Lower back maintenance - A question to you cagey veterans of pitching out there.

RB,

did we ever see a video of her pitching? Also, exactly what scan did they use to determine nothing going on in the spine?

. Something is way wrong here. I know, brilliant statement there.

OK RB, I watched the video again. How old is she and how long has she p itched like that? What I see in the video is a step style pitcher that is standing straight up through the entire course of the pitch. This is very stressful to the lumbar spine and has been the cause of a couple stress fractures to DDs on this board in the last year.

I am no doctor but if I had to bet, I am still going with a possible stress fracture to the lumbar spine. I remember one poster who had an x-[ray taken that showed nothing. He then pressed the issue and they did a different scan, I'm sorry but I dont recall which one, (bone density scan???) or something soundfing similar. THAT ONE found it where the x-ray did not. THIS IS WHY I ASKED WHICH SCAN.

Which one was performed? Dont have to say this but, x-rays dont show muscles. If it was an x-ray and they suspect a muscle problem,,,, hhhhmmmm.

KenB said:

Hal,
I teach "stay tall" at release, but can see how heel plant vs toe plant and a rigid knee could lead to issues. I also teach "no bending" at the waist or back bending in premotion and load. Kelsi Dunne comes to mind as a pitcher who would bend at the waist in premotion then hunched some at release. Kenzie Fowler had a delivery where she forcefully bent forward during load then snapped into a back arched position mid-stride that made me cringe. Ueno bows in premotion and leans forward at the waist in release. These motions seem risky to me, but only an opinion.

Finch had a motion that seemed tall at load and tall at release. This style of using the legs to generate power and to absorb the plant energy seems to be the least likely to injure the back--again, only my opinion.

I'm familiar with the Steadman Hawkins Report to the Coaches: Softball Pitching at the 1996 Olympic Games, which specifically addressed the pitching motion relating to shoulder injuries. Is there another report that addresses back injury?

Click to expand...

Hey Ken, Got to apologize here. Scanning over this thread again and just noticed your question seems to be addressed to me.

The report was specific to shoulder stress. Nothing about the back, at least what I have seen.

However, it does draw a line on the angle of the knee at LFT. Because of the angle of the knee AND the strong and aggressive forward momentum of the pitchers AND the fact that they MUST have a tremendous amount of resistance against the stride foot at LFT to throw a riseball, one must conclude these pitchers ARE on a backwards lean at LFT. If not, if they were standing straight up at LFT, every one of them would be walking through the pitch because the resistance to the stride leg would not be there.

The knee and the ankle are the bodies brakes AND shock absorbers. If you are on a backwards lean at LFT, any shock of stopping the back experiences is absorbed by the ENTIRE spine, as in straight up and down as it is designed to do. If the pitcher is trying to stop all that forward momentum force with the spine straight up and down, now thew stress is more of a back to front pressure and the spine is not designed to work that way, at least not well at all. SOMETHINGS GOT TO GIVE. And that something is the lumbar spine region.

I hope that makes sense.

halskinner said:

OK RB, I watched the video again. How old is she and how long has she p itched like that? What I see in the video is a step style pitcher that is standing straight up through the entire course of the pitch. This is very stressful to the lumbar spine and has been the cause of a couple stress fractures to DDs on this board in the last year.

I am no doctor but if I had to bet, I am still going with a possible stress fracture to the lumbar spine. I remember one poster who had an x-[ray taken that showed nothing. He then pressed the issue and they did a different scan, I'm sorry but I dont recall which one, (bone density scan???) or something soundfing similar. THAT ONE found it where the x-ray did not. THIS IS WHY I ASKED WHICH SCAN.

Which one was performed? Dont have to say this but, x-rays dont show muscles. If it was an x-ray and they suspect a muscle problem,,,, hhhhmmmm.

Click to expand...

Ya it was xray that supposedly ruled out bone issue. (along with some physical stress-tests for pain that the doc did - twist this/fold that/ and press.... no pain)

Then they did some balancing and strength-tests and concluded with a Gluteus Medius weakness imbalance compared with the rest of her strength.

DD apparently came back too fast in the first game of the season 4/16 when her back spasmed-up right in the 7th of the game (almost got the no-hitter in the first game of the year...)

Doc said the back heals fast and she was in to the Ortho for "adjustment" on 4/22 and yesterday 4/24 we had our first light warm-up again.

The Ortho doc said do a much slower ramp back into the game this time - next game three innings ONLY then add an inning each successive game day.

The surprising part overall here was the Ortho doc saying that the best plan for DD was NOT to be inactive (I was expecting the "sit out for x weeks/months" but did not get that.)

