Health & Exercise Forum

Guest Columnist: Janet Caputo, PT, DPT, OCS

The sport of fast-pitch softball has become one of the most popular sports for female athletes in the United States. Female pitchers might not use a hard ball, but their injuries are just as significant as their male counterparts. Their shoulders endure the same torture and torment of training and performance, but research remains limited on prevention of shoulder injuries. Because the majority of pitching injuries occur at the shoulder, conditioning programs typically focus on the shoulder girdle muscles. However, current wisdom from the USA Softball National Team suggests shifting the training emphasis to the lower body. If the pitcher’s lower body cannot support the dynamic movements of her upper body, the weakest link, the shoulder, will be sacrificed.

At the collegiate level, fast pitch softball speeds can reach up to 72 mph. Where does all this power come from? The power behind the windmill softball pitch (WSP) is the lower body. Actually, the glutei muscles (i.e. the buttocks) have been found to have the highest level of activity during the entire sequence of the WSP.

According to Stacey Nelson, pitcher on the USA Softball National Team, the stride position is the power position. For right-handed pitchers, the stride position occurs when the pitcher steps out with her left foot. During the stride position, her right arm is in full elevation, which requires scapular (shoulder blade) stability. However, for a stable and efficient scapula, a pitcher requires proper trunk positioning (i.e. core stability), and trunk position depends on pelvic position. The pelvis forms the stable foundation that a pitcher requires to prevent rotator cuff injuries. So what stabilizes the pelvis...the glutei or butt muscles!

A pitcher’s glutei muscles stabilize her pelvis not only for scapular stability, but also to promote energy transfer from her lower body to her arm. The energy transfer chain requires proper muscular sequencing for a pitcher to deliver the ultimate WSP: hip → pelvis → trunk → scapula. Because a pitcher’s lower body supplies more than 50% of her upper extremity energy, improving gluteal muscle strength will also increase ball velocity by increasing stride length.

Even though the glutei produce the driving force for the hip, dynamic strengthening demands a stable core! Core stability exercises are initiated with isometric plank exercises:

• Front Plank:
• Position: Support body weight on forearms and toes; tighten abdominals to maintain pelvis in a neutral position. Do not allow pelvis to tilt or back to sag.
• Hold: Progress as tolerated to 30 seconds
• Repeat: 3 times
• Increased Challenge: Perform plank with opposite arm/leg elevated.
• Side Plank:
• Position: Lie straight on side with legs stacked and rise up on one forearm. Tighten abdominals to maintain pelvic neutral. Do not allow pelvis to tilt or spine to sag.
• Hold: Progress as tolerated to 30 seconds
• Repeat: 3 times
• Perform both sides.

Once isometric core stability exercises are mastered, you may begin gluteal strengthening

• Clam:
• Position: Side-lying with hips and knees at 90°. Tie a resistive band around knees.
• Movement: With feet together, raise uppermost knee toward the ceiling. Keep abdominals tight.
• Repeat: 10 times for 3 sets
• Perform both sides
• Increased challenge: Increase band resistance.
• “X”-ercise for simultaneous scapular and pelvic resistance:
• Position: Standing with an elastic band or tubing configured in an “X” pattern between feet and hands. Keep knees straight, but not locked, and shoulder width apart. Keep palms facing forward and to the outside of the shoulders.
• Movement: Take several 2-inch steps to the left and then repeat to the right. Keep abdominals tight.
• Progress to 60 seconds as tolerated.
• Repeat: 3 times
• Increased challenge: Increase band resistance.
• One-Legged Bridge:
• Position: Lie on back with hips and knees bent. Hold thigh at your chest.
• Movement: Lift buttocks upwards. Keep abdominals tight.
• Progress to performing 3 sets of 10 repetitions as tolerated.
• Increased challenge: Lie upper back on weight bench (static challenge; easier) or stability ball (dynamic challenge; harder). This elevation increases gluteal work because hip movement increases.
• Repeat with both legs.
• Advanced “Bird-Dog”
• Position: On both forearms with one thigh on abdomen, knee bent and opposite leg extended.
• Movement:  Elevate extended leg toward ceiling. Keep abdominals tight.
• Progress to performing 3 sets of 10 repetitions.
• Repeat with both legs.
• One-Legged Balance
• Position: Standing with arms extended, lift one leg backward so that weight bearing leg is perpendicular to trunk. Keep abdominals tight.
• Hold: Progress as tolerated to 30 seconds
• Repeat: 3 times with each leg.
• Increased challenge: Perform a weighted ball catch/toss or use Body blade®.

Sources: International Journal of Athletic Therapy and Training and Lower Extremity Review

Visit your doctor regularly and listen to your body.

CONTRIBUTING AUTHOR: Janet Caputo, PT, DPT, OCS is clinical director of physical therapy at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she practices orthopedic and neurological physical therapy.

Photos: Jennifer Hnatko

Photo Model: Stephanie Puckett, Keystone College Women’s Softball Team

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in the Scranton Times-Tribune.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in Scranton, PA. He is an associate clinical professor of medicine at The Commonwealth Medical College.