The Injury Analyst

So the Phillies are turning fickle. I might not be totally unbiased here as a stark Dodger fan, but where is the loyalty? The man that pitched a perfect game and CY Young winner for you just two years ago is now on the trading block? I guess we could see it coming. 

In 2004, Halladay was put on the DL twice and was later diagnosed with a "tired throwing arm". His hard throwing tactics and high pitch counts were inevitably drawing him to the situation he is in today at the age of 35. According to Fangraphs.com, Halladay's velocity has been down with increasingly more shoulder soreness. What's the deal?

"Even a little soreness after throwing, pain, or being tired in the arm or having a dead arm is an indication that the player is out of his natural throwing groove. Inability to throw strikes and loss of velocity is another indication that a player is out of his natural throwing groove."  - Coach John C. Price.

A "natural throwing groove" or correct mechanics of a pitcher can be off ever so slightly and have a huge effect. Let's start with the chain reaction starting with tightness of the the shoulder joint. When the back of the shoulder joint is tight or stiff, it is harder to internally rotate your arm. In the arm acceleration and deceleration phases of picthing, or when your throwing the ball after the wind up, a pitcher needs to rotate to neutral from 165 to 180 degrees of external rotation (most shoulders only get around 90 degrees of external rotation). Let's just say Roy lost a few degrees of internal rotation when he throws. He still needs to get the ball placed where he wants it to go. He tries to maneuver so he can apparently get to neutral. But his arm is fooling him. He isn't getting to neutral. He is getting some motion from another joint to compensate for lack of shoulder motion. Whereis he getting the extra motion? 

When looking at compensations, one need look no further than the next joint usually. In Halladay's case, let's look at the scapulothoracic joint or the shoulder blade. When one is deficient in internal rotation, protracion and anterior tipping of the shoulder blade occur. In simpler terms, your shoulder blade moves outward and leans forward. Your "natural throwing groove" is off but what also happens is a tractioning of your nerves coming from the neck. When your shoulder blade slides out to the side, the distance from the neck to the arm increases. In people with good nerve mobility, this might not be a problem. Any tightness in your neck or in the thoracic outlet area, and now you have a constant tracion torque on the nerves, especially on the suprascapular nerve. Over time, your nerves aren't having it and start to get inflamed and you start to lose more motion and strength. The vicious cycle towards retirement begins.

Don't Get It, Try This: 

Put your elbow on a surface level to your shoulder with your fist towards the ceiling. Start to move your fist forward toward the table surface. At some point you will feel your shoulder blade move. The sooner it moves, the tighter your shoulder is.

J.M.