Tuesday, July 22, 2014

What is Little League Elbow and How Can It Be Avoided?

According to Dr. Thomas Souza DC LLE (Little League Elbow) is more like a syndrome than a pathology. It is usually an adolescent pitcher with medial or lateral elbow pain. The adolescent elbow has growth plates in it until around age 24. This information was given to me a general knowledge fact in chiropractic school. The long bone has a diaphysis, a metaphysis, and a epiphysis. The epiphysis is at the end of the bone and in adolescen children it looks like a broken fragment or chip on a radiograph or x-ray. Here is a x-ray of a normal child's wrist.
The end plates of the radius and ulnar bones look broken but these are normal, these bones have not matured yet. I used a wrist because it is easier to see the plates then the ones in the elbow. The radius and ulnar have a proximal end that articulates with the distal humerus. The distal humerus also has growth plates on the distal ends of it to. With LLE there can be two major complaints. The medial or inside part of the elbow may have stretch injuries from the throwing when the external rotator muscles pull the arm back an then stretch the ligaments and then compression injuries can occur on the lateral side. There is a law called Wolff's Law that also can come into play here to. There is a non union of the immature epiphysis along with stress from throwing and stretching of the tissues. Wolff's Law works like this, when a bone has added stress to it then it will increase bone building activity and lay down additional matrix to make that bone stronger. An example of that would be to look at the tibia and femur bones of a long distant runner that is 60 and a couch potato that is 30. The 60 year old runner will have more dense and slightly larger bones from the stress of all that pounding of the body on those knees. The couch potato has really no need for this because they do not bear a lot of weight on their bones so their radio-graphs will show less density in the bones. Now add this stress to a bone that is still not finished growing and you will see that on an x-ray of a child that is right handed, hard throwing, and pitching many innings that their right elbow joint may be slightly larger than their left. It will definitely have an increase in external and internal rotational range of motion in the shoulder as well. The excessive throwing can also cause the growth plate to mature early and the epiphyseal plate will close early. Medial elbow pain is usually due to microtrauma of the medial anterior oblique ligament. The stress may also cause fragmentation of the medial epicondylar ligament. Now imagine your little league all star throws with his right arm and hits from the right side of the plate too.
Now they are experiencing the same medial side arm stretch but holding a weighted lever. The developing arm is experiencing two to three times as much stress as when they were throwing. I hypothesize this from the fact that a baseball weighs nine ounces and a little league bat can weigh 18 to 27 ounces. Some people will argue with me that the swing has two hands involved and the throw only one. I can accept this argument to a point, but from high speed video I can still see the medial arm being stretched.
As much baseball as I played as a kid and all the complete games I threw as a pitcher I didn't injure my arm until I was in college. Here is the difference. I throw right handed and hit from the left side of the plate. My right forearm muscles were getting work on both sides and avoiding an imbalance. The internal rotators involved in throwing where not involved in my hitting, when hitting my external rotators were getting the work. My pectoralis muscle on the throwing side were not getting stretched on the hitting side. I noticed also that I had more than a few students that were not pitchers that were having medial arm pain in their elbow. I thought it was strange that their arms were always hurting and they were not pitchers at all. When I asked them what they did most they said, "I hit three days a week and play tournaments on the weekends." After working with these hitters for a few months their arm problems mysteriously disappeared.
Was it by chance? I really believe it was how I trained them. I used a weighted chain system and made them swing from both sides of the plate to strengthen their core muscles. In the beginning some of them complained that it hurt to much to swing with their top hand or the one stretching the medial arm side. I would have them just do the bottom hand swings with that arm. I had a one handed bat with a chain attached to it and I made them swing that from both sides of the plated using forehand and backhand. Lastly I cleaned up their mechanical flaws and made their swing more efficient. So based on my clinical experience I would train both sides of the whole arm and their arms problems resolved. They trained the accelerating internal rotator muscles and then trained the decelerating muscles. They trained the forearm flexors as well as the extensors and if they were significantly weaker with their bottom hand I had them do more reps with that hand until is became stronger. The pectoralis muscles are part of the internal chain, so the latissimus muscle on the back must be trained too. If your young pitcher is using rubber tubing then I recommend Jaeger Bands. Use these bands for resistance training then use then in the exact reverse motion. Start from the release and jump back the the wind up. The bottom line is if the growth plates are damaged at a young age then the damage may be permanent. Which can mean a lifetime of arm pain and problems. Start out slow when the arms are young and still developing and do not be in a hurry to get them to the major leagues. Baseball is typically a forward moving sport, so do not forget to train the backward moving muscle too. This will create stability and overall greater strength. I have no problems with inning restriction at the lower levels and if curve balls are going to be thrown then proper mechanics are a must. I see so many young players trying to snap the elbow and wrist to make the ball spin. This is a receipt for disaster. My personal recommendation is learn to throw a fastball consistently for strikes to locations first, then a change-up, and curve ball and slider last. I played with professional players that were in there 20's that did not throw a curve ball at all. Best pitch in baseball is a well located fastball with changes in speed. When these guys learned how to throw a slider or curve ball it just put another bullet in their gun.
I hope this information was useful. I value any comments or feedback.

