Slap Lesion Physical Therapy Treatment Before and After Surgery

SLAP is short for Superior Labrum from Anterior to Posterior, or from front to back. The labrum is the rim of cartilage found in the shoulder socket. An injury or tear to this part of the body is a SLAP lesion, which typically results from overuse, trauma and accidents such as falling onto your outstretched hand.

What are the symptoms of a SLAP lesion?

A person with a SLAP lesion or injury has shoulder pain, which becomes worse with throwing activities or when reaching overhead. The person may also experience some pain and soreness in the shoulder front when bending the elbow or turning the wrist. The person?s shoulder may also click or snap with movement and may feel like being dislocated. Diagnosis of this injury involves a physical examination of the shoulder and a contrast MRI scan.

What are the treatments for SLAP lesion?

Most cases of SLAP injuries respond well to non-invasive or non-surgical treatment so this would be the first option for any patient. After your injury, your doctor would first recommend some rest to help ease symptoms. Your doctor may also prescribe medication to alleviate inflammation and pain.

Next, you will have to undergo a SLAP lesion physical therapy, which mostly involves stretching and muscle strengthening exercises targeting the muscles around the rotator cuff and scapula. It is also important at this point to limit or make adjustments in the activity that caused the injury, which could be a sport or work-related activity.

Cold therapy is also a part of SLAP lesion physical therapy. Therapists make use of ice packs or ice massage to reduce pain and swelling by applying these agents four to six times in an hour for three hours. Therapists may also apply ice if pain or any other symptoms worsen after an activity.

Certain patients, especially athletes, who play sports or do activities that involve a lot of throwing may continue to experience pain despite undergoing proper SLAP lesion physical therapy program. When symptoms do not go away after 6 weeks of conservative treatment or SLAP lesion physical therapy, your doctor will then recommend surgery to treat your shoulder. In surgery, the doctor may remove torn cartilages or attach them back in place.

After surgery, you will need complete bed rest and you must avoid activities involving the treated area. After a period of rest, your doctor may then recommend SLAP lesion physical therapy to help you restore your shoulder?s strength and full range of motion.

Milos Pesic is a successful webmaster and owner of popular and comprehensive Physical Therapy information site. For more articles and resources on Physical Therapy related topics, Physical Therapy exercises and much more visit his site at:

=>http://physical-therapy.need-to-know.net/

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Save Your Shoulders With This Exercise

A lot of clients need to prioritize exercises for their upper back muscles. Because so many of us sit at a desk and computer all day, our posture becomes compromised. One of the key weight exercises to reduce shoulder problems that train the upper back is the Wide-grip Seated Row. This exercise trains the posterior deltoids, the rhomboids, and the lats, while putting relatively little stress on the shoulder joint.

When you do the exercise, make sure to keep your shoulders down so that you don't strengthen the already overstressed upper-traps. How do you know if you have stressed upper-traps? Stand up, and take a look in the mirror. Do you look like you are permanently shrugging your shoulders? If so, you need to work on your posture (both seated and standing). I encourage practicing perfect posture at every opportunity (whenever you can remind yourself - such as sitting at a desk, standing in line, driving, etc.).

In general, the wide-grip seated row strengthens a lot of otherwise neglected muscles, including the muscles of the rotator cuff. Because so many self-prescribed training programs focus on the front of the body (i.e. upper body pressing muscles), many people are weak in upper body pulling muscles. If this is your case, it will probably help to reduce the amount of pressing and increase the amount of rowing.

When I had an irritated teres minor muscle (a small muscle in the rotator cuff), I dropped all pressing for one month and focused on wide-grip seated rows, underhand grip seated rows, band pulls, and similar exercises to train the upper back and posterior deltoids. I have been problem free ever since. Of course, if you have any injuries, make sure to talk to your doctor and get the proper referral to a health care professional.

Craig Ballantyne is a Certified Strength & Conditioning Specialist and writes for Men's Health, Men's Fitness, Maximum Fitness, Muscle and Fitness Hers, and Oxygen magazines. His trademarked Turbulence Training fat loss workouts have been featured multiple times in Men?s Fitness and Maximum Fitness magazines, and have helped thousands of men and women around the world lose fat, gain muscle, and get lean in less than 45 minutes three times per week. For more information on the Turbulence Training workouts that will help you burn fat without long, slow cardio sessions or fancy equipment, visit www.TurbulenceTraining.com

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Fitness Tips That Can Help Your Golf Game

If you're really looking for more consistancy in your golf swing then stretching exercises that are "golf specific" will help your shoulders a lot! These types of fitness stretch exercises are designed to specifically help your back and rotator cuff area.

