As the 2023 Major League Baseball season is about to begin, Lawrence V. Gulotta, MD, will be busier than ever as the New York Mets’ chief orthopedic surgeon. And, as he is also an active member of the School of Special Surgery (HSS), he doesn’t just work with professional athletes.
Alas, spring is a time when the weather starts to get a little warmer and the number of daylight hours increases, and with this good news comes the motivation to play sports outdoors or even just work out a bit. more. But, as Gulotta is all too aware, getting back in shape is something that needs to be treated with great care, regardless of the PRs we hit last year.
M&F sat down with the sports medicine practitioner to find out how we can protect ourselves and avoid injury as we return to fitness, New York Mets style.
1. Always warm up
According to the expert, warming up is one of the most talked about yet most underused aspects of injury prevention. “Warming up is an important ingredient for improving performance and preventing injury,” notes Dr. Gulotta. “Most veteran Mets players have a pregame or practice routine that involves an element of cardio and then a muscle activation program that ‘warms up’ the muscles that will be needed to function.”
2. Be flexible
If you enjoyed the offseason a bit too much, you may have found that being sedentary has decreased your flexibility, which can lead to injury sooner rather than later. “Flexibility is important to prevent injury and increase performance,” says Gulotta. “However, it is equally important to ensure that the muscles around the joint are strong enough to support that range of motion. Having the strength to control a joint through its full range of motion is what we call ‘possessing this movement.” Often, teenage baseball players will have a lot of flexibility, but they don’t have the core strength to control that flexibility.
Gulotta says building strength around the core and focusing on flexibility through stretching and functional exercises will help protect joints like the elbows and shoulders. And, when it comes to elbows and shoulders, he is one of the most knowledgeable doctors in the field, serving as head of the shoulders and elbows division at the Institute of Sports Medicine within the HSS. This sports scientist has spent a lot of time researching why throwing a ball can be a dangerous task.
“The overhead throw is not a natural shoulder motion,” he says. “Our shoulders were made so that our arms would swing at our sides as we walked. They weren’t made to throw a ball over the head. Therefore, the forces exerted on the shoulder and elbow during the throwing motion put them at risk of injury. Recently, the players are bigger and stronger, and the training techniques are so good that they are able to generate tremendous force. That’s why we regularly see Major League Baseball pitchers pitching in the top
90mph. This extra strength puts the stabilizing ligaments and muscles around the shoulder and elbow at risk of injury.
3. Focus, but don’t overtrain
“Overtraining can lead to wear and tear which can then lead to injury over time,” says Gulotta. “Remember that baseball players don’t train specifically to gain muscle. They train to improve their performance. Their performance improves by gaining strength, but also by gaining core stability, flexibility , explosiveness and hand-eye coordination. Their training program takes all of these things into consideration.
The other part is that they focus on functional movement exercises that mimic the activities they will perform in a game. These exercises work multiple joints and muscles. This not only improves long-term performance, but also avoids overtraining any part of the body by performing isolated strengthening exercises, such as the bench press.
4. Understand the mechanisms
“The shoulder and the elbow are different joints,” says Gulotta. “The shoulder is a ball and socket joint, while the elbow is a hinge joint. However, both of these joints need to be stable to throw a ball. For the shoulder, the main stabilizers are the labrum (a type of cartilage) and the rotator cuff.The elbow is stabilized by the way your humerus and ulna bones interconnect, and the ligaments.
The main stabilizing ligament of the elbow is the one located on the inside of the elbow called the ulnar collateral ligament (UCL). Injuries can occur when these joints begin to lose stability, either from extreme exertion in throwing hard or from wear and tear over time. This is why we see labral and rotator cuff tears in the shoulder, stress fractures and bone spurs and UCL tears in the elbow.
5. Use resistance bands to win in the long run
“Resistance bands are a great way to strengthen the shoulder because they allow you to work in different positions and ranges of motion,” says Gulotta. “For example, a great drill for a baseball player is to work on internal rotation and strengthening external rotation with the arm in the 90/90 overhead position. This position mimics throwing a ball above the head and will help the athlete work on strengthening and stabilizing the shoulder throughout the motion required to throw.In other words, resistance bands allow athletes to gain strength throughout functional ranges of motion.
6. Find the right balance
“Deconditioning (during the holidays) is real and puts athletes at risk of injury as they begin to prepare for the season,” Gulotta shares. “However, 12 months of constant intense training, especially for pitchers, can also be bad. Most athletes reduce their workload for about two months during the offseason. They will still retain their flexibility and core strength during this period. They will also adhere to a nutrition program. This allows them to maintain their physical condition, but also to recover. This relative period of rest is necessary to prevent wear-and-tear type injuries and must be observed at all levels, especially in youngsters. About six to eight weeks before they show up for spring training, players will begin to intensify their own training. They will begin to do more sport-specific activities like throwing or hitting. This is all a gradual process that will continue throughout spring training Perhaps the greatest risk of injury is an acceleration n from training too fast.
7. Hurt? Don’t just pick up your ball and run home
“There are several exercises that can be performed without affecting the injured structure,” Gulotta says. “Blood flow restriction (BFR) training (using a pneumonic cuff) is another way athletes can maintain strength while recovering from injury. However, a professional should be consulted to design a safe training strategy to overcome an injury.
How to stay prepared this spring
With some final thoughts on staying in the game this spring, Gulotta sums up the lessons we can all learn from the way baseball players train:
- Take time to rest during the off-season so your body can recover
- Engage in a warm-up that activates the muscles you’ll use in a practice or game
- Work on flexibility, but also work on strength in different ranges of motion to ensure the joint can be stabilized in all positions. This will allow you to “own that range of motion”
- Resistance bands are a great way to perform functional strengthening that mimics the actions needed to perform a specific sport. They also allow you to strengthen yourself in various positions.
- Stay hydrated. It’s the most important nutritional ‘hack’ that can help prevent injury.
See you soon on the field!