Oh she's 17 and pitched that way her entire life (except for the Abbott bend-over thing we deleted three years ago)

RB, with all due respect to the good doctor, I DONT BUY THE DIAGNOSIS. Unless she does a more expensive scan to totally rule out a spinal stress fracture possibility, I dont buy it. I hope the Doc is right and I am wrong but I do not think so.

I have seen them misdiagnosed several times. If she did the forward dip, I strongly suspect it.

We all know there are doctors that will play down all types of injuries, play the insurance game, so to speak.

The way she is pitching in the video is still stressful to the lumbar spine, not as stressful as the forward dip but still stressful.

I strongly suggest you mention stress fracture to the doctor and push for the correct scan.

halskinner said:

RB, with all due respect to the good doctor, I DONT BUY THE DIAGNOSIS. Unless she does a more expensive scan to totally rule out a spinal stress fracture possibility, I dont buy it. I hope the Doc is right and I am wrong but I do not think so.

I have seen them misdiagnosed several times. If she did the forward dip, I strongly suspect it.

We all know there are doctors that will play down all types of injuries, play the insurance game, so to speak.

The way she is pitching in the video is still stressful to the lumbar spine, not as stressful as the forward dip but still stressful.

I strongly suggest you mention stress fracture to the doctor and push for the correct scan.

Click to expand...

Thanks a bunch Hal for your insights.

In a tough spot here with DD going to a well-known sports medicine ortho specialist here. I have a hard time thinking that some motion she did three years ago would have a current impact right now. But what do i know......

I also look at the nature of her getting hurt and then how quickly the pain goes away (2-3 days and all gone) it makes me think its muscle and not bone. (I have read somewhere that the back muscles repair themselves faster than about anything in the body.

As i believe you have allot of experience Hal i am going to interrogate the doc on further bone verification.

But i think that there is one more attempt here at coming back. We are going to strictly do this slow ramp back into action and if that ends in another spasm event trust me i will be looking for other answers.

Big wow on this injury though - never saw it coming - and after such a productive off-season,......just not fair for DD. But i am sure this story has been told a million times......

RB, I am praying I am dead wrong here. However, everything you told me, especially about doing the forward dip, points to a stress fracture. I first heard of that problem many years ago, I am guessiung maybe in 2000. A local pitching instructor taught the forward dip. I first saw it at a 14u tourney. I bumped into an old work friend I had not seen in years. Watching the game and yakking with him.

Other team tookj the field and he said his kid was pitching. Very tall very SKINNY. She was warming up and doing the forward dip. I immediately said "Ow", and asked if that made her back hurt? He said yes it does. Didnt see him again for a hndful of years. Saw him some years later. Shew had to quit pitching because her back got worse. Said the Dr had determined she HadScoliosis. I had alread heard of the stress fractures popping up in PA by then from the forward dip. Asked him if he had done any scans to rule it out, he said no.

A year or so after that he spotted me at a game and said they DID find a stress fracture in the lumbar area. Sorry for the long story.. That same instructor and the forward dip was responsible for two more pitchers getting the same diagnosis. Ended both their careers also.

You are the Dad. Do whatever you think is right. This is the rest of her life we are talkingf about, not just her HS pitching career.

I'll be praying I'm wrong.

halskinner said:

RB, I am praying I am dead wrong here.

Click to expand...

It wouldn't be the first time, you said basically the same thing to me when I started a similar thread about my dd a couple of years ago. We were fortunate to find the right people to help her and she has pitched without back pain ever since.

RB, I looked at the video of your dd and she is similar to my oldest dd in terms of build and pitching mechanics and while she is upright in her motion, like my dd, she is not a step-style pitcher. At the time my younger dd had recently had her first lesson with Denny Tincher and I remembered him telling me about the back and other health problems Angela had had during her pitching career so I emailed him a video of my older dd to ask him if he could see anything in her motion that was causing her back pain. Your video was shot from CF so it's harder to get a very good look but I'd suspect he'd say the same thing to you that he told me which was that there wasn't anything in her motion that would cause pain but a few things that could aggravate existing pain.

I was skeptical when he suggested finding a good sports chiro but my wife was barking up the same tree for us to take her to the sports chiro she had been going to. We took her several times and the guy gave her some stretches and other exersises for her to do on her own and that did the trick. I'd suggest looking into that, perhaps contact the nearest D1 university with a FP program to inquire where they send their pitchers with similar issues. Any sport that requires as much repetitive motion as pitching is likely to have atheletes with similar imbalances so you could also inquire with friends of atheletes in different sports that have had health issues to see who was able to address them successfully.

Good luck

People have told me I am over protective of pitchers, a worry wart, etc, for years.

hope she does great.