By stretching these muscle groups on a regular basis you can make big strides in improving your swing.Some of the most common injuries to golfer's occur because of a lack of flexibility in their back. This usually affects the area of the rotator cuff. Injury prevention is another reason why it's so important for you to start some type of golf specific exercise routine right away, if you don't already have one.

Have you ever stood in front of a full length mirror and watched yourself going through your swing motion? It may sound a bit silly, but by going through the motion slowly you can actually feel the muscles that you use while performing this movement. When you get to the top of your rotation try going just a bit further and holding it for ten seconds. Don't hurt yourself or bounce, but hold it just enough to feel a slight discomfort.

Once you've done this on one side, switch sides and do it again. Do both sides twice the same way. You should notice that it's a little bit easier the second time. You should also be able to go a little bit further now that you've warmed up your muscles a bit.

Next, try stretching directly overhead. Get all the way up on the tips of your toes and reach for the sky, holding it for a few seconds. When you come down go ahead and spread your feet more than shoulder width apart and simply bend over and "hang there" loosely.

Do NOT bounce as you could possibly tear a muscle. All that you want to do is hang there and breath deeply while counting to ten by one thousands. One thousand one, one thousand two, ect. Do this a second time. Reach for the sky as far as you can, hold it for a few seconds and relax.

Spread your feet again and bend over forward and hang there while counting. You can go farther the second time, can't you? Now try it with your feet together. This is a bit more rough if you're just starting out, but remember not to bounce, but to just hang there, count to ten and repeat. If you continue this regularly there will come a point in the near future where you'll be able to easily touch your toes without bending your knees. Can you imagine the flexibilty that you'll have when you've achieved this?

Once you've done this you'll feel like a million bucks. I've had some days where my spine will just pop right back into place. It's simply a wonderful feeling and will help your golf swing a lot. If you do this on a regular basis, you'll soon see a marked improvement in your game.

There are many different exercises that are specifically for golf fitness that you might find helpful. I recommend that you either invest in a good book on golf fitness, get with a fitness coach that specializes in golf fitness or, if you have the time and the money, do both.

Joe Stewart is a sports fanatic that writes articles on different topics that interest him. Would you like to get a 30 minute consultation with one of the countries best known trainers for golf improvement exercises if he was willing to skip his $150.00 an hour fee? You can get more Golf tips by going to http://www.GolfFitnessTips.net or by simply clicking on Exercises Golf Illustrations

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Bodybuilding Periodization: Bodybuilding Workouts without Bodybuilding Pain

Periodization is a very popular word in the bodybuilding and powerlifting worlds. It seems that every day we see an article promising us great gains through the use of this or that periodization scheme. We have old school linear periodization. We have new school Russian waved periodization, for example, by Boris Sheiko or Pavel Tsatsouline. We have Westside Barbell?s conjugate periodization. Well, get ready, because now we have yet another form of periodization: Pain Periodization.

What is Pain Periodization? Is it some new hardcore bodybuilding method? Is it the latest fitness fad? Is it some leftover practice of the Marquis de Sade? Is it a new reality game show? That would be three nos. It is simply a common sense way to schedule productive bodybuilding exercises that might otherwise be discarded. Read on and I?ll explain, but first let me illustrate the problem we are trying to overcome.

We all know that there are exercises that we both love and hate. For example, skullcrushers are one of the best triceps moves for getting those huge guns. Unfortunately, some of us also get nasty elbow pain after a few weeks of skullcrushers. It?s the same with presses behind the neck. Some of us swear by them for their ability to build cannonball delts. Some of us swear at them for their ability to produce rotator cuff pain. We all love the bench press, but not all of us can handle the shoulder strain the bench press can produce. Luckily, there is an answer. It?s called Pain Periodization. Let?s break it down.

Pain Periodization is a method of planning our workouts so that we can use our favorite exercises without letting the pain get out of hand. We use the exercise for a certain preplanned period, and then move on to something else. As James Brown would say, we ?hit it and quit it.? Let?s look at some examples.

For shoulder size, we might like the behind neck press. But after four or five weeks, the rotator cuff is so sore that it takes a month to heal. We have forsaken the behind neck press altogether and instead used machine shoulder presses. We?d like to do behind neck presses, but we can?t afford the pain and possible down time. By using Pain Periodization, we can have our cake and eat it too. We can start using our favorite shoulder exercise again and still retain shoulder health.

