendon and its supporting structures. Understanding its role in arm and shoulder kinematics can go a long way in the care and prevention of the shoulder and elbow in throwers.
- Look at other areas such as: neck flexors, scalenes, SCM’s and the masseter. Be able to identify altered tone of these muscles and their impact on shoulder girdle.
- Strengthen the Shoulder, Rotator Cuff and Posterior Shoulder Girdle: Lastly, understand not all overhead work is the same. If the athlete is capable of performing overhead work, strengthen the shoulder and be smart about it. A major league pitcher doesn’t need to be maxing out on a barbell military press.
HERE’S THE BREAKDOWN FOR YOU:
1. Sufficient Mobility – Scapula Upward Rotation, Shoulder External Rotation, Thoracic Extension and its impact on Glenohumeral Joint Rhythm.
“If I see the scapula winging in upward rotation (tipping away from the thoracic cavity) we know immediately there is a red flag. Scapular movement is very important in relation to proper movement of the humeral head & clavicle.” - Cindy
In general, most baseball players, especially pitchers, are already hypermobile; meaning they likely have excessive mobility in their arms and shoulders. However, throughout a long period of spring and summer ball, the shoulder girdle can become locked down, subsequently creating a variety of compensation patterns that impact their natural mobility.
Scapular upward rotation is an area that Cindy and I both agree should be evaluated prior to diving into overhead work. If the scapula is locked down, it can tend to create a myriad of problems throughout the shoulder girdle and arm. I’d say 9/10 out baseball players I see that have arm issues have some type of scapular restriction.
Eric Cressey goes into great detail about scapular upward rotation and I tend to agree with his assessment of the scapula. When at rest, the angle of the scapula should sit at about 5 degrees from the spine. So, you want to see the inferior medial border angle more towards the lateral part of the body compared to the superior medial border. Or in layman’s terms, the bottom inner part of the scapula is more angled out than the top part of the scapula. As movement occurs (namely abduction of the arm) it’s the humerus that is primarily involved in the first 30 degrees of movement, not the scapula. Past 30 degrees the scapula should begin upwardly rotating to assist the movement of the arm.
Ideally, we’d like to see around 55-60 degrees of upward rotation when the arm gets to a full 180 degrees. The glenohumeral joint handles about 120 degrees of that motion. When restriction here occurs, the humeral head will ride up in the socket sparking labrum issues, bicep tendon issues etc.
In no particular order, sufficient external rotation is another area to evaluate. It is not uncommon to see guys arrive in the off season and lack the ability to fully externally rotate their shoulder. Good external rotation would fall in the category of roughly 90+ degrees. A passive range of motion test for shoulder external rotation typically can provide you valuable insight. If external rotation is lacking, then proper mobility drills should be incorporated to address this (FRC principles). If you go directly into a lot of overhead work, you’re likely going to see issues occurring in the low back as the athlete tries to get into an overhead or externally rotated position. Hyperextending the lower back while trying to externally rotate the shoulder is a common movement pattern that needs to be eliminated.
Another test that we utilize is a supine shoulder flexion test. Normal shoulder flexion is 150 degree, and hypermobile would be recognized at 180 degrees (if the scapula is stabilized). Another common area of dysfunction is to see athletes not be able to reach over their head in this test without significant extension (arching) of the lower back.
2. Evaluate the bicep tendon and its supporting structures.
If someone comes to see me complaining of shoulder or elbow pain, one of the first things I’m going to look at is the bicep tendon.
The long head of the bicep assists in supporting the shoulder joint along with the rotator cuff muscles. The long head of the bicep traverses along the intertrabecular groove and attaches on the glenoid of the scapula. The long head of the bicep is held in the intertrabecular groove by the transverse ligament. The transverse ligament is formed from the tendon attaching the subscapularis muscle to the greater and lesser tuberosities of the humeral head. It’s also formed from the tendon from the supraspinatus tendon and additional rotator cuff muscles.
Laxity of the transverse ligament will allow the bicep tendon to slip. Most of the time it will slip medially, however it can slip laterally. This is extremely important because any amount of slippage can change how the muscles of the arm and shoulder contract and relax. Many times, issues can be found in scapula as the body tries to protect the bicep tendon, and in other cases it can travel down towards the elbow. There is typically accompanied weakness of the subscapularis and/or supraspinatus as well.
Usually a manual muscle test of the bicep tendon can be performed to evaluate any slipping that may occur. Ensuring there are no issues with the tendon and its supporting structures can go a long way in shoulder and arm health, and should be evaluated before overhead work is performed to reduce the risk of injury or poor motor pattern development.
3. Evaluation of the muscles of the stomatognathic system (mouth and jaw) as well as the neck flexors/scalenes and sternocleidomastoids (SCM). Be able to identify altered tone of these muscles and their impact on the should girdle.
Dr. David Walther states: “Shoulder dysfunction is often secondary to remote problems. Often the remote problem may not be symptomatic, but it causes neurological disorganization that interferes with shoulder muscle harmony.”
The tone of the muscles of the stomatognathic system is an area I tend to look at with all my throwers and most athletes/clients in general. Many of these muscles may actually have problems in and of themselves, or they can simply be on the negative end of a forward head posture or kyphosis. The stomatognathic system is very active in the dynamics of the body. For example, during walking the sternocleidomastoid and upper trapezius muscles are alternately inhibited and facilitated.
Tone of these muscles can create unnecessary tension around the cervical spine subsequently inhibiting muscles of the shoulder girdle, chest, back and arms from doing their job.
Evaluation of the stomatognathic system can get pretty deep but a good starting point is simply looking for basic biomechanical function; ie: not presenting excessive kyphosis, forward head posture etc. Basic muscle testing while challenging these muscles can be a good indicator of excessive tightness or dysfunction.
4. Strengthen the Shoulder, Rotator Cuff and Posterior Shoulder Girdle: Not all overhead work is the same. If the athlete is capable of performing overhead work, strengthen the shoulder and be smart about it.
So the bottom line in this conversation is that in our opinion NO, overhead work isn’t a cardinal sin with throwing athletes, as long as mobility standards have been met. I think it’s important to understand that not all overhead exercises are created equally. It simply doesn’t make any sense for a high level pitcher to be performing heavy barbell military presses. There are a variety of other ways to train that will reap the same rewards with less risk of injury.
“Many of the classic rotator cuff exercises do a great job in strengthening the shoulder and eliminate the need to perform heavy overhead work. Additionally, I love incorporating scapular strengthening work with my clients. – Cindy Caudy, PT
“Pending mobility prerequisites have been met, we’ll move on to stability and strength. That doesn’t mean we avoid all overhead work (chins, face pulls etc.) but overhead dumbbell and barbell work is limited, if not completely eliminated.” - John
Our mobility work incorporates scapular movements of all kinds. However we still typically adhere to the concepts of FRC when working on mobility and progressing to stability and strength. This is by no means an exhaustive list, but here are a few of our favorite overhead exercises we like to incorporate: Upside Down Kettlebell Carries, Scapular Pullups, Suspension Trainer variations, Face Pulls, Isometric YWA’s, External Rotations w/ Cuban Press & single arm curl to presses. Be smart and use your instincts when working with overhead athletes. They’re not fragile little athletes that’ll break if you challenge them, but care should be given to consider the demands of their sport.
For more information you can email me at email@example.com or visit out website at www.elitelevel.net.
John Nelson, MS CES CPT FRCms Founder/Director Elite Level
Cindy Caudy, PT Next Level Training Elite Level Physical Therapist/Medical Director