Cincy 360 -- Tony Pike with Bob Mangine

Tony talks with Bob Mangine from UC about shoulder injuries, hamstring tendinitis, and more on ESPN 1530!

Episode Transcript

(00:00):
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(00:21):
Come all back, Cinty three tosix. You just heard it right
there, a service of our friendsat Penn Station. Thanks to them forgetting
us underway here in the third houron this Wednesday afternoon, the eve of
the fourth of July, where alot of fireworks are going to be happening.
Ideally, you want to see fireworksat the ballpark, and well,
in order to do that, youhave to have enough players healthy for the
Cincinnati Reds to continue to see thefireworks. So let's talk the health side

(00:44):
of the Cincinnati Reds with our goodfriend from Novacare and the University of Cincinnati.
He joins us. Now, BobMan, Jean, Bob, what's
going on? Howard? You Tony? Just getting ready for the fourth of
July. I'm great fireworks. It'sgreat to hear your voice well, it's
good to hear yours turning. Congratulationson having a baby. Thank you and
you mereth. I hope we're gettingsome rest at night, Yes, sure,

(01:08):
absolutely. All right here here,here's the question I have for you,
Bob, because we had a calleron the show yesterday bring this up
about shoulder injuries and baseball, andthe Reds just have a bad track record
with shoulder injuries and getting guys backand re injuring the shoulder. And I
don't think that's just a Cincinnati Redsthing, but in baseball, let's talk

(01:32):
shoulders a little bit. Obviously,Matt McClain is the big shoulder injury here
with the Cincinnati Reds, and theyhope to get him back at some point
this season. But what is itabout shoulder injuries and your expertise that does
make it difficult in baseball in particularfor these guys to get back to full
strength or not have a situation wherethey re injured that shoulder. Well,

(01:53):
when you look at shoulder in baseball, you've got a couple of causal factors.
You know, one is you gotvolume, and these guys are throwing
a lot every you know, fouror five days they may be in a
rotation, they may be in therotation every three days. So you've got
to have a shoulder where they canhandle that volume versus the shoulder. And

(02:15):
I've seen three professional players in mycareer that we're all center fielders, and
you know, they take that longball up, you know, three hundred
feet out, and then they're tryingto make the throw back in and they
fill a pop in their shoulders.So you have what we call the traumatic
shoulder, and that's the guy whomakes that one heavy throw and really feels

(02:36):
something going his shoulder. And thenyou've got the guys who are throwing every
day a lot of pitches Texas especially, in which you know they're they're they're
trying to throw for maintenance a littlebit. They're trying to throw in the
games situations, so that the shoulderrequires probably the most maintenance of any body
part in Major League baseball, minorleague baseball baseball, because you know you're

(03:01):
living and dying buy what that shoulderis doing. You know, watching Reds
last night, you know they theybrought in, you know, very specific
pitching situations, you know, basedon what the Yankees were thrown at them
and so you know, you gotguys that might be sitting in the bullpen
warming up and then all of asudden they get out of an inning and
then they sit back down. Thentwo innings later they get up and they

(03:23):
warm up again, and there's somethere's people out there and you know they're
training staff, they're pet staff thatare out there work with those guys to
make sure that they're staying warm inbetween those throws. But then all of
a sudden they get in the game, they throw hard for two or three
batters, and then bang their outof the game. And then you've got
to have a maintenance program for thatpicture so that the next day, if

(03:44):
he's needed for you know, twothree more batters, that they can get
up and throw again. So thekey word in baseball is definitely maintenance.
Your training staff, the PT staff, they are really working on maintenance with
these eyes to make sure that ifyou need to I cannot remember the guys
named and beginning that m you onlypitch like two or three batters. Can

(04:08):
he come back anything tonight? Theonly way he can do that is if
he's work with the prating staff toget ready to come back in tonight.
When you think of throwing does fromthe shoulder specifically, do different arm angles
make a difference or is that morein the elbow because I look at Matt
McClain who's had the shoulder, andyes, you're not just swinging in a
game, but you're taking batting practice, you're swinging on your off day,

(04:30):
you're going to be you're having alot of swings. But fielding ground balls
from a second base standpoint or evenanywhere in the infield or a pitcher,
you're constantly changing the arm angle atwhich you're releasing the ball. Does that
put more strain on the shoulder aswell or does that kind of stay in
the elbow area. When you lookat the studies out of Birmingham at the
ASMI American Sports Medicine Institute that doctorAndrews started forty years ago or so,

(04:56):
and you look at some of thebiomechanical data, there's a pretty similar position
of the shoulder in reference to thetrunk, so that you're usually in that
position we called the scapular throwing position. And it doesn't matter like who is
Mark Fedricks remember fedrianch You used tothrow it like side arm bent over.
He still had the same angle asthe guy who was thrown overhead. It's

(05:20):
just that he bent his body intoa position, but the shoulder trunk angle
ratio was pretty close to the same, so that you know, for maximum
pitching capability. Everybody keeps looking atthe shoulder, but watch the guys like
and the guy that most I remember, and of course only because of mold,

(05:40):
is a guy named Goost Dosage.And I don't know if you remember,
though, but when he kicked hiships, his power came from his
hips, and that's why he couldthrow one hundred and two mile in our
fastball as his whole trunk was evolved. It wasn't just the shoulder if you
didn't have great dynamic stability, goodmuscles, and the elbow and the shoulder.

