The Injury Analyst

"He's got some inflammation that we're going to calm down"

Ok. Now What?

"We thought in between starts was enough time to do it."

To do what?

"maybe they'll do an MRI"

To find...

"If he's going to get a (cortisone) shot"

Of course he will.

These are just some of the comments made by Boston Red Sox manager Bobby Valentine after putting Josh Beckett on the 15 day DL this weekend. The one calming factor in all this is that historically Beckett goes to Dr. James Andrews when something serious is afoot. Dr. Andrews, founder of the Andrews Sports Medicine and Orthopaedic centers and the American Sports Medicine Institute (ASMI) is world renowned not just for his surgerical prowess but for his collaboration with the top biomechanists and movement scientists in the country, including physical therapists Kevin Wilk and Michael Reinold.

 The reason he may want to supplement the usual treatment of rest and cortisone shots is his recent bouts with other lingering injuries. The key to the shoulder is in the thumb and latissimus dorsi ("lats" as they are usually referred). If we stick to the main principles with overuse injuries we can draw the lines from one injury to another.

  Principle #1: Pain inhibits muscle recruitment.

Principle #2: When one muscle in a muscle group isn't working properly, another muscle will have to carry the extra load, thereby creating a non-synergistic joint which leads to a dysfunctional joint.

 Principle #3: When one joint isn't functioning properly, the joint above or below will take on the extra task to complete the action the body is trying to take.

Now let's connect the dots. Beckett hurt his thumb. This altered his mechanics enough with his hand and wrist that he needed support from another neighboring joint: the elbow and shoulder. The extra forces needed to maintain velocity and control had to come from somewhere and that's where the lats came to play. The lats are used in the arm acceleration phase until follow through. They become overworked and now the shoulder joint is not working in synergy with the rest of the rotators of the shoulder. Now assuming those chain of events are the cause of his problems, how would a shot help? In the short term, it would decrease inflammation along with rest and ice. But where's the end game and hopefully retirement isn't where he's headed. Luckily he has Dr. Andrews waiting for him in Alabama.

Don't Get It, Try This:

Grab a ball and throw it. Now grab that same ball and try throwing the ball without bending the wrist. Notice more motion at the shoulder (hand coming forward is shoulder internal rotation) or at the trunk (rotating or twisting). Now try limiting the wrist or shoulder from coming forward. Now it all becomes trunk. Now you got the basic principle: when one joint is limited, the surrounding joints kick it up a notch to help.

 J.M.