Ref:Differential Diagnosis and Management for the Chiropractor 4th Edition, Thomas Souza DC

Tuesday, July 8, 2014

Why my social experiment?

The Bible says, "You have not because you ask not. Ask and Ye shall receive." So whenever I have come to a point in my life where I really am in need of something, I just ask. I first voice it out loud to the universe, then in pray, then I begin to just ask people. Sometimes I tell them what I am up too and they ask me how they can support me. So I just flat out tell them how. They have a choice then. They can choose to say, "Good luck with that." or point me in a direction, or lastly pull out there wallet and be a blessing to me. No good deed goes unnoticed. Once I had a young missionary come to me and ask for monthly monetary support.
I gave him and his new wife over a few dollars a month for almost two years. I would have loved to have been able to do what he was doing but I couldn't. I want to be part of the solution to the problems that he was solving so by giving I was part of that solution after all. Any time someone enrolls you or me into their vision then the vision collectively grows. I personally felt a sense of accomplishment and pride when I would get letters from Matt every few months updating me on everything that was happening. One time another group was going to Africa and reached out to the community for support. I was compelled and move into action. I did not have any extra money at the time so I looked for other ways to create income. So I had this black powder rifle that I had built with my own two hands at a cost of $250.00. I sold it for $450.00 and gave it all for the trip. When the group got back they gave me an amazing hand made basket made by one of the villagers on the trip. Every time I see that basket I smile and remember that I made a difference in someone's life. The universal power of reaping and sowing in my life has been a powerful force. One seed of corn yields 2 to 4 full husks of kernels. So I am asking now. I have been on a personal mission to start and complete chiropractic school and become a primary care doctor that specializes in the treatment of musculoskeletal and neurological issues with a safer alternative to surgery. I have plenty of friends that are and have been a blessing in my life already. But I am asking for not one ore two people to be a blessing or a change in the world. I am asking for all of you to participate. I'm am asking for the power of many to do a little which in turns becomes something very big in the end. Now if I was really brave I would ask for my whole tuition to be paid. Honestly I am looking forward to paying off my loans. I earned this debt and especially may degree that I am working on. I want the satisfaction and accomplishment of completing all of this in excellence. So how do I enroll you into my vision? I have been adjusting people since I was in high school. Mostly of this adjusting was easy stuff. My mother had been working for in a factory for years and would tell me how and where to put my hands and how to push on her back to make it crack. I was adjusting and I had no clue. After receiving a neck injury in high school my mother took me to see Dr. DeWitt. He was an old adjuster who had trained at Palmer Chiropractic College in Davenport, Ia. Dr. DeWitt adjusted me, and it hurt at first. I didn't have a clue like I due now about acute or recent injures and or chronic conditions and what to do. I will say this about Dr. Dewitt, he was honest. He told me that the adjustment may hurt. It did and I wasn't surprised. The main point is I got better. I asked lots of questions and received lots of answers. Then I would try these techniques being used on me on others. At first I was a little rough but with some practice I got better. To this day I have not had a person tell me I hurt them doing chiropractic on them. How is this possible that an untrained, unlicensed, and unskilled person could have these results? I only have one answer for that question, Intent. My intent has never been to hurt but only to heal. I have always thought that when I do this adjustment you are going to feel great. I have learned a lot in the last two years and I have 4 set of boards to pass to become a licensed chiropractic physician. For the last two years I have lived on rice, top ramen (only for the first year), lots of juice and fruit, nuts, quinoa, and very little meat. It is too expensive. When I came to school I had budgeted out all my expenses....except the board exams. There are little emergencies that I have to plan for just in case something happens so I can pay all my bills and still be able to eat. There have been some months where I have not paid all my bills and have even been negative in my bank account for more than a week. I have received food from a food bank once. I have had a few girlfriends give me their canned food that had been in their cupboards and bring me food. It gets hard around finals when I have no money for food and my brain need energy to stay sharp and study. I have met a great girl how has helped me out financially when I have really needed it. I pay her back when I can. Bottom line is I can only do so much and I only have so many hours in a day, and lastly I am not 24 years old. I am in great shape but I do not have the energy that I had in my 20's. So I am reaching out and asking for help. Seriously I am only asking for a $1.00. From 2000 face book friends. This money is only to be used for my exam fees which are $610 for part 2 and part 3, and $350 for Physical Therapy and the big on $1200 for part 4. The grand total of all these exams I have left is $2740.00 which non of my financial aid covers. So I put in long hours at my desk studying till 12:00 or 1:00 am only to wake up at 5:00 am start studying before school. I umpire as much as I can, but the summer is almost over and so are the little leagues. I cater when the opportunities come up. So i am not sitting on my butt doing nothing and expecting something. I just have short comings and gaps that I need help sometimes with. This is why I am reaching out to all those I know. If you have had a great experience with me or something I have done and have ever wondered how can I do something for Greg Shepard. This is how you can.