(06:01):
Every time these fastball pitchers would throwa ball, they would dislocate their
shoulder and dislocate their elbow. Itall comes down the muscle control, hip
control. And that's one of thereasons when you talk about literally pictures and
you looking at the kids at sucha high rate of lnor collateral ligament injuries,
is the fact that these kids don'thave great core strength, they don't

(06:23):
have the glutes, they don't havethe gluten means they don't have the abdominals
and they can't get great trunk rotation. And these guys that make it to
the major leagues, if you watchthem throwing, you look at their hip
kick height and things like that.They're using that hip to propel and get
the acceleration going so that by thetime you get to the shoulder, you've

(06:46):
already got a lot of acceleration momentumand you're just now decelerating. And there
was a study one time, andI cannot remember, I want to say
Steve O'Brien, doctor O'Brien is outof New York, and he looked at
label injuries and a lot of questionbecame was it at the cocking phase where
they're all the way back where they'repulling on the labor or is it at
the time of delivery and relief wheretheir bodies are still flying forward and they're

(07:12):
actually tractioning or putting pressure on thelabrum or pull you know, almost pulling
the labrum out, And is thatwhere the injury occurs. So you really
have a lot of different mechanics outthere when you're throwing, because your shoulders
moving to ten thousand degrees a second, and if you don't have great strength,
and that's why a lot of theseguys try to come back too soon.

(07:34):
They don't have enough strength, andthey get on the mountain, start
their throwing program and they have toshut them back down. So that you
know, there's a really fine balancebetween mobility and strength. But again,
you have to have great hips,and these young kids don't have good enough
hips, and they need to getthem off the darn field and in the
weight room and start working with themmore for them to have one chance of

(07:57):
elbow injuries. We could we couldprobably do an hour long on just injuries
with the Cincinnati Reds right now.But there is one other one I want
to get with you while we haveyou today, and that is jam Or
Candelario of the Cincinnati Reds. DavidBell said last week Bob that he's dealing
with hamstring tendonitis. The issue becamewith what David Bell said after he said

(08:18):
he's been dealing it with dealing withit for more than a week and that
it's progressively not getting better. Nowwith the DH and baseball, they can
maybe just use him as a DHmore. He's missed some games over the
last week. When you think ofhamstring in any sport one that's a buzzword.
To me, that's not good.Tendonitis never seems like a good thing.

(08:39):
A player now in the first halfof the season dealing with hamstring tendonitis
that's progressively not getting better tells youwhat, well, I can tell you
a lot of different things. Imean, you know, I had a
player last year that I struggled withhamstring, getting him back and actually never
can get him back to the restof the season. But the bottom line
is once they start going down theroad where they're getting partial tears in the

(09:03):
hamstring, and again we don't knowas it in The ten in itself is
we don't like to use the wordtendonitis because generally the tendon by the time
it starts being painful, is usuallynot inflamed. It's usually partially pouring,
and it has been that way fora while. And so now all of
a sudden you're dealing with what wecall tendinopathy or tendinosis, and those are

(09:26):
hard to those are really hard toget better. You usually have to use
an arcase o. Here at theuniversity, we've got some really outstanding xpedic
surgeons who you know, we've startedusing PRPs, We started using stem cells
and you know, injectables in orderto stimulate the healing. But when you
do that, you got to shutthem down for about six weeks. It's

(09:48):
not like I can put a stemcell in there or a PRP injection,
platelet rich plasma injection in there andsay, oh, you're going to be
better in three days. Initially wetry that. You can tell attendance.
When we try to get them backin seven days after their injections, we
find out it really didn't. Itdidn't work, So then we had to
start taking longer periods of rest toget them back to you know play.

(10:13):
And the other thing is you gotto have a great rehab program. You
got to have a pet who's familiarwith hamstrings. You got to have that
rehab specialist who works primarily in centrics. You know, there's there's a lot
of issues with ham strings. AndI told you you know in the past,
the two I hate the most orlower abdominal strains in any athlete and

(10:33):
a hamstring strength because they just giveyou fits. Because of how much people
don't realize how much you use yourhamstring when you're trying to control your core,
and people don't realize how weak theirlower abdominals are until they strain a
lower abdominal But you really have tohave, you know, somebody familiar with
it working with them, and somebodythat specializes in movement analysis. But but

(10:58):
yeah, they are difficult, andthere's if I had a simple answer,
you know, I would have hadmy king back in three weeks, right,
and I didn't, you know,So that is all of us.
Yeah, that that feels like.The concern is just there's so much unknown
with so many of the injuries rightnow. With the Cincinnati Reds. Bob
is the National director of Sports PhysicalTherapy Clinical Residency for Novacare, also with

(11:22):
men's basketball and golf at the Universityof Cincinnati. He joins us each and
every week. Bob, thank youso much for your time this week.
I look forward to next week.We'll talk a little Olympics with you on
the show. Yeah, Olympics myfavorite thing. Thank you, Bob,
You're awesome. We'll talk again nextweek. Have a good holiday YouTube you
guys, have fun and be safe. Thank you, Bob. That is

(11:43):
Bob Manjean from the University of Cincinnati. We got to get a break in.
We've got some Bengals still to getto, and we've got some buy
sell hold still to get to.In our number three of since he three
to sixty thanks to Penn Station onESPN fifteen thirty. And you're better right
aspend your afternoon unless you've got andDecker with you, and you do, don't