I’ve been a pitcher as far back as I can remember. As an only child, I would while away my summer days by throwing a tennis ball against a brick wall, pretending that I was Dave Stieb while trying to hit imaginary targets. The ability to throw strikes served me well as a youngster, as other kids my age didn’t have the opportunity – or desire – to develop the muscle memory required to consistently command their pitches. As I grew older, I was relied on more and more to carry the pitching load of lacklustre teams trying to punch above their weight.
A history of abuse
In my mid-to-late teens, I pitched for a team in the North Dufferin League while simultaneously playing for a London, Ontario-based travel team when I would visit my Dad during summer vacation. I couldn’t get enough baseball and loved every moment that I was on the mound. To me, the more I could pitch, the better. And my coaches indulged my desire to pitch as much as I could. The concepts of pitch-count management and innings limits were foreign to my coaches.
As the end of one particular season approached, my team entered a tournament carrying a track record of futility. My coach wanted that trend to change, and broached the idea to me of starting back-to-back games. I thought this was a terrific idea. Although tournament games were limited to seven innings, I pitched all 14 innings and we won both games. That would never happen today, with strict pitch counts and mandatory periods of rest for youth ball players. My parents weren’t invested in my baseball career enough to monitor what was happening, and I placed my faith in a coach who I trusted to be a responsible adult. I didn’t think it was unusual at the time, but knowing what I know now about developing young pitchers, my coaches didn’t do my arm any favours.
During university I took a hiatus from playing competitive baseball. However, my baseball-crazed roommate and I would regularly go to the local ballpark we worked at to throw simulated games and see how far we could throw frozen ropes from the outfield. Then we could try to throw the baseball out of the ballpark to straight-away centrefield from home plate. Repeatedly. We were not smart. This is when I began to feel more than “normal” soreness in my shoulder in the days following throwing sessions.
Serious shoulder discomfort
Following university I moved home and resumed playing for a senior, elite-level team in the Greater Toronto Baseball League. Indoor workouts were great and I was throwing free and easy. Our first outdoor practice took place in early April on a cold, windy day. It was an intra-squad game and I toed the rubber. It took a considerable amount of time to warm-up and I didn’t feel entirely warm as I began the game. On my 4th or 5th pitch, I remember feeling a “tugging” feeling inside my shoulder. The next few pitches were 10-15mph less than what I was used to throwing. I remember my pitching coach yelling “throw max effort!”
“I can’t,” I said. “It’s too cold.”
That night my shoulder throbbed and pulsated like it had its own heartbeat. I continued to practice, but couldn’t throw nearly as hard as I was accustomed to. The more bullpens I would throw, the more I felt like I was losing my range of motion; my shoulder was stiff and slow. When Hall-of-Fame closer Trevor Hoffman famously injured his shoulder, he described it as “like air going out of a tire.” I could relate. But did I go to a doctor? Of course not.
Image courtesy of Buzzle
Are you hurt or are you injured?
I consulted a friend who was a recent kinesiology grad and asked her opinion as to what might be happening in my shoulder. She said it was likely just a shoulder strain, maybe some bursitis. She recommended a two-week period of rest and I would be as good as new. Two weeks became three weeks, three weeks became four. I resumed throwing bullpens and made my season debut in relief. With adrenaline pumping, I did my best to throw “max effort.” Only I couldn’t locate my fastball in the strike zone. With every pitch, I felt searing pain that cut deep through the core of my shoulder. After walking two and allowing a single – while generating only a single out – I was pulled from the game.
Sitting on the bench as the adrenaline subsided, I could feel there was something deeply wrong inside my shoulder – structurally wrong. Did I go to a doctor? Of course not. Why was I so foolish? Two reasons:
- “Playing through pain” and “grinding it out” is the prevailing ethos among the baseball community. “Are you hurt or are you injured?” In my mind I was hurt and I was going to find a way to overcome my shoulder issue, whatever it was.
- I was cemented in the first stage of the Kübler-Ross model of grief: denial. From the Mayo Clinic: “Refusing to acknowledge that something is wrong is a way of coping with emotional conflict, stress, painful thoughts, threatening information and anxiety. You can be in denial about anything that makes you feel vulnerable or threatens your sense of control, such as an illness, addiction, financial problems or relationship conflicts.”
Typically, when there is something wrong with a pitcher’s shoulder, the outcome is devastating. Pitchers facing elbow surgery generally recover and regain their form – upwards of 82% of the time. For pitchers facing shoulder injuries, the outcome is far less certain due to the complexity of the joint. Since the shoulder is so complex, there are so many things that can go wrong. A torn rotator cuff or labrum can end a career, professionally and recreationally. There’s ligament damage. Capsular tears. Thoracic outlet syndrome. Only 35-50% of pitchers return to form following surgery. And these pitchers are generally cared for by the top sports medicine professionals in North America. That wasn’t going to be the case for me. If (when) a doctor found something was wrong with my shoulder, my days of pitching were over. In my mind, anyway.