Here is an example 8-week workout plan using Pain Periodization.

? Weeks 1-2 Behind Neck Press

? Weeks 3-4 Machine Press

? Weeks 5-6 Behind Neck Press

? Week 7 Machine Press

? Week 8 Prehab/Rehab

In the above example, we used the behind neck press for 2 weeks only, then went to the machine press which we find easier on the rotator cuff. We don?t just keep using the behind neck press until our shoulder health is wrecked. In effect, we ?hit it and quit it.? In the second 4-week period, again we use the behind neck press for 2 weeks followed by the machine press. Also shown is an optional week of rehab or ?prehab? during which time we drop all heavy overhead pressing and focus on rotator cuff work and stretching. This one-week rehab phase can work wonders for our shoulder health.

Let?s look at another example using the bench press. We all want that big bench press, but we don?t want a blown rotator cuff. We can use Pain Periodization to allow us to work the bench press without wrecking our delts. Like this:

? Weeks 1-3 Bench Press

? Week 4 Machine Bench

? Weeks 4-6 Bench Press

? Week 7 Machine Bench

? Week 8 Rehab/Prehab

Are we getting the picture here? In both of these examples, the ?painful? exercise was alternated with an exercise that we find to be easier on the body. The examples were slightly different, but the main idea is the same. The pain producing exercises were used only for a short period, and then we switched exercises before the pain had a chance to accumulate. In essence, we ?hit it and quit it.? Try Pain Periodization. It may be just what you need to resurrect some of those forsaken exercises.

Randy Williams is an online personal trainer with 24 years of weightlifting experience. Please visit my blog at http://massactionheroes.com/ and sign up for my free newsletter and receive a 2-part free report on bread and butter bodybuilding set methods. Inquire about online personal training by emailing me at Randy@massactionheroes.com

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Achieving the Dream Quest for 90 MPH

The objectives of this program:

1.To achieve a velocity reading of 90 MPH or greater on the JUGS Radar Gun.

2.To apply all available linear force to the back of the baseball.

3.To maintain a healthy and strong arm, while being able to pitch 2-3 times per week.

Variables that effect throwing velocity in baseball pitchers:

1.Applying direct force to the back of the baseball.

2.Flexibility in pelvis during balance/acceleration phase of pitching motion.

3.Lead leg stability after foot plant.

4.Torso rotation during acceleration.

5.Use of scapular muscle used during pitching motion.

6.Elbow/bicep extension during the pitching motion

7.Break/release to plate.

8.Rotator cuff strength and durability

9.Use of forearm during pitching motion.

10.Use of available force from wrist during pitching motion.

The Program:Achieving the Dream:Quest for 90 MPH

In this section, each velocity variable will be addressed and discussed. Exercises will be provided to improve strength and precision in each domain. Data from previous research will be documented to provide creditability to the exercises listed. At the end of this section, the program?s schedule will be clearly illustrated to inform coaches on the specific time commitment required to successfully complete this program.

Velocity Variable #1Applying direct force to the back of the baseball with correct arm action
The application of direct force to the baseball is illustrated with elbow circle break of the pitching hand right before acceleration. With the elbow circle break, the ball never travels out of a straight line with the plate. The pitcher?s fingers should always stay behind the ball. Pitchers need to fire their relaxed pitching elbow down and around toward 1st base. This may come into conflict with many pitching coaches mythology of the high cocked arm position during the balance phase of the pitching motion. But by evaluating action photos of many elite pitchers like Kerry Wood, Mark Prior, Nolan Ryan, and Roger Clemens it is clear to see that these throwers consistently stay behind the ball through the throwing process. Also, these pitchers achieve full extension in front of their body through an elbow angle of less than 90 degrees as their hand travels pass the ear during the acceleration phase. The following exercises promote staying behind the ball and increasing straight-line strength:

A.Weighted Baseballs(Set of three: 4oz, 5oz, and 6oz)
B.Stretch Cord

Velocity Variable #2Flexibility and strength in the pelvis during balance/acceleration phase of pitching motion
Through research it has been documented that the pelvis is one of the most important body parts in promoting velocity. In fact, during a 2003 study by T. Inohiza he incorporated the ?Matawari? stretch routine to his daily exercise schedule. During a three-month period he was able to gain 12.42 MPH on his fastball. Moreover, the stretching also helped his bat speed. Stodden and colleagues (2001) also studied the effects of the pelvis on velocity and concluded that with a higher pelvic velocity a pitcher could throw harder during his delivery.

