Enhance Performance Article Archives

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More Rationale for ACL Injury Prevention Programs for Youth Female Athletes

There is fairly definitive evidence that females have lower hamstring strength and subsequently lower hamstring-to-quadriceps (H:Q) strength ratios in comparison to men. This has a significant impact on the ACL injury rates in female athletes, as the hamstring assists in protecting anterior tibial translation and strain on the ACL. Thus, ACL injury prevention programs have traditionally incorporated exercises to enhance this ratio.
Yet another study has been released in the latest issue of the American Journal of Sports Medicine by researchers out of Norway looking at the H:Q ratio, but this time in a group of prepubescent children from 7 – 12 years old. The study looked at isokinetic strength of 368 children. The results show that hamstring strength and H:Q ratio was significantly lower girls between the ages of 8-12. No significant differences were observed in 7 year old subjects, though the amount of females was lowest in this group. I am not sure if the results would have been the same if the group size was larger. In total, boys had a 10% increase in H:Q ratio.

Clinical Implications

It is well known that injury prevent programs have been shown to be effective in preventing ACL injuries, especially in female athletes. Based on the results of this study, it is apparent that some of the musculoskeletal gender differences that have been associated with a higher incidence of ACL injuries in females are present in children under the age of 12. Thus, it may be advantageous for young female athlete to begin injury prevention programs designed to enhance hamstring to quadriceps ratios.

One particular program that I have read about lately is the PEP program developed by Holly Silvers and the Santa Monica ACL Prevention Project. PEP stands for Prevent injury, Enhance Performance.” I have not used this program myself but I like the concept and it was backed up by a research report in the August 2008 issue of AJSM that demonstrated that subjects that did not perform the program had a 3.3x higher injury rate. The program consist of a 15-minute training session designed to be performed as a warm-up prior to athletics. The program includes running, agility, stretching, strengthening, and plyometric exercises in the format of a dynamic warm-up that can be performed in a group setting.
Another program that is popular is the Sportsmetrics program developed by Dr. Frank Noyes and the group at Cincinnati Sports Medicine. This program has been around for several years and has some research implemeneted within the program components. If you are interested, they also have a full certification program. Here is a video about the program:

Follow the above links for more details on the programs. Has anyone tried the PEP, Sportsmetric, or similar ACL injury prevention program? If so, tell us about your experience and share any recommendations.

Why 9-year-old Jericho Scott Can Throw a Fastball and What You Can Do to Increase Your Velocity

9-year-old Jericho Scott has an exceptional ability, throwing a fastball.  The Little League pitcher was banned from pitching in his youth baseball league in New Haven, CT this summer due to his “excessive” 40-mph fastball

To help the non-physicist reader, that translates to a 95+-mph fastball on an adult-sized baseball field. 

While this story received a lot of attention in the media this summer, it has started to cause a backlash of youth players and parents seeking to gain an edge in their pitching performance.    
It seems that every strength and conditioning facility, program, and camp claims to be able to help develop “5+ more mph” or similar claims. 

These are very bold statements, in my mind, and may be much more harm than good, especially if they utilize techniques that may not be suited for each player at different maturity levels, such as aggressive strengthening programs, heavy plyometric programs, and weighted-ball throwing programs.

The Two Main Reasons Jericho Scott Can Throw a 40-MPH Fastball

  1. Physical Development – Probably the most important factors are his physical attributes, including his size and physical maturity in relationship to his peers (I would bet he has longer fingers than his peers too, but that is another topic).   Also, I have never met Jericho, but I would bet that he threw a lot so far in his life and that he was throwing well at an early age.  In order to throw a baseball, you need humeral retroversion (Crockett AJSM ’02), that is you need to achieve excessive amounts of shoulder external rotation, which is achieved by having a large amount of humeral retroversion.  Studies have shown that throwers with excessive ER also have a corresponding amount of humeral retroversion.  This develops when you are a child and you throw while your growth plates are open (Meister AJSM ’05).  This is also why girls used to “throw like a girl.”  Females did not participate in youth baseball in the past so they did not throw a lot while their growth plates were open.  “Throwing like a girl” basically just means that you can not achieve a lot of shoulder ER.  Sorry guys but males that did not throw a lot as a child will also throw like this.  Crockett (AJSM ’02) showed this when assessing retroversion in a group of soccer players that did not play baseball when growing up.  If you don’t have this retroversion and ER, you can’t throw a fastball.
  2. Biomechanics – The second most important reason that Jericho can throw so fast is his mechanics.  The act of throwing is a complicated process that requires a precise interaction of your entire body.  Your body must work towards developing and transferring energy in a fashion that allows the ball to explode to the plate.  Any inefficiency in your mechanics will lead to “energy leaks” that will waste your developed potential energy.  Even professional Major League Baseball pitchers will see fluctuations in their velocity that is caused by inefficient mechanics, even subtle changes that can not be detected by the naked eye. 

Notice that the two main reasons that Jericho can probably throw with such velocity have nothing to do with his strength, his workouts, or his training programs.  

Don’t get me wrong, I believe that you need to be strong to throw well and to stay healthy, but this is not the reason why most youth can throw well and others can’t.  This is why I wonder when I see advertisements for youth strength and conditioning programs that are designed to increase velocity.  I know it is a marketing trick because no child is going to get as excited about injury prevention as they are performance enhancement.  I am certain that there are several amazing programs out there that are safe and effective, and I would never discourage you from seeking out these programs to maximize your body’s potential, but I caution that you understand that there are many different types of programs available.

What Can You Do to Increase Your Velocity

  1. Play baseball as a child.  You don’t need to pitch at an early age, but you need to play a lot of baseball to develop retroversion.  If you participate in baseball at an early age you will develop retroversion.
  2.  If you want to take the extra step and seek the advice of a professional, try to work with a baseball/pitching coach to develop good pitching mechanics at an early age.  This will help you learn how to pitch (rather than throw) effectively and give you a competitive edge in your league.