With the 2023 Major League Baseball season about to get underway, Lawrence V. Gulotta, M.D., will be busier than ever as the head team orthopedic surgeon for the New York Mets. And, as he’s also a serving member of the School for Special Surgery (H.S.S.), it isn’t just pro athletes that he works with.
Alas, spring is a time when the weather begins to turn a little milder and the number of daylight hours increase, and with this great news comes the motivation to go all in on outdoor sports—or even just workout a little more. But, as Gulotta is all too aware, getting back into game shape is something that should be treated with great care, no matter what PRs we were hitting last year.
M&F sat down with the sports medicine practitioner to find out how we can protect ourselves and avoid injury as we spring back to fitness, the New York Mets way.
1. Always Warm Up
Warming up is one of the most spoken about, and yet most underutilized aspects of preventing injury, says the expert. “Warming up is an important ingredient in improving performance and preventing injury,” notes Dr Gulotta. “Most veteran Mets players have a pregame or workout routine that involves some element of cardio, and then a muscle activation program that ‘warms’ up those muscles that will be required to perform.”
2. Be Flexible
If you’ve been enjoying the offseason a little too much, you may have found that being sedentary has decreased your flexibility, and this can lead to injury sooner rather than later. “Flexibility is important to prevent injury and to increase performance,” says Gulotta. “However, it is equally important to ensure the muscles around the joint are strong enough to support that range of motion. Having the strength to control a joint throughout its entire range of motion is what we call ‘owning that motion.’ Often, adolescent baseball players will have a lot of flexibility, but they do not have the core strength to control that flexibility.”
Gulotta says that building strength around the core, and focusing on flexibility through stretching and functional exercises will aid in protecting joints like elbows and shoulders. And, when it comes to elbows and shoulders, he’s one of the most knowledgeable doctors on the field, serving as the chief of the shoulder and elbow division at the Sports Medicine Institute within the H.S.S. This sports scientist has spent a great deal of time looking into why throwing a ball can be a hazardous task.
“Overhead throwing is not a natural motion for the shoulder,” he says. “Our shoulders were made so that our arms swing by our sides when we walk. They were not made to throw a ball overhead. Therefore, the forces placed on the shoulder and elbow during the throwing motion put them at risk of injury. Recently, players are bigger and stronger, and the training techniques are so good that they are able to generate a tremendous amount of force. That is why we are routinely seeing Major League Baseball pitchers who are throwing in the high
90s mph. This additional force puts the stabilizing ligaments and muscles around the shoulder and elbow at risk for injury.”
3. Focus, Just Don’t Overtrain
“Overtraining can lead to wear and tear that can then result in injuries over time,” says Gulotta. “Remember that baseball players do not train to specifically gain muscle. They are training to improve their performance. Their performance improves by gaining strength, but also by gaining core stability, flexibility, explosiveness, and hand-eye coordination. Their training program takes all of these things into consideration.
The other part is that they concentrate on functional movement exercises that mimic the activities they will need to perform in a game. These exercises utilize multiple joints and muscles. This not only improves performance in the long term, but it also avoids overtraining any one body part by performing isolated strengthening exercises, such as the bench press.
4. Understand the Mechanics
“The shoulder and elbow are different joints,” explains Gulotta. “The shoulder is a ball and socket joint, whereas the elbow is a hinge joint. However, both of these joints need to be stable in order to throw a ball. For the shoulder, the main stabilizers are the labrum (a type of cartilage) and the rotator cuff. The elbow is stabilized by the way your bones of the humerus and ulna interconnect, and the ligaments.
The main stabilizing ligament of the elbow is the one on the inside of the elbow called the ulnar collateral ligament (UCL). Injuries can occur as these joints start to lose stability either due to extreme efforts to throw hard, or due to wear and tear over time. That is why we see tears of the labrum and rotator cuff in the shoulder, and stress fractures and spurs of the bone and UCL tears in the elbow.”
5. Use Resistance Bands for the Long-term Win
“Resistance bands are a great way to strengthen the shoulder because they allow you to work in various positions and ranges of motion,” Gulotta explains. “For example, a great exercise for a baseball player is to work on internal rotation and external rotation strengthening with the arm in the 90/90 position overhead. That position mimics throwing a ball overhead and will help the athlete to work on strengthening and stabilizing the shoulder throughout the motion required to throw. In other words, resistance bands allow athletes to gain strength throughout functional ranges of motion.
6. Get the Balance Right
“Deconditioning (during time off) is real, and puts athletes at risk of injury as they start to ramp back up for the season,” Gulotta shares. “However, 12 months of constant intense training, especially for pitchers, can be bad too. Most athletes decrease their workload for about two months in the offseason. They will still maintain their flexibility and core strength during this time. They will also adhere to a nutrition program. This allows them to maintain their conditioning, but also allows them to recover. This relative period of rest is necessary to prevent wear and tear type injuries, and is something that should be observed at all levels, particularly in youths. About six to eight weeks before reporting to spring training, players will begin to ramp up their own training. They will begin to do more sport-specific activities such as throwing or hitting. This is all a gradual process that will continue throughout spring training. Perhaps the greatest risk for injury is a training ramp-up that is too fast.”
7. Injured? Don’t Just Pick Up Your Ball and Run Home
“There are several exercises that can be done that do not affect the injured structure,” Gulotta says. “Blood flow restriction (BFR) training (using a pneumonic cuff) is another way that athletes can maintain some strength while they are recovering from an injury. However, a medical professional should be consulted to devise a safe training strategy when overcoming an injury.”
How to Stay Ready This Spring
With some final thoughts on staying in the game this spring, Gulotta summarizes the lessons we can all learn from how baseball players train:
- Take time to rest in the offseason so that your body can recover
- Engage in a warmup that activates the muscles that you will be used during a workout or game
- Work on flexibility, but also work on strength throughout various ranges of motion to ensure that the joint can be stabilized in all positions. This will allow you to “own that range of motion”
- Resistance bands are a great way to perform functional strengthening that mimics the actions necessary to play a specific sport. They also allow you to strengthen in various positions.
- Stay hydrated. It is the most important nutritional “hack” that can help prevent injuries.
See you on the field!