By Josh Boggs
This has become a theme with the throwers I’ve been working with in-house at Prime Performance and is a very common question I receive on twitter. I’ve had several athletes tell me bicep pain is the worst pain they ever have when throwing. So, I shall try to some potential reasons why, from a movement and mechanical perspective, your bicep hurts and potential ways to correct the issue.
Why Bicep Pain Is Bad
Plain and simple: it HURTS. BAD. It also is a likely precursor to bigger issues, namely in the elbow and shoulder. Because the bicep is a muscle, it’s highly likely the bicep isn’t going to be what eventually tears or breaks. Eventually it’ll likely be either a UCL tear from the poor deceleration pattern that’s likely an issue or, because of where the bicep tendon attaches in the shoulder, it becomes a labrum issue. Needless to say, not something you want. Simply put, bicep pain is something to address, not put off.
What’s Causing the Issue?
The first thing I ALWAYS look at when an athlete is complaining about pain when throwing is their assessment. Even before I break out the camera and look at high-speed video, I want to see how the athlete performs even the most basic of movements. If an athlete struggles to perform a proper squat, single leg-raise, or lacks shoulder mobility, you can expect them to struggle to move well on the mound and, as a result, deal with some pain. In-house, we have a very high correlation between throwers experiencing bicep pain and a lack of shoulder internal rotation. So, what does this mean? In a nutshell, if you cannot internally rotate at the shoulder, your bicep takes on a lot of eccentric force to slow down both the humerus and the forearm. Since throwing a baseball is the fastest movement in sports (can be up to 8,000 degrees per second, even 6,000 degrees per second in youth throwers), you’re asking your bicep to do a lot of work in slowing that motion down if you’re limited in either strength or controllable range of motion.
When we look at throwers with high-speed video, some things we’ll normally see, assuming the athlete can’t internally rotate for whatever reason, may include:
premature elbow extension
complete elbow extension before release
throwing elbow crossing the midline of the body
athlete’s “cutting” the ball
lack of pronation through release
among other things.
How Do We Fix It?
Well this answer is a little complicated because…. It depends. Every athlete is different and moves different. Which is why it is critical that you ASSESS every thrower you work with. As I mentioned before, based off our in-house findings, the predominant theme is a lack of shoulder internal rotation. How do we fix internal rotation? Again, it depends. What we see in most of our athletes is poor rib positioning and a lack of activation in the serratus anterior muscle. Some long-term solutions include reaching work in their training as well as in the athlete’s pre-throwing routine to strengthen and prepare the muscles to do their job. Adding some reaching work can sometimes allow the coach to “correct” the pattern, if only for a short time before the brain reverts to the old pattern. In that window of time we can train the “correct” pattern and build some strength and coordination in that pattern. This is all assuming it’s a movement function/pattern issue and not just a mechanical flaw.
If it is deemed a mechanical flaw that isn’t because of a deficiency elsewhere, overload baseballs and wrist weights become the focal point in training. Wrist weights especially can allow us to simultaneously train the posterior shoulder muscles eccentrically as well as promote a more proper deceleration pattern. Overload balls in the pivot pickoff drill, also promoting proper deceleration and arm path can correct the issue over time.
In conclusion, your bicep pain could be caused by a myriad of issues and there is no quick fix. It’ll take some work, but bicep pain is not something to overlook. And whether your dealing with bicep pain or any other kind of pain, I believe I have given you a solid plan to fix it. Assess your movements and mechanics, find your deficiencies, work to improve them. If you’ve never been assessed, I’d recommend finding a local PT or trainer who is qualified and get one done ASAP. With the winter quickly approaching, have a PLAN to fix your pain. Because I can guarantee you, it won’t go away on its own.