Arm Care Program

In my time working with baseball players I have spent a lot of energy learning about arm rehabilitation exercises and implementing them. I think this is one of the things we did best as an organization with the Chicago Cubs and I am proud to say that my arm care routine has improved since leaving. This probably encompasses the most cumulative representation of my career in baseball and I'd like to share it.

First, I'd like to define arm care as I refer to it. This program is the combination of rehabilitation exercises that I think all throwing athletes should complete in some variation. This is not necessarily for injured or rehabilitating athletes, although there is a lot of overlap. This also does not contain mobility exercises which I do believe are vital to arm health but not applicable to this program. This also doesn't contain maintenance treatments such as soft tissue treatments, intermittent compression, electrical stimulation, etc. The purpose of this program is to provide a foundation of strength and motor control to the muscle of the shoulder, forearm, and scapula for optimal health and performance.

I like to divide arm care into sections which allows my athletes to select exercises for each section that work for them and their facilities. This also allows them to add their own exercises where they see fit. I think it is vital to understand the why behind the what and autonomy helps to do that. The sections are: Shoulder, Scapula, Serratus, Stabilization, Forearm, and Plyometric.

Shoulder

I consider shoulder exercises to be those that work the rotator cuff muscles in the most traditional rehabilitation sense. These are exercises typically done with light weights or bands and are typically the internal and external rotation movements at the shoulder. A base of strength in the rotator cuff is vital! It is one of the first things we check on injury evaluations and has been shown over and over to be important for arm health.

Tips

- Monitor posture when doing rotator cuff exercises.

- Use lighter resistance to limit compensation.

Scapula

The muscles of the scapula are in the middle of the back and control scapular positioning during overhead movement. In addition to the serratus, I think scapular strength is the most overlooked aspect of shoulder health. The scapula provides the foundation for the shoulder to move. Scapular issues will cause shoulder and elbow issues and a bad scapula (called scapular dyskinesis) is a very common issue. 

Tips

- Use full range of motion, the scapulas move through a wide range during throwing.

- Your body will try to compensate by using the neck and low back muscles when the scapular muscles are fatigued or weak.

Serratus

The serratus anterior muscle is located on the rib cage and attaches to the underside of the scapula. It is vital for controlling the position of the scapula yet it is not well understood or trained. The serratus is best trained doing push and pull movements of the scapula. Often the "push-up plus" exercises is used to train this. That same movement can be done in a variety of positions. Strengthening the serratus in conjunction with the scapular muscles provides a solid foundation for shoulder movement. 

Tips

- Again, monitor posture when doing serratus exercises. The scapulas should move on the ribcage without the spine flexing or extending to compensate. 

Stabilization

Another primary role of the rotator cuff is to stabilize the shoulder or hold the humeral head in the glenoid fossa. Stabilization exercises are those that utilize dynamic and multidirectional movements requiring the rotator cuff to fire. The best example would be Bodyblade exercises. However, there are plenty of other ways to train stabilization exercises.

Tips

- The throwing motion places the arm in a lot of challenging positions for shoulder stability. Train stabilization exercises in a variety of positions.

Forearms

Forearm exercises are more than wrist curls. There are layers of muscles in the hand and forearm that provide support to the elbow while throwing. The back side (extensors) of the forearm works in conjunction with the front side (flexors) during forearm movements, yet they are not typically trained. 

Tips

- Complete full range of motion.

- Address both sides of the forearm as well as the muscles of the hands and fingers.

Plyometrics

Plyometric exercises for the upper body have become mainstream in baseball. In terms of upper body, these exercises are typically ones where balls of different weights are thrown in different ways. I think this is awesome but I think they are implemented too soon. The throwing motion is a very dynamic movement and plyometrics are more than appropriate to train for dynamic movements. However, if there isn't a good foundation of strength, endurance, and control established in the previous categories, plyometrics tend to amplify compensations and reiterate poor patterns.

Tips  

- Plyometric exercises should have a load and explode set up. Consider the rhythm to the movement to make sure this sequence is being achieved.

As far as sets and repetitions, I typically recommend 2-3 sets with as many reps as it takes to create a good burn or when form starts to break down. This provides more awareness to form and helps to build endurance as athletes continue further as they become more accustomed to the exercises. Typically, I want to hit each category twice a week adjusting where necessary. The ultimate goal here is to help the athletes create a routine that they own and understand. 

I have created an app that has video examples of exercises in each category that I like to have my athletes follow. The link is provided below. Again, I think it is more important to understand the goal of each section versus the specifics of each exercise. When utilizing this program, I like to give my athletes categories for the day to complete based on their schedule and workload. Eventually, I want to transition to where the athlete understands their own routine and I am there to facilitate the program versus directing it. The arm care program has all exercises that athletes can do on their own. Whenever possible, I want to do exercises with them. I follow the same logic with different implementation where I am involved in the exercise resistance. 

Link to Arm Care Program

As overhead throwing athletes, I think it is vital to work on these exercises on a semi-daily basis. The strength, endurance, and motor control gained through these exercises helps athletes to stay healthy, perform better, and get the most out of training sessions. This doesn't encompass every exercise possible and there are plenty of other factors (mobility, recovery, workload management etc.) that go into staying healthy. Understanding the concepts behind the program is crucial to developing an individual routine for throwing athletes. That's all for now...from the training room.