Tendonitis in the elbow or shoulder from pitching is an extremely common problem in baseball. If you do not learn what is causing the problem, it could become chronic and end your pitching career. This was my diagnoses at 18 years old, even after rotator cuff surgery.
This is a case that is not remedied with rest alone, or surgery, or definitely not more throwing. It takes some chunk of time to not only heal the joint but rebuild the joint and if you do not have a good game plan, it will have you chasing your tail for relief.
In this article, I will give you the top ten steps to overcome shoulder and or elbow tendonitis when pitching. I will first define some of the symptoms of tendonitis and also provide some insight into what causes this common problem. Last of all I will talk about how important arm health is in the 3X Pitching Velocity Program approach.
Symptoms of Pitching with Tendonitis
Tendonitis is a very broad term to diagnose joint pain. I believe the term is only used when the medical professional is at a loss for a real diagnoses. If I was to go to a doctor because I was concerned with the health of my arm and he or she told me tendonitis, I think I would probably loss my mind on them. This has more to do with my history of doctor visits during my years of rotator cuff surgery and rehab. Let’s just say it was a nightmare!
I will look at the symptoms of tendonitis in the shoulder and elbow of the pitcher. I have dealt with both so I am speaking purely through personal experience. I am not a doctor, so I highly advise that you see a doctor if you are concerned about the health of your arm and if they tell you it is tendonitis, then go for a second and third opinion if needed.
Shoulder Symptoms of Tendonitis
- Pain in the middle of the shoulder down the middle of the arm.
- Pain in the front of the shoulder deep into the rotator cuff.
- Pain in the front of the shoulder going down the bicep.
- Pain in the back of the shoulder underneath the shoulder bone.
- Pain in the back of the shoulder down the to the middle of the back of the arm in the tricep.
- Pain in the neck just above the throwing shoulder.
Elbow Symptoms of Tendonitis
- Pain in the medial or inside the elbow where it connects to the end of the ulnar bone.
- Pain in the bicep where it connects to the elbow joint.
- Pain on the outside of the elbow going over the top of the forearm.
That is all the areas I have experienced pain and I know that is most of the areas where tendonitis can be a problem. If you have any of these symptoms but have never been to a doctor, you have a very good chance that they will tell you it is tendonitis especially if the pain does not go away.
The best way to define pain that should be of concern is on a 0-10 scale. Zero being no pain at all, 5 being just a little more than soreness and 10 being pain that is unbearable and will not go away. If you are experiencing a 5+ then you need to take precaution and follow these steps below to recovery. My pain was at a 12 the day I tore my rotator cuff. I couldn’t sleep at night and was pitching on massive amounts of pain killer which I HIGHLY ADVISE AGAINST.
If your pain is a 7+ then it is highly recommended that you go to a doctor for a full evaluation.
What is Tendonitis?
Tendinitis is inflammation, irritation, and swelling of a tendon, which is the fibrous structure that joins muscle to bone. In many cases, tendinosis (tendon degeneration) is also present. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002209/
What Causes Tendonitis?
Mainly overuse but just because you stop throwing for a while doesn’t mean it goes away. Think of your tendons like tires on a car. If your tires are wearing out, just because you stop driving the car for a few months doesn’t mean when you get back into the car you will have new tires. You will need to change them eventually. Well, you don’t have to change your tendons but you do have to rebuild them. The miracle of life is the fact that the body not only heals but rebuilds itself. Rest alone will heal the body but not always rebuild it. This requires applying resistance in certain areas, at certain intervals, at certain loads, to trigger the bodies rebuilding process to a certain level.
To learn more about this healing and rebuilding process, to overcome tendonitis when pitching, here is the top ten steps to overcoming tendonitis for pitchers.
Top Ten Steps to Overcome Tendonitis When Pitching
If you are someone you know has symptoms of tendonitis from pitching then here is 10 steps to the road to recovery. If you fall short of these ten steps then the chances of recovery is limited.
- Stop Throwing – This first step is unavoidable if your tendons are inflamed and in pain, then you need to stop causing more wear and tear. Yes, more throwing causes more wear and tear. If your body is healthy, it can survive and rebuild each throwing session but if it is not, then you will continue to damage the joint until it is inoperable.
- Rest – This doesn’t mean do something else like sit around and play video games until 2 in the morning. It means go to bed early and sleep as long as needed. Take a nap in the day if needed. Brush your teeth with your other arm and do as much with your other arm as possible. When I tore my rotator cuff I learned to brush my teeth with my left hand and I still use my left hand today.
- Ice – Don’t listen to the hype around ice. There is no conclusive evidence proving the effects of icing either way. That means there is nothing proving it definitely works or doesn’t work but their is some cases saying it may work and some saying it may not. All I know from experience is if I didn’t ice my arm after pitching in my career, I noticed a significantly longer recovery time but I have heard from others who did not feel any effect. If you want to learn the science behind it and how to ice effectively checkout my article on why pitchers should ice.