I began a steady diet of anti-inflammatories and loaded my shoulder with a thick layer of A535 or Voltaren Emulgel before each game. Eddie Harris would be proud. I even experimented with some prescription-strength painkillers.
Like Eddie Harris, I re-invented myself as a junkballer. Nothing was straight, speeds were varied, I would pitch backwards in counts. If I was to throw a fastball, it was strictly for the element of surprise. I was able to achieve some level of mediocrity, a small measure of respectability. But I wasn’t having fun. The pain remained, the command of my pitches was fleeting.
I haven’t got an arm like you, kid. I have to put anything on it I can find. Someday you will too. – Eddie Harris, Major League
The next summer I moved to London, Ontario, and joined a team in the Southwestern Senior Baseball League, a league at the same level as the GTBL or COBA. I had a few new tricks in my arsenal: new arm angles to try to combat the searing pain I would feel in my shoulder when I would throw a pitch. Naively I thought things would be different. On the first pitch of my first appearance of the season, the pain returned – worse than ever before. I removed myself from the game and removed myself from the team shortly after. Did I go to the doctor? Of course not.
I thought to myself that my pitching career might be over. I spent a few seasons playing softball and slo-pitch, but it never really scratched the baseball itch. And the pain was still there, even on innocuous throws. So my clever solution was to take a year or two off from even throwing a baseball. That should be sufficient time to heal whatever is ailing me, right?
Fast-forward to February of 2016. With a yearning to resume pitching, I contacted Canada’s premier baseball facility, Centrefield Sports. Having convinced myself that throwing too many pitches early in the season might have been responsible for my shoulder issues in the past, I began an ultra-conservative throwing program with catcher Larry Balkwill. 15 pitches for the first bullpen. 20 for the second. And so on. I was feeling pretty positive in the early going, being able to command my “fast”ball to both sides of the plate and beginning to regain the feel for my curveball. But as soon as Larry encouraged me to air it out and “throw through the target,” the pain came back and the ability to throw strikes left me. At the same time, throwing in a cage beside me was an overweight, out-of-shape 12-year old kid. He was throwing heaters at age 12 much faster than I could throw at age 35. Feeling defeated, I went home and thought of what I could do differently. More A535? Vick’s vapo rub? A stronger anti-inflammatory? Then I saw a tweet from ESPN’s Keith Law that resonated with me:
Pain is your body telling you something's wrong, ibuprofen is you telling your body to shut up https://t.co/Nn8fSuKLjp
— keithlaw (@keithlaw) April 22, 2016
The next day I called my doctor and made an appointment.
Shoulder impingement syndrome
My doctor saw me the same day and I performed my favourite shoulder trick for him. After examining my shoulder, he confirmed what I had dreaded: there was something seriously wrong with my shoulder. He sent requisitions for an ultrasound and an MRI. He also referred me to the Fowler Kennedy Sport Medicine Clinic at the University of Western Ontario.
Immediately I made an appointment at Fowler Kennedy and met with a physiotherapist who was a disciple of Cressey Sports Performance, probably the most respected functional trainer for baseball players – specifically pitchers. Clients of Cressey Sports Performance include Curt Schilling, Tim Collins, Corey Kluber, Jeff Hoffman, and Jake Arrieta. I felt that I was in good hands, and I was right. After a lengthy conversation of my history and a quick functional assessment, she had a diagnosis. After years of abuse in my younger years, the muscles in my shoulder compensated in an effort to protect my rotator cuff. This caused a chain reaction of events to occur: the position of the arm bone’s humeral head shifted in the glenoid (shoulder socket), thus decreasing an already narrow space in the shoulder known as the subacromial space. Then, when the tendons of the rotator cuff muscles pass through this narrowed space during the throwing motion, they are pinched. This pinching leads to irritation and inflammation, which leads to the thickening of the tendon and even further problems because there is even less space in the shoulder for a thicker tendon to pass through. The result is called a supraspinatus shoulder impingement, and it’s really quite painful. It’s a common injury among MLB players too. Pedro Martinez, Brandon Webb, Jordan Zimmerman, Raisel Iglesias, Chris Young, Sean Manea, Luke Gregerson, Andrew Miller, Danny Duffy, Jose Ramirez, Joe Kelly, Dellin Betances, Seth Lugo, Kyle Hendricks, and even Blue Jays players Jose Bautista, Scott Richmond, Danny Barnes, Jesse Litsch, and prospect Justin Maese have all landed on the disabled list at some point in their careers due to shoulder impingement. Some were able to recover, and some were not. For more information on shoulder impingement, Baseball Prospectus has a great article on shoulder impingement as part of their series on common injuries in baseball.
My physiotherapist did a provocative test called the “Hawkins Test” (named after the surgeon in the video above, Dr. Richard Hawkins) to try to re-create the pain in my shoulder that I felt when throwing. It worked; it hurt bad. Then, she manually re-positioned the humerus of my shoulder and performed the test again. With a re-positioned humerus, there was no pain whatsoever! I was assigned various exercises using surgical tubing-like therabands, and was told that if I put in the work, I would be able to replicate what she did in the clinic: the ability to throw pain-free. I left Fowler Kennedy walking on sunshine.
