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Clearing the Kinetic Chain in the Throwing Shoulder

E.A.T.A. Annual Meeting, Boston Mass.Sunday, January 9, 2005

Joseph Przytula B.S., M.A., A.T.C., C.S.C.S.Copyright 2004-2005, Joseph Przytula

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Gary Gray

Vern Gambetta3

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MOSTABILITYGary Gray:

The ability to functionally take advantage of just the right motion, in just the right plane, in just the right direction, at just the right time. The opposite is instability, which is any degree of mobility which cannot be controlled.

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Vern GambettaMovement is not an isolated event that occurs in one plane of motion. Rather, it is a complex event that involves synergists, stabilizers, neutralizers, and antagonists all working together to reproduce efficient, triplanar movements.

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Tuesday, May 23, 2000TOP NEW JERSEY PROSPECTS ****

1.Corey Smith, ss, Piscataway (N.J.) HS2.Bobby Hill, ss, Newark (Atlantic League)3.Kevin Cust, c, Immaculata HS, Flemington4.Chris Buglovsky, rhp, College of New Jersey5.David DeJesus, of, Rutgers6.Shaun Stokes, rhp, William Paterson College7.Mark Michael, rhp/3b, Gloucester Catholic HS, Gloucester City8.Chris Young, rhp, Princeton9.Kevin Barry, rhp, Rider10.Bryan Edwards, rhp, Newark (Atlantic League)11.Darren Fenster, ss, Rutgers12.Anthony Giarratano, ss, Christian Brothers Academy, Marlboro13.Casey Cahill, rhp, Immaculata HS, Flemington14.Greg Burke, rhp, Gloucester Catholic HS, Gloucester City15.Jamell Rosario, of, St. Augustine Prep, Vineland

16.Carlos Ferreiro, c, Elizabeth HS

April 5, 2000 Newark Star Ledger

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The scapula & rotator cuff are weak! Let’s isolate them from the rest of the

body & teach them a lesson!

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Question: Should we be training the shoulder in an isolated environment?

• Blasier et al 1992: “…if tension on any one of the components of the cuff was omitted or significantly reduced, there was a substantial reduction in anterior joint stability compared with when tension was applied to all components”

• Siff, 2001: “…rotator cuff injuries are not necessarily aconsequence of rotator cuff muscle weaknesses or imbalances, but often due to defective technique and timing of the production of force over the range ofmovement.”

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Evaluating the shoulder by way of the Kinetic Chain

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Kinetic Chain Testing- What are we looking for?

Is a particular segment hypertonic & tight?Is there enough ROM to get the job done?Is the athlete guarding because of pain?

Is the segment’s ROM adequate, but moving too slow?

Is the athlete overweight? What is their overall fitness level? Is more power training required?

Is the segment spending too long in the loading, or eccentric phase (collapsing)?

Is the segment just not strong enough?Could a foot orthosis be necessary?

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Early Windup Phase: Front hip flexed, horizontally adducted, internally rotated.Common Fault: Thigh cannot pass midline

Test: Pitcher' s prayer position c/ relative R

hip int. rotation, subtalar joint in./eversion

Common CompensationCorrect

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Late Windup Phase: Stand Tall, Butt Tucked In TightCommon Fault: Weight back on heel or forward torso

Test: Knee, ankle excursion c/ overhead

reach

Common CompensationCorrect

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Why is the gastrocnemius important to the

shoulder???

Your foot bone connected to your ankle bone,Your ankle bone connected to your leg bone,Your leg bone connected to your knee bone,Your knee bone connected to your thigh bone,Your thigh bone connected to your hip bone,

Your hip bone connected to your back bone,Your back bone connected to your shoulder bone…

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Stride Phase, Arm Cocking: Shoulders level, “heavy” on support legCommon Faults: High Lead shoulder, backward lean to torso, pushing off of support leg.

Incorrect: Backward lean to torso, high lead shoulder. Bad Front Plane Hip Load

Incorrect: Pushing off the rubberCorrect

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The Serape Effect- (Logan, 1960)

The myofascial sling created by the rhomboids, serratus anterior, external & internal obliques.

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Test: Frontal plane balance c/ R. leg medial reach

Early Stride Phase TestsTest: Frontal plane R. hip excursion

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Late Stride/Late Acceleration Phase

Incorrect:Poor hip extension & rotation, compensates c/ lumbosacral flexion. Stress to ant. capsule

Correct

Incorrect:

Same as above, but stress at medial elbow due to low arm angle

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Test for the Late Stride/Late Acceleration Phase: Rotational Lunge and Reach

Common Compensations:

1. Short Step (lack of hip extension).

2. Long Step, but compensates with hyperlordosis (look for the “bowstring” effect in the rectus abdominus).

3. Flexing at the waist ( sacroiliac, iliosacral dysfunction).

4. Arm(s) & Elbow(s) drop and/or move forward in the sagittal plane (tight pectoralis minor and/or latissimus dorsi, kyphoticthoracic spine).

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The Deep Arm Lines & The Functional Lines

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The Follow Through Phase: Are the Clutch & Brake working correctly?

Who Will Rescue the Posterior Capsule, infraspinatus, Teres Minor, and Rhomboids?

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The Posterior Shoulder’s Best Friends

The Posterior Spiral Line (as shown in a left handed pitcher) The Posterior Functional Line

1. “Inside” Hamstrings

2. Sacrotuberous Ligament/Sacrum

3. Piriformis, Gemelli

4. Gluteus Maximus

5. Erector Spinae, Multifidus, Rotatores, Intertransversarii

6. Latissimus Dorsi/Thoracolumbar Fascia

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Improper Follow Through

Poor “Relative” Internal Rotation of Femur

Foot Still in Pronation

Neutral Torso

Ouch!! Don’t blame me! Look down the kinetic

chain!

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Functional Testing for the Follow Through Phase:

Left Leg Balance with Anterior Lateral Right Arm Reach

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Link Sequencing (Kibler 1998)

“The scapula is pivotal in transferring the large forces and high energy from the major source for force and energy—the legs, back, and trunk—to the actual delivery mechanism of the energy and force—the arm and the hand.” Forces that are generated in the proximal segments have to be transferred efficiently and must be regulated as they go through the funnel of the shoulder.”

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The Thoracic Spine- The Scapula 's Home!

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Thoracic Spine Evaluation- Transverse, Frontal Planes.

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Part II: Techniques for Clearing the Kinetic Chain

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Clearing the Kinetic Chain

• Muscle Energy Technique-– Joint Dysfunction (spine/pelvis), Muscle Spasticity

• Myofascial Release– Muscle, Tendon Dysfunction, Nerve Entrapments

• Functional Joint Mobilization– Joint Dysfunction

• 3D Strength & Flexibility Training– Muscle strength, endurance, power, flexibility– Axonotmesis & other nerve injuries

Clearing the Kinetic Chain in the Throwing Shoulder Joseph Przytula M.A., A.T.C., C.S.C.S.

Sunday, January 9, 2005, 1pm

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