By: Dr. Trey Martin PT, DPT
Have you ever watched ESPN and on the bottom line ticker, you see that your favorite NBA player is sitting out for "load management"? What is load management and why do all of these players need it now? The first thing to think about is acute:chronic workload ratio. In a simple sense, the key to this ratio is that your body is trained for the task at hand. Let me give you this real world example. I do not run for distance often. If I sign up for a marathon this weekend (high acute workload) without much prerequisite training (low chronic workload) the chances of me getting injured increases dramatically. On the flip side, if Jimmy has been training all year to run this marathon, and he ran his final prep day of 22 miles (high chronic workload capacity) then the marathon (high acute workload) will be something he is prepared for. Another brief example, middle-aged men and achilles tears. Similar to above, middle-aged men who haven't been exercising, playing sports, or active as much as they used to be will try to play basketball one weekend like they are 25 again. Their achilles hasn't seen much training this decade and playing basketball is too much demand for the tendon to handle. One large pop later and you see my point.
Baseball is my background and throwing injuries are one of my passions. One of my career goals, is to work with local baseball players and help them to peak performance with lower injury rates. Using load management concepts, let's zoom in on some current pitfalls we see in the baseball world today. We know that pitching competitively 8+ months out of the year results in a 5x increase in surgery risk, averaging 80+ pitches an outing results in 4x increase in surgery risk, and pitchers who regularly pitch with arm fatigue had a 36x increase in surgery risk. The obvious reaction is to have people throw less. Problem solved, right? Not quite! I call this the Goldilocks Equation. Throw too little before giving max effort at a baseball showcase and you have the same recipe as me trying to run a marathon next weekend with no training. Throw too much, and you have all of the aforementioned risk increases. We have to build our athletes up to withstand the stress of the season. In my opinion, the Goldilocks middle ground needs to look like this.
1) We need to fortify our baseball strength and conditioning programming. No more mindless long distance running, power cleans, and excessive weighted ball work. Spend more time on rotator cuff exercises, lower body strengthening, rotational power, core work, and soft tissue care.
2) Take a long, hard look at season scheduling. Do you need an extra 15 games of fall ball or do you need to gain 15 pounds of muscle? (99% of the time, it's the 10 pounds of muscle).
This recipe is the difference in a D1 talent being a draft pick, a D3 talent going D1, or someone with no college offers getting a scholarship. My dream is simple. I want to radically change how we look at baseball performance. I want to teach you how to perform your best and lessen your chance of a throwing arm injury. The best way to do this is through a robust strength program and managing the demands of the season appropriately. For more information on load management, check out Tim Gabbett's work. He has been a real pioneer in this space and most of what I have written about here is inspired by his work.
If you are a baseball player and this is something that hits home with you, I would love to connect and see if I can help. You can shoot me a message on here in the contact section, come see me in person at Pursuit Physical Therapy in Orlando, or find me on instagram @athletedocrehab.
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