There are lots of similarities in the dysfunctional or painful shoulder. In general, most of these young men and women sit at the top of the heap in their overall size, strength, and powerBaseball Player Throwing Baseball in Stadium capabilities. This is a great advantage to have over your competition, but in many cases, like the ones we often see, these strengths expose many different weaknesses.

The one we’re highlighting here is “ipsilateral thoracic spine rotation lack.” We call it ‘thrower’s spine.’ During normal trunk rotation and shoulder horizontal abduction (think cocking the throwing arm), the t-spine and ribs should rotate and angle themselves back toward the direction of the dominant arm. More often than not, this lack of dominant side rotation is very apparent in our painful or dysfunctional baseball and softball players.

If you are working with throwing athletes, be sure to check and address this aspect of their movement econ. This lack of mobility will ask the shoulder to produce the remaining mobility needed to complete the throw.

As previously discussed, the movement economics of asking the shoulder to do what the t-spine should be doing is obvious. We’re taking an activity that by itself is already violent and difficult and therefore very movement costly and adding more ways to waste movement capital. Unless the movement account is VERY BIG, there won’t be too many throws before you are overdrawn.

Knowing what other mobility or stability issues exist in your athletes is very important. If ‘thrower’s spine’ isn’t the most significant movement econ issue, this mobilization won’t deposit the most considerable lump sum to the movement account. If it is, then here is an excellent first-line treatment and home exercise that we use with great effectiveness: the side-lying t-spine rotation (documented as SL T/S rot):

Have the athlete lie on their non-dominant side. If they are right-handed throwers, they should be lying on their left. Next, they should maximally flex their hips up toward their chest as in the ‘fetal’ position. This posture ensures that all subsequent rotation happens at the t-spine and not with help from the hips or lumbar spine. Lastly, the athlete will place their hand behind their head or reach straight ahead with their dominant arm as if pushing away from their chest. The set-up is complete.

The mobilization is simple: The athlete will turn their head toward their dominant side as far as possible. Once the cervical spine is maximally rotated, begin to track the elbow or arm in as big of an arc as possible toward the dominant side. The position is held once the barrier to continued rotation is met; a long five count is fine. There shouldn’t be pain at this time, but restriction to further movement or an urge to lift the knees is normal. Keep the knees together and the bottom knee in contact with the ground/plinth. The mobilization should be done x10, and then t-spine rotation should be reassessed in standing. If there is a major difference between the two sides, mobilization should be done more toward the deficient side.

Note: There are some pretty high-quality videos available if you search 'side lying thoracic spine mobilization.'

This movement econ strategy should add the funds necessary to get you or your athletes back on the hill.

Be well.