Thursday, July 3, 2014

Rehab vs. Training the Arm

Alan Jaeger a personal friend, Cal State Northridge Alumni, and professional throwing trainer has put a new article worth reading. I have known many players that trained with Alan and achieved amazing results. I believe that his information has personally allowed me to keep throwing into my 40's without injuring my arm. He has many videos and even a book on throwing and they are all worth their weight in gold.

http://baseballnews.com/throwing-programs-of-elite-pitchers

Thursday, June 19, 2014

What Does It Take to Be the Best?

To be the best your ways of BEING have to align with what you are trying to accomplish. For example, for me growing up I wanted to be a few things. A doctor, A professional motor cross rider, a police officer, a marine, and a professional baseball player. As I grew older I started talking more and more about being a professional baseball player then anything else. I one point I gave up riding motor cross because I feared I would injure myself and not be able to play baseball. So my ways of being started to change to conform to what I was really wanting. I like to party too, but when the partying and drinking began to affect my baseball performance then I had to cut that out too. Again partying and drinking were not in alignment of what I was wanting so I changed my way of being. I even used performance enhancers to elevate my game. Some people say, "You did whatever you had to to make it happen." It it the same with chiropractic school. The closer I get to the prize the more I see myself modify my behavior. I am on a three week break now and all I can think about is how I am going to pay my daughters medical expenses, where can I find extra work, and how many hours a day do I need to study to prepare for my next round of board exams. Everyday I do not put in the time of my craft I feel like I am going backwards. I am not wired for mediocrity. I find it hard to sleep at night just getting by in school with C's. Nobody is going to know what I received for a grade in school accept me. They will just see that I have a doctorate in chiropractic. People will just trust that I know what I am doing. Only thing is I know that I am just getting by and it bothers me. I question my knowledge of the situations. If I only know 70% of the material how can I be 100% sure I know what is going on? Maybe I am to hard on myself? Maybe I ask too much of myself? I remember training as a player and what that required. It required can't see hours. Can't see hours are hours that people can't see you working. Before people wake up and while they are sleeping at night, I was honing my craft. I remember some nights hitting with Eric Cole of the Houston Astros at 11:30 pm. I have worn out so many pairs of batting gloves I should have bought stock in Franklin, Easton, and Rawlings. That is what it takes. Champion Sports has a moto that I align with. "It takes a little more to be a Champion." They are right. There are guys with unbelievable natural talent. If they do not continue to grow, experience, change, adjust, and get better, then in a short period of time they become average players. The raw player or average player that continues to do repetitions and develop their skills will so pass the natural player that does nothing. I find myself lying in bed at night saying how am I going to get the reps I need to become a professional at chiropractic? The back and neck are not an Iron Mike with the ability to just spit out fastball after fastball. How am I going to get patient reps? How will I be able to diagnose injuries and subluxations correctly if I only have 250 treatment hours to graduate? It seems impossible to me sometimes. Then someone says, "That is why they call it a practice." I get to practice on unknowing participants. I am going to take some 60 year old woman's neck in my hands and give it just the right amount of thrust to move the bones in a way that gives her relief without giving her a stroke. Sound scary to you? It used to be scary for me. Today, two years later I know that my intention is to put life back into the body. I only with to restore things not destroy them. I love chiropractic because it has many similarities to baseball. Both are performance and result driven. Both require daily practice to improve. Continuing education is a requirement for both. My body has to be able to perform at a high level for both. Proper practice leads to better performance. I have heard people say perfect practice equals perfect performance and there is truth in this. What is really required is the discipline to be committed to what I say I want and the actions I do. I can say I want to be a chiropractor, but if I just go to school and do the minimums and then find other things to occupy my time and I really committed to what I said I wanted? Am I really doing a little more? Am I really doing what it takes to become a champion for chiropractic? If the results are not in alignment with the goal then there is only one piece of the equation to change and that would be the action. I am committed to changing the results and the action. What are you committed to doing?

Wednesday, January 22, 2014

Online Academy has been SHUT DOWN.

I have recently shut down the online academy because of the financial strain that is associated with keeping a business open while being in chiropractic school. So I have chosen to shut it down for the time being. I will keep this site open and have another site that I am working that will encompass baseball and chiropractics. I love baseball and will always be part of the game, just more on the clinical side instead of as an instructor. Thank you for all your support over the years. Greg Shepard

Monday, May 6, 2013

NOS Swing Trainer by Speed Chains

This is a great product. I own one and take it with my where ever I go. The small balls are easy to carry in a small bag or even a plastic bag.

Sunday, May 5, 2013

ASEA: Research from prestigious lab says, "This stuff really changes the biology of the body."

This is a great discovery. Double blinded cross over studies are a good thing. They test 2 groups 2 times giving them either the placebo first and then the experimental agent or the agent first then the placebo. Either way they collect data from both groups on both treatments. Some things to keep in mind. How look do the effects of ASEA stay in the body? If group A had ASEA and then was later given the Placebo, would there be any residual affects in the system and how much would this impact the results. Would the group that got the placebo first benefit from the week of training before they were given ASEA? With research you have to not only look at the variables of the research but also a bigger picture. What things could really make the results invalid?