I often have parents of young baseball players in Las Vegas ask me about training their child in a “baseball specific” program and working on the shoulder or rotator cuff. A “baseball specific” program…mmm….really. Ok you want your son to: 1. Run fast? (That’s important in every sport!!) 2. Have superior hand eye coordination for catching? (Again all sports) 3. Have a strong core and rotational strength for hitting? (EVERY sport) 4. Be able to decelerate and change direction on a dime! (mmmm…..do I really have to say it?) 5. Ok….last but not least, “strengthen the shoulder/rotator cuff” (A strong AND stable shoulder is important for everyone, not just athletes!!!) Ok so you think that’s a “baseball specific workout” if he just works on the rotator cuff? So some may ask, why should the baseball player be working on the rotator cuff? Is it because baseball is an overhead sport, like a swimmer, tennis player or a QB in football, and more demand is placed on the rotator cuff (and the entire shoulder joint for that matter)? Well the answer is yes!! But would that make it a tennis or swimming program also? Why not just make it a “build a healthy superior athlete” program? What a player or parent must relies is that there is more to a strength and conditioning program for baseball players that just a healthy shoulder or rotator cuff! OK…now on to the boring science stuff! The two main bones of the shoulder are the Humerus and the Scapula. Let’s talk about the scapula and consider why the scapula is important? Normal shoulder motion involves a coordinated rhythm between movement of the shoulder blade on the chest wall and movement of the ball in the shoulder socket. This is called the “scapulohumeral rhythm.” Because the shoulder socket is part of the scapula, many conditions involving the shoulder joint cause secondary problems related to scapular motion and position. These secondary problems can, in turn, worsen the primary condition. Next let’s take a look at the scapulothoracic joint, it is one of the least congruent joints in the body. No actual bony articulation exists between the scapula and the thorax, which allows tremendous mobility in many directions, including protraction, retraction, elevation, depression, and rotation. The lack of bony attachment predisposes this joint to pathologic movement, and, consequently, makes the glenohumeral joint highly dependent on the surrounding musculature for stability and normal motion. The scapula is attached to the thorax by ligamentous attachments at the acromioclavicular joint and through a suction mechanism provided by the muscular attachments of the serratus anterior and subscapularis. This suction mechanism holds the scapula in close proximity to the thorax and allows it to glide during movements of the joint. While many muscles serve to stabilize the scapula, the main stabilizers are the levator scapulae, rhomboids major and minor, serratus anterior, and trapezii. The glenohumeral “protectors” include the muscles of the rotator cuff: the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscle groups function through synergistic cocontraction to anchor the scapula and guide movement. The scapula moves through a gliding mechanism in which the concave anterior surface of the scapula moves on the convex posterolateral surface of the thoracic cage. These muscles work together to coordinate the balance of movement between the shoulder joints, thereby maintaining scapulohumeral rhythm. When the muscles are weak or fatigued, scapulohumeral rhythm is compromised, and shoulder dysfunction results. This dysfunction can cause microtrauma in the shoulder muscles, capsule, and ligamentous tissue and lead to impingement. During all movements of the glenohumeral joint (especially movements involving more than 90° of flexion or abduction), it is of paramount importance that the scapular-stabilizing musculature be strong enough to properly position the scapula. So is it really just about the rotator cuff when training a baseball player? Think about it, this is just a little piece of the puzzle. What about the rest of the body? Brian Van Hook MS CSCS Van Hook Sports Performance Training Las Vegas, Nevada