What Is Assessment Based Arm Care?

Arm care has become commonplace in baseball. Players and coaches at all levels now appreciate the importance of a good dynamic warm-up and strengthening the shoulder, which is lightyears ahead of where we once were. In case you don’t remember, running poles and a bag of ice was the extent of arm care not too long ago.

Much of the change is from developing research showing that both velocity and risk of injury are associated with arm strength and range of motion. The problem is that most arm care is a cookie-cutter approach with the hopes to cover it all with broad strokes.

General arm care is better than nothing, but if you are going to dedicate the time and effort, why not optimize it for maximum return. In meeting the specific needs for players, an assessment-based approach is necessary to customize programming rather than a one-size-fits-all approach.

In this artical, we’ll highlight the importance of assessment-based arm care and indicate how it refines players’ routines which is a vital aspect in physical preparation and performance enhancement.

The Birthplace of Assessment Based Arm Care

All 30 MLB organizations test their player’s shoulder strength & range of motion regularly. They’re not likely to share their secrets or methods since it’s something that gives them a competitive advantage. Yet, we know that it’s getting done based on the latest research and our relationships with the medical staffs involved.

What caught our attention is that arm assessments were only happening with the elite few. And despite the evidence showing its importance, college, high school and youth players were being left out to dry.

As with everything, a lot of it comes down to time, money and people. Organization with large budgets have large medical and strength staffs that can support arm care initiatives. However, despite advanced support, injuries are still rising, even at the professional level (reference Conte 18 year study and Erickson Trends in Medical UCL Surgery). This is possibly a result of missing observation windows, where a coach who is building at team with limited time, money and staff can have the athlete perform arm care assessments everyday with our ArmCare app and therefore, minimize gaps in time points for assessment and allow for customizable programming to happen all the time.

Even if a coach does decide to make it a priority, it needs constant monitoring and analysis to break down the good and bad, and to make actionable recommendations based on the issues that come up.

The Arm Care app assists both coaches and players in decision making, as both stakeholders are guided through shoulder strength and range of motion exams which exports individualized arm care programs designed to build stronger and more durable arms.

The Tools for Testing

Delivering assessment based arm care to the masses first requires the right tools to make it happen—starting with a measuring device.

Accurate strength measures requires a dynamometer, which is a scientically-valid tool to measure muscle force.

The Activ5 is highly accurate solution that offers all the advantages of a high end dynamometer and puts it in the palm of your hand. It can be travelled anywhere, from home to the ball park and anywhere in-between. Strength testing has never been easier and so accessible in the history of the game.

At only $245 for the Activ5 dynamometer, attachment straps, range of motion chart, and one year access to the Arm Care app, players can get accurate and real-time information to gauge their arm health and strength.

Assessment-based arm care isn’t merely collecting numbers. It’s about making actionable decisions based on measurement outcomes. The app expedites time in decision making and doesn’t require a medical staff and analytics team to determine what a player needs to do in training.

Advanced Testing Equipment for a Fraction of the Cost

Medical-grade strength testing devices usually cost over a thousand dollars.

The ground breaking Activ5 dynamometer is just as accurate and at a price anyone can afford.

Using Assessments to Build the Perfect Arm Care Plan

Assessment-based arm care uses quantified data and player feedback to build and prioritize a training plan.

There are four variables to consider in customizing a player’s program:

  1. Player Profile- This accounts for the player and their current circumstances. Some are very simple and grow with time, such as the player’s age and their arm care experience. Other characteristics fluctuate, such as their current season. This will impact the training volume and frequency that is prescribed.
  2. Exam Results- Strength and range of motion data provide a wealth of information regarding a player and their needs.
    • Strength- The ability to base a program off of actual strength numbers, allows a player to work on specific weaknesses and then push their training harder when ready. For example, if a player’s strength measures a deficiency or imbalance for their posterior rotator cuff (the decelerators), training should prioritize this until corrected. Whereas, a player with good arm strength that’s well balanced, a functional program that prioritizes other links in the chain is most appropriate. Some may not consider things like hip and core training as part of arm care, but the evidence shows that it’s important to consider [Link to Hip & Core Article].
    • Range of Motion- It’s been well established that range of motion changes are common with baseball players due to the stresses of throwing. These changes can limit a player’s performance and put them at greater risk for injury if left unaddressed. Assessing discrepancies such as comparing the throwing arm to the non-throwing arm, show how a player is adapting to both their acute and chronic workloads and helps to adjust the plan.
  3. Player Feedback- We can’t just use the objective results from a players assessment to deliver individualized arm care protocols. Competitive schedules and throwing workloads can affect how players’s throwing arms feel, and coupled with any discomfort felt by the athlete, the most appropriate programming can delivered at the right time. To deliver the proper program, we need to know if the player pitched today (or had a heavy throwing workload). If they did, they would get a recovery based post throwing arm care program. In addition to the active recovery program, the player would be put on a program to restore their internal rotation range of motion (unless they have excessive ROM) for the next few days. It is well known that players lose significant internal shoulder rotation range of motion following an outing. If it is not properly addressed, the deficit can accumulate with throwing over the season and puts the player at higher risk of injury. Internal rotation loss signifies a capsular restriction at the back of the shoulder and this is related to SLAP tears and other disorders of the shoulder (reference the Burkhart papers on scapular dyskinesis). We also need to know if they are pitching tomorrow. The last thing you want to do is crush the rotator cuff with strengthening exercises the day before an outing. Player feedback is also essential for managing sore or tight in their medial epicondyle, being the bony bump of the inner elbow, or the ulnar collateral ligament (UCL), which is the ligament repaired by Tommy John Surgery. If they are tender, the player needs to communicate with the coach and see a sports medicine official immediately. DO NOT THROW THROUGH PAIN.
  4. Risk Monitoring- Pitching while fatigued is the number one risk factor for throwing-related injuries. The American Sports Medicine Institute (ASMI) is the leading research think tank focused on baseball injuries and they found that adolescent pitchers who undergo elbow or shoulder surgery are 36x more likely to have routinely pitched with arm fatigue. If the populate studies had the Arm Care app and could accurately detect fatigue, it is likely that the injured population would be reduced in this study. Changes in strength and range of motion have to be observed frequently for best results.

The Assessment Process

The Arm Care assessment only takes 6-minutes and it doesn’t require any assistance from a medical professional or a coach.

The exam can be completed at home or at the field using the testing equipment (Activ5 dynamometer & ROM Chart) and following the videos and audio prompts on the App. Typical assessment are taken weekly, but athletes and coaches can initiate testing at anytime during the season to continue to monitor progress and fatigue.

Following the assessment, a player will receive a detailed report card with metrics on their strength and symmetry as well as trends based on previous exams.

For players who are wanting to engage in a weighted ball velocity program, the report card also provides a 20 point arm diagnostic. The Pre-Velocity Program Screen provides a simple Pass or Fail as well as a detailed description for each diagnostic.

Maximize Your Arm Care Plan

The most effective arm care program extends far beyond simple band work to prep for throwing. A daily assessment should dictate the prep, recovery, and strengthening to address the most pertinent issues affecting a player’s arm that day. Treating acute problems and then layering in the necessary strength training at the optimal time allows one to take advantage of a high performance program designed for a high performance arm.

The Assessment-Based Arm Care Program include:

  1. Prep- Specific prep work is necessary to address any sore and tight areas for a player to meet their training demands that day. Following the individualize prep, a dynamic warm-up will activate essential muscles for total body performance.
  2. Recovery- A high-level training program must also include techniques to promote rejuvenation and to keep the arm and body fresh. These strategies include stretches, massage, exercises, nutrition, hydration, and sleep.
  3. Strength- It’s important to build strength, speed, and conditioning of the key stabilizers to protect and develop the arm. For some players, this can fit alongside a strength training program completed at the gym, whereas others may do this when at the field. Either way, the assessment process should be used to identify any weak links and to push training when the time is right.
  4. Hybrid- The Hybrid training days are a combination of strength and recovery and are used to deliver functional strengthening that doesn’t specifically target the rotator cuff muscles.

The Future of Arm Care

Baseball players are currently flying blind when it comes to knowing what their arm needs. Most people find their arm care online, or provided by their coach and may be not be receiving what their arm specifically needs.

As the old adage goes, “If you’re not assessing, you’re guessing.” In 1982, Orthopedic Surgeon,  Dr. Frank Jobe introduced the first arm care program which has been later adapted into the Throwers Ten Program (http://www.youthpitching.com/exercises.html). Although shoulder injuries have declined, elbow injuries have risen in the nearly 40 years that arm care has been available to baseball players. A possibility exists that general programming may further muscular imbalance since up until this point, measuring equipment was not made accessible to the community of athletes who play the game. As a result, working with 3-5 lbs weights, or light bands may not be an adequate enough stimulus to prevent injury.

ArmCare.com takes guesswork out of the training equation and delivers a program to players that is specific to their needs.

Your arm is important to us and it should be to you. Use the app, stay healthy, gain valuable game experience and reach your true competitive potential.

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