A.Groin Stretch
B.Hip Flexor Machine
C.Hamstring Curl

Velocity Variable #3Push and Lead leg Stability
The strength and stability of pitchers lower body has been proven to be very important for throwing velocity. In 1998, Bruce MacWillams conducted a study that examined ground reaction forces during the pitching motion. The study?s results indicated that leg drive is a significant factor in pitcher?s throwing velocity. The push motion in the delivery is not the only important action of the lower body. The lead leg that blocks forward movement is also an essential element in a pitcher?s throwing velocity. In a 2001 study, Matsuo found that high velocity throwers were able to plant and extend the lead knee to provide stability to the pitching motion. In addition, the Lexington Clinic was provided an outline evaluating kinetic movements. They included a .89 correlation between throwing velocity and lower body strength. The following exercises promote strength and extension of the lower body:

A.Lunge
B.Squat
C.Clean and Jerk
D.Calf Raises
E.Leg Press
F.Leg Curl

Velocity Variable #4Torso rotation during acceleration
The speed and strength of a pitcher?s torso is another key element in throwing velocity during the pitching delivery. In the September 2003 edition of Coaching Management magazine, former White Sox Strength and Conditioning Director Vern Gambetta, acknowledged that the torso plays a key role in getting the arm in the proper throwing position. In addition to Gambetta, Arnel Aguinaldo, from Children?s Hospital San Diego, conducted a study, which proposed that larger body segments create most of the velocity in throwing. Speed of the trunk is not the only aspect of torso that needs to be developed. Late trunk rotation is a movement that can help increase force applied to the ball along with keeping the arm healthy and safe. Jordana Bieze reported in the June 2004 issue of Biomechanics that collegiate, high school, and youth pitchers rotate less than 15% of their way through the pitching motion. Rotating too early can produce added strain to the arm and shoulder. The following exercises promote strength, increase speed, and delayed rotation of the torso during the pitching delivery:

A.Medicine Ball
B.Total Abdominal Work
C.Leg Lifts

Velocity Variable #5Use of scapular muscle used during pitching motion
The scapular muscle is an under utilized muscle by developing pitchers. The muscle is not developed because many pitching coaches believe weight training, specifically upper body resistance training, tends to promote injuries and will not produce higher pitch velocity. Robert U. Newton and Kerry I McEvory, from the Centre for Exercise Science at Southern Cross University conducted a study, which compared an upper body resistance-training group to a group that performed medicine ball exercises. The 8-week study found that the upper body resistance-training group was able to produce a higher pitch velocity than the medicine ball group. In 2000, Donatelli published a study in the Journal of Orthopedic and Sport Physical Therapy. The study suggested that the strength of the scapular muscle could play a vital role in preventing injury. The following exercises promote strength in the scapular muscle and provide general upper body resistance training:

A.Bench Press
B.Seated Row
C.Lat Pull Down
D.Push Up
E.Dumbbell Flys

Velocity Variable #6Elbow/bicep extension during the pitching motion
According to a 2001 Fleisig and Andrews?s study, elbow extension is one of the four key elements found in high velocity pitchers. Elbow extension occurs during the acceleration phase of the delivery right before release. High velocity pitchers like shot putters, typically pronating their pitching arm and extending through release. The following exercises promote strength and increase speed of extension:

A.Use of the Shot Put(4lbs)
B.Shoulder Press
C.Tricep Pulldown (Standing/Sitting)

Velocity Variable #7Break/release to plate
While examining a Major League pitcher?s delivery it is easy to see the smooth and ease of their motion. Although, each pitcher has different styles, they all possess a certain rhythm that makes their movements look natural. This is not a born characteristic. It is learned throughout their career by constant practice and repetition. In 2001, Stodden found that pitchers who practiced consistent mechanics created higher throwing velocity in their pitches. Moreover, the pitching mound resides 60?6 from home plate. If a pitcher can cut that distance down and release the ball closer to home, a pitcher can gain added pitching velocity. Moreover, to improve mechanics pitchers need to produce the same throwing action during the delivery, but not create undue stress on the pitching arm. During an ASMI study, they concluded that throwing at 50-75% can be beneficial to pitchers because they are able to reproduce actually delivery, but not game ?like stress on their throwing arm. Dry mechanical and towel drills let pitchers recreate the pitching motion to improve techniques. Stamina is another variable this domain works to improve. According to an article by Medco Sports discussing Elbow and Shoulder Problems in Youth Baseball Players, using the kinetic chain can help pitcher use less energy. The kinetic chain is the proper sequencing of body movements in the pitching delivery. The chain includes seven body segments: legs, pelvis, spine, shoulder girdle, upper arm, forearm, and hand. Using dry or towel mechanic drills can only encourage the proper sequencing of the kinetic chain. The following exercises promote consistent mechanics, while helping pitchers release the ball closer to home plate:

A.Towel Drills:Total Delivery, Stretch, Bounce, Bounce, Reach, Grab/Circle Drills
B.Dry Mechanical Drills:Cross Arm, Stretch/Pull, and 3 Point Line Up Drills

Velocity Variable #8Rotator cuff strength and durability
The rotator cuff is a key contributor to the overhand throw. Pitchers must maintain a strong and healthy rotator cuff if they want to be successful on the mound. In fact, in an outline of kinetic movements by the Lexington Clinic, they found that the shoulder is responsible for 21% of the force placed on the ball. If a pitcher can strengthen this muscle, it is easy to see how pitch velocity can be added. A University of Hawaii review of literature can back up this claim. It was reported that Toyoshima conducted a study and concluded that 53.1 % of an overhand throw velocity was due to the action of the arm. In another 2001 study by Galloway and Koshland, their worked focused on finding a pattern in shoulder or elbow centered activities. Their findings suggested that shoulder-centered activities were illustrated with straight or curved finger paths. Since the pitching motion requires straight and curved finger action, strengthening the shoulder and corresponding tendons should provide optimal velocity results. Furthermore, in a 1996 comparison performed by Fleising and colleagues, he found that quarterbacks and pitchers perform many of the same movements. In was concluded that cross training between throwing activities can be beneficial to players in both sports.

A.Arm Swings
B.Jobe Exercises with 2lb dumbbells
C.Football Throws from 20 yards

Velocity Variable #9Use of forearm during pitching motion
The forearm is vital to achieve high velocity in the pitching delivery. In Will Carroll?s 2004 book Saving the Pitcher; he discussed the use of the forearm in the pitching motion. During the acceleration stage, the pitcher?s forearm will pronate, giving the ball its last bit of energy. Dr. Joshua Dubin explained in his #13 Injury Management Update on Pitcher?s Elbow, how a flexed wrist will activate the forearm flexors during the release of the baseball. Even the most inexperienced pitcher can tell that the forearm lends to force during the pitch. By keeping a hand on the throwing forearm and moving the throwing fingers, a pitcher can feel the movement inside the forearm. By developing the forearm muscle, pitchers will be able to powerfully pronate their arms during this stage in the delivery. The following exercises promote muscle development in the forearm muscle:

A.Forearm Curls with Bar
B.Reverse Forearm Curls with Bar
C.Hammer Curls with Dumbbell

Velocity Variable #10Use of available force from wrist during pitching motion
The wrist is a very important lever in the pitching motion. In fact, Norihisa Fujii from the University of Tsukuba concluded after a 2002 study that wrist flexion and strength are major contributors for increasing throwing velocity. In addition, many pitching coaches have incorporated a ?wrist flick? during their throwing warm up progression. The Lexington Clinic reported that the wrist accounted for 10% of the force applied to the baseball during the pitching delivery. Force is not the only function the wrist may perform. Many pitching instructors agree that proper wrist movement can help a pitcher?s control and command of pitches to their target. The following exercises promote strength and increase speed of wrist motion:

A.Weighted Balls(12oz)
B.Hand Grip/Tennis Ball
C.Shot Put Flips(4lbs)
D.Wrist Rolls

Council Bluffs (IA) Abraham Lincoln High School

9-Week Schedule

Monday
Groin Stretch(Morning/Night)Shot Put Flips
Hip Flexor Machine Hamstring Curl
Squat Clean and Jerk
Bench PressShoulder Press
Tricep PulldownLat Pulldown
Arm Swings with Baseball (20/20)Jobe Exercises (Frontal, Lateral, Elbow Ex.)

Tuesday
Groin Stretch(Morning/Night)Vertical Jumps (5 X 10)
Side Jumps(5 X 10)Weighted Ball Workout (Arm and Wrist)
Stretch CordLunges
Tennis Ball Squeeze (100)Calf Raises
Medicine Ball (Weight Transfer)Leg Curls

Wednesday Groin Stretch (Morning/Night)Shot Put Flips
Hip Flexor MachineLeg Lifts
Hamstring CurlWrist Rolls
Reverse Forearm CurlsHammer Curls
Medicine Ball (Rotation)Push Ups
Arm Swings with Baseball (20/20)Jobe Exercises (Frontal, Lateral, Elbow Ex.)

