Internal Impingement

Stretching: The Truth

I'm planning on a series of articles to update our readers on some of the current concepts in pitcher related injuries and diagnoses that most fans have not heard much about.

We've all had our fill of reading about pitchers with rotator cuff and glenoid labrum tears. There are some interesting trends in sportsmedicine that have lead to changes in exercise programs throughout the majors and minors in an attempt to protect pitchers from a cascade of preventable injuries most fans don't know about.

Diagnoses such as:

GIRD: (Glenohumeral Internal Rotation Deficit...not to be confused with the stomach malady also known as GERD which Cubs fans get from watching too many losses). Pitching (both cocking phase and deceleration phase) leading to a tight or thickened posterior shoulder capsular ligament plus a loose anterior capsule and loss of internal rotation of the shoulder. Extra external rotation of the shoulder develops at the expense of internal rotation.

Scapular Dyskinesia: Shoulder blade weakness with altered kinematics.

Internal Impingement: Thought to be related to posterior shoulder contracture from GIRD with subsequent instability of the shoulder as the humeral head (ball of the shoulder joint) which shifts back/posteriorly and upward/superiorly). This is a different entity from subacromial or rotator cuff impingement which is more common and typically occurs from friction outside the shoulder joint.

...and finally connecting the dots, sorting out how the the injured or weakened shoulder (scapula) leads to severe strain on the elbow and tearing of the Ulnar Collateral Ligament (aka the Tommy John injury).

My attention to this topic started last summer, when  I heard a remarkable interview on XM radio with renown Orthopedic Surgeon, Dr. Craig D. Morgan with hosts Jim Memolo and Rob Dibble. The focus of the interview was Stephen Strasburg's shoulder tightness and the subsequent ulnar collateral ligament elbow injury that lead to "Tommy John" reconstruction of that ligament last summer. Dr. Morgan said that he had predicted elbow problems in Strasburg by watching the way he held his shoulder.

More on how the arm bone is connected to the...after the jump.

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  • Joe: "We lost. They beat us. Now where's my '09 Guigal Bordeaux glass...?

    The E-Man 30 min 21 sec ago view
  • I forgot how rail thin skinny Carl Edwards Jr. Is - he threw some nasty stuff - hope that continues

    Eric S 36 min 4 sec ago view
  • HAHAHA! I love it here! Brilliant...

    The E-Man 38 min 53 sec ago view
  • "The pressure of going for the regular-season wins record is now gone."

    Brilliant. Maddon is a genius!

    Brick 43 min 30 sec ago view
  • "Drink copiously but responsibly."

    Done and done. Thanks for that.

    Brick 44 min 22 sec ago view
  • Oil Can Boyd now pitching for the Cubs

    Eric S 53 min 11 sec ago view
  • - The pressure of going for the regular-season wins record is now gone.
    - Joe will come up with more wacky dress-up ideas for the team to wear after they lose their next get-away game.
    - There is more clarity on Spencer Patton.
    - We play the Reds next. They aren't very good.
    - We'll have at least a 9 game lead after today.

    Other than that, not much -- nasty stretch. Two ugly losses in the last 4 games.
    Ugh -- give Lackey a 4-1 lead, you hope for better.

    billybucks 56 min 57 sec ago view
  • It's a long season. There will be stretches like this. It's Saturday night. Drink copiously but responsibly.

    Jackstraw 1 hour 27 sec ago view
  • That valuable RBIGIDP.

    Brick 1 hour 34 sec ago view
  • Someone talk me down here.

    Brick 1 hour 14 min ago view
  • I remember AZ PHIL talking about Bour's power during the Hendry era.

    The E-Man 1 hour 41 min ago view
  • Time to scrap the scouting report on Justin Bour and get a new one. Sheesh.

    billybucks 1 hour 44 min ago view
  • Contreras seems pretty adamant he'll play anywhere Madden wants him to so as long as he stays hot and with all the injuries it'll be pretty nice to have yet another bat Madden can move around.

    johann 4 hours 43 min ago view
  • Rizzo in, Zobrist out, Willson in LF, Montero back and Almora batting 9th ... let's score some runs

    Eric S 6 hours 10 min ago view
  • Time for Mr. Oh to get some save chances.

    Newport 6 hours 25 min ago view
  • Rosenthal does it again! Comes in with a 3-1 lead in the 9th -- double, BB, HR...ballgame.

    Very nice win last nice -- could have caved in after the bottom of the first. It would be OK if guys stopped getting hurt, and if SF would lose a few.

    billybucks 9 hours 24 min ago view