Whether you’re a pitcher, position player, overhead thrower in a different sport, or coach of these athletes, you have likely heard of the rotator cuff and know that it is an important part of shoulder health and function. However, most athletes and coaches don’t understand the rotator cuff well enough to maximize the effectiveness of their training.
The shoulder is a complex “joint” comprised of four joints: the sternoclavicular joint, the acromioclavicular joint, the scapulothoracic joint, and the glenohumeral joint, to which most people refer when discussing the shoulder. In order for the shoulder to move optimally, especially in the context of overhead throwing, all of these joints must function well. For example, if the scapula is restricted through upward rotation, extra movement will occur at the glenohumeral joint compromising the stability and health of the joint.
The rotator cuff is a group of four muscles that help keep the head of the humerus centered on the glenoid fossa. The shoulder allows extreme ranges of motion but this comes at the expense of stability. Unlike the hip, which is also a ball and socket joint, the glenohumeral joint is not deep and therefore it is much less stable. While the femoral head sits securely in the acetabulum, the humeral head sits on the glenoid fossa, like a golf ball on a tee. The job of the rotator cuff is to keep the humeral head centered on the glenoid fossa. In order to make sure this can happen under the extreme forces and velocities that happen during pitching, the rotator cuff must be strong and trained in a progressive manner just like all other aspects of the training process.
One of the biggest contributing factors to an athlete’s long-term development is whether or not they can remain healthy. Athletes who stay healthy can perform more training sessions. Provided they’re planned appropriately, this means enhanced development over their injured counterparts. The rotator cuff is an important piece of this puzzle for throwers as shoulder injuries tend to have less favorable recovery outcomes than elbow injuries (Sgroi and Zajac, 2018).
Internal rotation strength/power is extremely important for throwing velocity. Internal rotation can be thought of as the gas, as this contributes significantly to arm acceleration and can reach velocities of 7500 to 7700 degrees per second (Seroyer et al., 2010). However, external rotation is also extremely important, as it not only sets up the high velocity seen during acceleration via layback, it also must decelerate the arm and act as the brakes. In order for ball velocity to be maximized, arm acceleration must be allowed to occur for as long as possible, and to the highest possible velocity. In the same fashion that vertical jump height will be limited if an athlete cannot land safely, throwing velocity will be reduced if the arm cannot be decelerated safely. If your body does not believe that it can safely slow your arm back down, peak internal rotation velocity, and the duration of arm acceleration are likely to be reduced. If you want elite gas, you also need elite brakes.
Rotator cuff strength is typically trained with some half-hearted band work or maybe some light dumbbells at the end of a training session. These methods aren’t necessarily bad, but if the training is never progressed benefits certainly aren’t being maximized. Instead, I’ve been using a new progression to enhance throwing performance.
General Preparatory Period (GPP)
In the early offseason, or GPP phase, I will generally begin with side-lying external rotation as this position gets the highest muscle activation of the infraspinatus and teres minor, per EMG (Reinold et al., 2004). We can target the cuff and prepare the tissue with relatively higher volumes without using very intense means. This helps athletes prepare for the more intensive means to come without introducing them too soon coming off a competitive period when a recovery period may be advisable.
The focus here should be on smooth reps at a moderate pace, slight abduction of the shoulder (with a rolled up towel or a pad), and maintaining stacked shoulders.
Specific Preparatory Period (SPP)
From here, I progress to supramaximal eccentrics as the muscle action type is specific to what we’ll be asking the external rotators to do when decelerating the arm. Additionally, this allows for higher loading as eccentric strength can be up to 40% greater than concentric strength (Bompa, 1999). Eccentric training also provides some helpful tissue adaptations, such as increased fascicle length which can improve performance and reduce injury risk (Duclay et al., 2009).
The focus here should be maintaining contact with the pad or rolled up towel at your side and reaching a point with the band resistance that you are not able to concentrically externally rotate.
Drop catch variations are the next progression as they are even more specific as throwing involves an extremely fast eccentric action (the drop and a portion of the catch) and powerful isometric (the catch). As I said previously, the faster these two muscle actions can occur, the longer and faster the arm is allowed to accelerate and the higher ball velocity can be. Additionally, as the velocities are more specific to sport performance the transfer to on-field performance is better.
Focus on dropping the ball, not tossing it up, and catching/stopping it as quickly as possible.
Finally, prior to the season, tryout, or specific competition rapid oscillatory internal and external rotations are used. This helps train quick contractions and relaxation and reversal from one direction to the other. As we know from previous research, the ability to relax extremely fast is what separates elite athletes from good ones (Van Dyke and Dietz, 2014).
The focus here should be on moving as fast as possible through the entire range of motion of the exercise. When performing these movements care should be given to staying as relaxed as possible/avoiding unnecessary tension in other parts of the body (relax face/jaw).
All of these variations will be used toward the end of a training session as these muscles will be used for stabilization during the other movements during a session and fatigue should be minimized in order to maximize output.
Training external rotation is an extremely important part of any program for overhead throwing athletes. However, the way it is typically trained does not maximize performance or health and therefore must be modified. The model I’ve laid out above is just one option and can be made more or less specific with various ranges of motion, arm positions, and other progressions or regressions based on the needs of the specific athlete.