- Compression – This has about the same amount of evidence or a little more than icing when it comes to healing muscles and joints. Some people experience a significant healing effect from compression while other experience nothing. I recommend it when resting and for restoring mobility like how Dr. Kelly Starrett uses his voodoo bands.
- Elevation – The theory behind elevation is that it helps bring the blood from the joint back to the heart by elevating the arm above the heart which in return pumps new blood back to the joint. New blood brings nutrients to help stimulate the healing processes.
- Nutrition – This step is critical because your body needs tons and tons of different materials to rebuild itself like a contractor needs tons and tons of different materials to rebuild a house. Eating cereal all day or fast food would be liking giving a contractor some plywood and a hammer to rebuild your entire house. You need to first learn what nutrition is important to stimulate growth in the body for an athlete and then you need to do your best to feed your body this nutrition on a daily basis. This is not only challenging but expensive. You can download my nutritional guide called the 3X Performance Enhancement Guide here to get started.
- Strength Training – You are definitely not at the end of the road to recovery at this point. You may have healed the joint from causing more damage to it but you definitely have not rebuilt it back to a level of playing competitively again. The good news is you are finally in a place to rebuild the joint because it is healing itself again. This means you can apply the loads to the arm to stimulate growth. If the arm is not in a healthy place at this point strength training could cause more pain. Any pain during this training should be avoided if it is more than just soreness. It also isn’t enough to just load the joint, you need to develop strength through the entire body so the other joints can help share the load as you develop better mechanics. To learn how to implement an effective strength and conditioning program checkout the 3X Pitching Velocity Program below.
- Power Training – This sounds like something extra to this rebuilding process when it is actually something so important to joint integrity that those who do not have a lot of it really suffer. An orthopedic surgery, who put his son through the 3X Velocity Camp and was a big believer in the Olympic-style training in the program, told me that Olympic lifters compared to Bodybuilders rarely ever have joint injury. He then told me why. He said when a joint is injured, this is when the bones move into a direction that the joint was not built to move into. This puts the tendons and ligaments in a vulnerable position which as the joint continues to flex or extend, causes the damage or tear. What prevents the joint from being injured when this happens is when the muscle surrounding the joint can not only fire strong enough to stop the movement but fast enough before it damages the tendons and ligaments. For example, Bodybuilders may have the strength to stop the movement but not always the speed which is developed better in Olympic Lifters. Studies have also shown that if pitchers do not have the power in the flexor mass then the UCL must handle more of the load which if high enough will damage or tear the joint (1).
- Mechanics Training – You can start mechanics training after the arm has started to heal just keep the reps low. This means if you do not feel the inflammation anymore then you can start some light training with your throwing mechanics. Once you have developed some joint integrity through the strength and power training then you can increase your reps and intensity. You will need a set of throwing drills along with professional video analysis to help you develop the better throwing/pitching mechanics that more than likely was making the overuse a lot worse. The 3X Pitching Velocity Program has an advanced system of throwing mechanics and drill training that is currently being used at the Major League Level.
- Routine – Your body needs a routine when it comes to not only recovery but pitching. Your body needs to be able to predict the energy and workload required of it to survive. More than likely getting out of routine is what caused the arm injury in the first place. This is why the benefit of pitch counts is not in mainly limiting pitches as a whole but more in predicting the amount of pitches you will throw each game. Getting back into a routine again, will help the body more quickly get back to playing.
3X Pitching Arm Care
A big mistake most pitching specific “Arm Care Programs” make is that they over rep the small muscle groups and completely neglect the big muscle groups. The small muscle groups are built to drive the fine motor skills of holding the ball and positioning the grip for the specific pitch. The big muscle groups are built to generate the force behind the body being converted into the ball. When the small muscle groups have to work for the big muscle groups, due to the lack of power production in the big muscle groups, then the small muscle groups will over fatigue quickly. So, over repping the small muscle groups and neglecting the big muscle groups in conventional “Arm Care Programs,” this will just compound the overuse and arm abuse issue.
In the 3X Pitching Velocity Program it develops the big muscle groups to a level that they will not only relieve the work from the small muscle groups but they will also start to drive the pitching mechanics in a more efficient manner. This strength/power training along with the advanced pitching mechanics training makes the 3X Pitching Velocity Program the best program you will find to prevent and almost eliminate tendonitis. If you want to learn more about this revolutionary approach to arm care and pitching velocity then continue to read the site and watch the videos on the YouTube channel.
Learn more about the 3X Extreme Pitching Velocity Program or get started TODAY adding 5-10+mph!
- Langer P, Fadale P, Hulstyn M. – Evolution of the treatment options of ulnar collateral ligament injuries of the elbow. – Br J Sports Med. 2006;40(6):499-506.