Thursday
Groin Stretch(Morning/Night)Vertical Jumps(5 X 10)
Side Jumps(5 X 10)Weighted Ball Workout (Arm and Wrist)
Stretch CordLunges
Tennis Ball Squeeze(100)Calf Raises
Medicine Ball (Weight Transfer)Leg Curls

Friday
Groin Stretch(Morning/Night)Shot Put Flips
Hip Flexor MachineHamstring Curl
Forearm Curls with BarDumbbell Flys
Bench PressSquats
Clean and JerkLeg Press
Arm Swings with Baseball (20/20)Jobe Exercises (Frontal, Lateral, Elbow Ex.)

Saturday
Dry Mechanical Drills
Towel Drills
35 Mini Football Throws (20 Yards)

Sunday
OFF

Exercise Series
?Three sets of ten on each exercise
?Three sets of ten seconds each during the Groin Stretch Activity hold for 20 seconds each
?Weighted Ball Workout Below

Weighted Ball Workout

Week 1-2TTHTotal ThrowsSequence of Throws

549-18-18-9 (5oz-6oz-4oz-5oz)

Week 3-4TTHTotal ThrowsSequence of Throws

6010-20-20-10 (5oz-6oz-4oz-5oz)

Week 5-6TTHTotal ThrowsSequence of Throws

6611-22-22-11 (5oz-6oz-4oz-5oz)

Week 7-8TTHTotal ThrowsSequence of Throws

72 12-24-24-12 (R-O-U-R)

Week 9TTHTotal ThrowsSequence of Throws

78 13-26-26-13 (R-O-U-R)
Replication of Decker Sports Training Manual

*Optional

*Week 10TTHTotal ThrowsSequence of Throws

549-18-18-9 (6oz-7oz-5oz-6oz)

*Week 11TTHTotal ThrowsSequence of Throws

6010-20-20-10 (6oz-7oz-5oz-6oz)

Materials

1.Stretch Cord3ft or comfortable length
2.Weight room AccessSchool or Local Weight room
3.Medicine Ball8lbs
4.Mini FootballSmaller size than standard
5.Weighted Balls 4oz, 5oz, 6oz
6.TowelKitchen or Bath
7.Shot Put4lbs

Methods

The purpose of this workout is to help developing players achieve maximum throwing velocity. Each daily workout isolates the body parts that function during the delivery of a pitch. All of the exercises listed needs to be performed at 100% intensity. The only way a player can gain strength is to push themselves beyond their current level of resistance. For motivation, coaches should test players throwing velocity with a radar gun every three weeks. Players should view the results and analyze their dedication and commitment to the program. A majority of players should receive positive feedback from testing if they are fulfilling the program?s requirements at a high intensity level. Also, this testing gives players the opportunity to create short-term goals. To maintain muscle memory, players should try and play 10-15 minutes of regular long toss twice a week. An emphasis should be placed on a circular elbow path, front side shoulder tilt, and pull down. If a player experiences shoulder pain during their workouts, they should stop the exercise immediately. If the player?s shoulder pain persists, they should seek medical attention.

References

Bieze, Jordana. Early trunk rotation may affect shoulder load in young pitchers. Biomechanics, 6:04, 2004.

Carroll, Will. Saving the Pitcher: Preventing Pitching Injuries in Modern Baseball, Ivan R. Dees, 2004.

Donatelli, R., Ellenbecker, T., Ekedahl, S., Wilkes, J., Kocher, K., and Adam, J. Assessment of Shoulder Strength in Professional Baseball Pitchers. Journal of Orthopedic Sports Physical Therapy, 30(9) 544-551, 2000.

Dubin, Joshua. Medial Epicondylitis. Injury Management Update. Information obtained from http://www.dubinchiro.com

Fujii, N, Hubbard, M. Validation of a three-dimensional baseball pitching model. Journal of Applied Biomechanics, 18:135-154, 2002.

Galloway, JC, Koshland, GF. General Coordination of Shoulder, Elbow, and Wrist Dynamics during Multijoint Arm Movements. Physiological Sciences Program, University of Arizona, 142(2) 163-180, 2002.

Gambetta, Vern. Mound Muscle. Coaching Management, 11:06, 2003.

Information on Toyoshima?s report obtained from http://www.drkochno.com/pitching.htm

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