Like a good boy, I did all of my exercises diligently. I was a highly motivated client, constantly chasing the pain-free pitching carrot dangling from the proverbial stick. But every time I threw the ball – no matter how many exercises I did – the pain came back. It turned out that a few strengthening exercises weren’t going to re-position my damaged shoulder after 10+ years since the symptoms originally presented themselves.
Then a breakthrough happened. My physiotherapist taught me how to manually re-position my shoulder and keep it in place using kinesiology tape. For the first time in over 10 years, I was able to throw pain-free. I couldn’t have been happier.
With a new feeling of confidence, my physiotherapist and I agreed that I would finally be able to test my arm on a pitching mound. During pre-game warm-ups, I felt strong and had fairly decent velocity on my warm-up tosses. When I moved to the bullpen, however, I didn’t feel comfortable at all. While I was able to throw straight with relative ease, when it came to creating a downward plane on the ball in order to locate within the strike zone, there was a great deal of discomfort. With that said, I learned long ago that bullpen performance does not necessarily translate to in-game performance. In this case, the lack of comfort I felt in the bullpen translated directly into the game. I struggled to find a consistent arm slot, release point, even my stride was inconsistent and ineffective – all because my shoulder was feeling weird. My initial response was to pitch through it, thinking that I would eventually find my rhythm like I had always done in the past. It was important to me to prove to my new team that I was, in fact capable, but an older teammate who I respected immensely encouraged me to pull myself from the game in order to save myself for the rest of the season. So, that’s what I did, and I’m glad that I pulled myself when I did. Pitching through the pain of shoulder impingement syndrome – like I had been doing for the past 10+ years – usually leads to a full or partial tear of the rotator cuff. Lucky for me, that hadn’t happened, and I was fortunate enough to have a teammate who was looking out for my well-being to prevent it from happening.
All of the symptoms that I experienced in my younger days came back – swelling in the shoulder, an aching, throbbing pain and it lasted many times longer than regular muscle soreness lasts. It turns out that kinesiology tape wasn’t quite the magic pill I thought it was going to be. I went back to the sports medicine clinic and we gingerly worked through some elementary exercises. I met with a sports medicine doctor and he did some additional provocative shoulder tests. Yes, I had a shoulder impingement. No, there was no reason to think there was a tear in my labrum. The best course of action would be maybe a cortisone shot and some rest – and to keep pitching until I felt comfortable with the tape.
I continued to use kinesiology tape and constantly experimented with positioning and the amount of tension in the tape. It definitely took some getting used to, but the more I practiced with the tape, the more comfortable I began to feel. Eventually, I was able to throw strikes at will, pain free, all because of the kinesiology tape. (And a manager who stuck with me when I was complaining of searing pain in my shoulder while walking the whole ballpark. It’s not often a manager continues to run a guy out to the mound, complaining of shoulder pain while sporting a patchwork tape job. Those guys don’t typically have a track record of success, but thanks to my manager’s faith in me, I was able to turn things around.)
The moral of the story
It’s been more than three years since I first saw a doctor about my shoulder and I’m finally in a place where I feel comfortable pitching. My velocity is about 60-70% of what it was in my 20s; I can’t tell if that’s from the shoulder impingement, additional damage in the shoulder that I don’t know about, or the fact that I’m now 39 years old. I can throw bullpens of between 80-100 pitches and recover within days. Before, if I threw 20 pitches, it would take me a week to recover – if I was lucky. I’m still a junkballer, but I’m having fun playing baseball again, and most importantly, I’m playing pain free.
What’s the point of this story? The point is, because I foolishly adhered to baseball’s culture of “playing through pain” and “suffering in silence,” I lost 10 years of playing the sport that I love. I squandered the peak years of my athletic career because I didn’t want to ask for help. While I’m eternally grateful to be able to play again, I’ll never know what might have been had I seen a doctor immediately and continued playing with a fully healthy shoulder. I hope this story serves as a lesson to baseball players of all ages: if you feel there’s something wrong, speak up. Get the help you need. Otherwise you could miss the best baseball years of your life for no reason at all.
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I’m 39 years old now but haven’t felt this good on a mound in 10 years. Shout outs to @balkwont for his off-season tutelage, @chris.newman.50 for his expert game calling, Jon Traut from London Pain and Headache Clinic for rehabilitating my shoulder ?, and the best physiotherapist ever at @fowler_kennedy_sport_medicine for post-ACL surgery care and showing me a shoulder impingement work-around. Grateful to still be able to play the sport I love as an old person, with the best group of guys I’ve ever played with in the @londonorioles ???? #baseball #ldnont #shoulderimpingement #kinesiotape #kinesiologytape #acl #aclrecovery #aclreconstruction #aclsurgery #aclfamily #aclrehab #acupuncture