It’s no question that the shoulder is a troublesome area for a great number of folks out there. Most of you that read Mike’s website on a regular basis are looking to treat the shoulder in some capacity—either physical therapy or performance based. Throughout my career as an Athletic Trainer and Strength Coach, I have worked predominantly with baseball players, or clients dealing with shoulder issues.
In regards to assessing and training for “good” shoulder function, I know Mike is a big advocate for determining what a muscle’s true “role” is beyond just direction(s) of movement and I couldn’t agree more. The rotator cuff may abduct, internally and externally rotate the shoulder, but its true role is to center the humerus in the glenoid during these movements to maintain proper joint congruency.
Rhythmic Stabilizations are great exercise variations that train rotator cuff timing and control in varying positions of instability. While I was completing my Master’s degree at Springfield College and working with their baseball program, I incorporated these exercises with everyone probably 2-3 times a week. I loved that they were a good way to train rotator cuff control/timing in various positions without excessively loading up the shoulder—this was especially true as throwing volumes increased later in the off season and in season.
However, I always wondered what the efficacy of these drills had in the sense of shoulder performance.
Relative to baseball, this meant throwing velocity. So I put this to the test! I conducted my thesis research on the “Effect of Reactive Neuromuscular Training on Pitchers.” In this study, I investigated how velocity was impacted immediately after performing rhythmic stabilization drills. My initial hypothesis was that velocity would improve. Theoretically, these drills are intended to promote proximal joint control, therefore should improve the overall function of the shoulder. Seemed simple enough, but let’s take a closer look at the study.
The Effect of Reactive Neuromuscular Training on Pitchers
Participants were 13 collegiate male baseball pitchers between the ages of 18-22. Participants were free of any shoulder or elbow injury that withheld them from playing activity within the previous 6 weeks.
Test Day 1:
- All participants were measured for total shoulder range of motion (Internal Rotation + External Rotation) with a goniometer. Total ROM ranged from (155-237 degrees).
- Each participant threw 10 warm up pitches.
- Each participant threw 10 four seam fastballs from the windup and pitching velocity was recorded with a radar gun.
Test Day 2:
- 2-3 days later (depending if they were a starter or reliever)
- Each participant threw 10 warm up pitches.
- Each participant performed 2 separate drills.
- Each participant threw 10 four seam fastballs from the windup while pitching velocity was measured with a radar gun.
Here are videos of the 2 reactive neuromuscular training drills:
Supine Rhythmic Stabilization
Half-Kneeling Rhythmic Stabilization
Key Findings
I am going to be honest; I was surprised by the results of this study! Most pitchers actually threw the ball slower than before!
Significant differences were noted in pre- and posttest Maximum (p < .004) and Average (p < .002) velocity. This equated to a 1.56 MPH decrease in average velocity and 1.62 MPH decrease in maximal velocity!
Another key finding was that greater Total ROM was highly correlated (r= .61) with posttest Maximum velocity. This means that those with greater shoulder ROM responded more favorably to these drills when compared to those with less shoulder ROM. Also, players that possessed the greatest amount of shoulder ROM—loose shoulders—threw the hardest overall.
Clinical Implications
Like I said before, I was quite surprised by the results that I observed in this study, but after looking further into WHY I may have gotten those results, it made a bit more sense. First, with any sort of isometric exercise, we are facilitating slow twitch type 1 muscle fibers that are in charge of posture and control. Pitching is the fastest motion in all of sports, so this acute activation in slow twitch fibers may have had a negative impact on improving maximal pitching velocity, contrary to what I previously would have suspected.
Possibly the most interesting and re-affirming point that was drawn out of this particular study was that some pitchers responded more favorably to the exercise protocol than others! The big takeaway from this: there is no “secret program” or “one-size-fits-all” program that will make you throw harder, or make your shoulder feel better. IT ALL DEPENDS ON THE INDIVIDUAL. There is a continuum: those who are “tight” (i.e. less total ROM), “loose” (i.e. more total ROM), and all those in between. Based on this particular research, and concepts like joint centration and the core pendulum theory, it seems that if you are “tight” it may be best to improve joint mobility, address soft tissue concerns, or joint positioning to see improvements in joint function and performance. If you are “loose”, it may behoove you to improve your overall joint control and just get stronger. This is why constantly assessing and individualizing programs for your athletes, clients, and patients is so crucial. Otherwise, folks will fall through the cracks and you won’t maximize your results with those you work with regardless of what population it is.
Mike’s Thoughts
Great article Sam! This is a nice research study looking at a topic very important to me. I outlined how I incorporate rhythmic stabilizations into some of my programmin in my Optimal Shoulder Performance DVD with Eric Cressey. Since that time, I am thrilled to see so many strength and conditioning coaches and personal trainers incorporating this into their programming.
I couldn’t agree more with Sam’s overall conclusion – each program must be individualized. This is important as not every needs the same program or should have the same emphasis. Based on this study it looks like performing rhythmic stabilizations prior to pitching should be included in pitchers that have been assessed and determined to be “loose.” This makes sense to me.
In regard to the overall lose of velocity in the tight players, I think there may be many other factors that should be considered, including what happened in the 2-3 days between testing sessions. Perhaps tight players bounce back differently? More importantly, we don’t know if the lose of velocity was a normal occurrence in this group of subjects throwing 2-3 days later. Future studies should randomize the groups and have half of the subjects perform rhythmic stabilizations before their first throwing session.
Another thing I would add is that the subjects were all college-aged pitchers. I am a big believer that older pitchers may need more preperation work prior to throwing to get the rotator cuff firing and prepared to throw. Perhaps these findings would be different in other age groups.
I’m not sure I am ready to stop performing rhythmic stabilizations before a game in those that are tight, however I will certainly keep this knowledge in mind when individualizing someone’s programs in the future, especially loose athletes.
Great research and article by Sam! Thanks for contributing to our knowledge of how to treat baseball pitchers!
About The Author
Sam Sturgis holds a Bachelor’s Degree in Athletic Training from Quinnipiac University (2010) and Master’s Degree in Strength and Conditioning from Springfield College (2012). A skilled Strength Coach and Athletic Trainer at Pure Performance Training in Needham, MA, Sam works primarily with baseball athletes and clients rehabilitating from injury. Sam has developed a successful off-season baseball Strength & Conditioning program in which many athletes utilize. Sam has also been a regular contributor to the Pure Performance Training website.
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