Baseball Pitching Biomechanics with Glenn Fleisig - Episode 36

There is no doubt that Dr. Glenn Fleisig, from the American Sports Medicine Institute, has been the leading authority on baseball pitching biomechanics.

He’s spent his entire career researching the science of baseball in an effort to reduce pitching injury rates.

In the episode, we will dig deep into the last 30-plus years of his research to learn about baseball pitching injuries.

Full show notes: https://mikereinold.com/baseball-pitching-biomechanics-with-glenn-fleisig

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Transcript

0:34

On this episode of the sports physical therapy podcast. I am joined by Dr. Glenn Fleisig. Glenn's a biomechanics and director of research at the American sports medicine Institute in Birmingham, Alabama, with Dr. James Andrews. Glenn has spent his entire career working on baseball, pitching biomechanics, and has really helped shape much of what we know about the science of baseball. In addition to ESMI. Glen is the founder of the American baseball, biomechanics society and advisor to MLB USA baseball in little league baseball. In this episode, we're going to talk about Glenn's research over the last 30 plus years on trying to help reduce pitching injury rates in baseball.

Mike: 1:23

Hey Glen, thanks so much for joining me on the podcast today. How is everything going?

Glenn: 1:28

Everything's great spring's here. Baseball season's here. Work's gone great. Uh, life's good. Yeah.

Mike: 1:35

I like it in an amazing baseball season too, with the pitch clock and shorter games. I know, you know, we'll probably get into a little bit of that as we get into the podcast, but I feel like baseball's been a whole lot more fun this summer for me at least. You know, having these two and a half, two hour and 45 minute games instead of four hour endeavors, right?

Glenn: 1:52

For sure. I mean, I, I'm enjoying it from two point sides of, of the coin. Uh, as a fan, I'm, I'm loving it. I'm watching a game, and I'm watching a whole game before I have to go to sleep. But as a, uh, sports mess and scientist, I'm involved with Major League Baseball as an advisor, as a consultant, and I'm working with them on these pitch timer rules. And, uh, it's really been quite, uh, quite successful I think.

Mike: 2:16

Yeah. No, I completely agree. But, um, I'm super excited to have you on the show. You and I have been talking about doing this for a few months now. Um, so it's good to finally get you on. Um, I, I, I don't know if people realize this, but you and I have known each other for a long time, over 25 years now. So, um, I think that means a couple things. One is, um, we're both old. I think that's part of it, maybe, perhaps, but, uh, but also to be honest, I, I've learned so much from you over the years. But, but I really am a proud member of the asmi family. I'm really proud to call you one of my mentors. Uh, you were part of the fellowship program I did back in the day. Uh, but more importantly, you're a great friend. So, uh, I'm really excited if there's this episode, I know you and I are gonna have a great conversation because we have these conversations and just for the first time, we're gonna hit record and share it with other people, right.

Glenn: 3:02

For sure, for sure. You know, you say things like that and, and I am proud of mentoring people like you. I'm very proud of you, Mike, by the way. And, um, But, uh, uh, the, the comment that really gets me best is when people say, uh, you're a good friend. Cuz I, I, I think personal quality's really important and, um, I, I take that compliment. Well, yeah.

Mike: 3:21

That's awesome. That's awesome. You know, I do share oftentimes, um, how we first met, which was, um, me calling you cause I thought this was funny. A lot of people ask me, Hey, how'd you get into sports? How'd you get into baseball? How'd you get into pro sports? And I always talk about how I, you know, I, you know, back in the nineties, you. You had to search out. I'm like, so who are the best people in baseball, sports, medicine? And obviously I found you in the American Sports Medicine Institute and um, I'll never forget the day. Um, I literally called you like on a phone. Like I had a landline. You had a land. This is before the internet, before cell phones. And I remember, I'm like the second ring you just answered like a s m i. This is Glen. And that's, you still answer the phone that way 25 years later when I call. It's amazing. Um, but you picked up the phone, Glen, it was amazing.

Glenn: 4:05

Yeah, yeah, yeah, yeah. I, I don't know if I remem, I don't remember you've told me this story. I don't remember that cause I got so many calls and stuff, but Yeah. Uh, I enjoyed, um, you reaching out to me and, uh, I remember you being a, a, a fellow, or I don't remember what it is called, under Kevin Wilk. And also you did research here in the lab. I remember we did some. Early research on, uh, emg the muscle activity during, uh, that are used in exercises for baseball pitchers and yeah, it is. I, I remember this journey. Well, I'm glad it's worked out well. Yeah.

Mike: 4:35

Yeah, it was fun. Some running and cutting stuff with Gene and Steve and Nigel and I mean, tho those were the days. That was, that was a fun time. But, um, but yeah, I mean, you know, moral of the story again is, you know, I, I sought out the best and I reached out and I was just fortunate enough to find somebody like yourself that actually cared about giving back. And actually, you're so open, so patient with me, so, you know. Yeah. Come. Come to Alabama, come do projects with us. Um, it was, it was really, uh, refreshing. So, um, you know, I try to also do that and give back just the way that you guys did that for me. So thank you so much for all that.

Glenn: 5:09

I, I wanna say on that, um, I also learned from my mentors, uh, Dr. Andrews and Dr. Chuck Diman. And I, I learned, well, maybe it was my personality anyway, but I learned from them, they're always team players and listening to other people and never too big to listen to other people and always willing to work with others and, and help younger people. So I think I give credit to some of my mentors.

Mike: 5:32

That's great. Yeah. We all get better together, right? I think that's a great way of saying that. So, um, well let, let's talk about you, right? Not about me, but let's talk about you. Um, you've spent your, your entire professional life almost studying baseball, right? And, um, really a strict niche. And don't get me wrong, you've done so many other things to so many other sports and to rehab and surgery and all those other things. But baseball's always been your thing. Um, why don't we start with that? What, why don't, why don't you kind of tell the audience a little bit, what made you wanna focus on this, you know, how'd you get started working in this area? Tell me a little bit about like, the origin and the beginning of as m I. I'd love to hear some of that story.

Glenn: 6:09

Well, I mean, the original plan was to be the center theater for the New York Mets, you know, um, as when I was a kid, I loved baseball like a lot of our listeners do. Um, and, uh, when I was at high school and I did not make the, uh, high school baseball team, but I made the high school math team. I thought maybe, maybe I need a new plan here, you know? So, um, so I liked baseball and I just, uh, I went to a school up in your neighborhood. I went to MIT for college and, um, and did, did mechanical engineering. It, Mike and I just figured my life would be, uh, doing mechanical engineering, building mechanical things and just playing and watching baseball on the side. But then at MIT there's a senior thesis project and, uh, one lab was doing welding of metal and one lab was doing, Circuitry for cars. And one lab was analyzing golf swings. And I'm like, well, this, this looks like fun. And I walked in and talked to that professor there, Dr. Uh, Robert Mann. And I said, um, what's this? Can I do my senior project here? Sure. And I worked with this other, uh, master graduate student doing a, a golf swing. And uh, afterwards I told Dr. Man, 1984, this was 1983, I said, uh, I want to, um, get a job doing this biomechanics, this sports biomechanics, and. It's, it's, uh, 40 years ago, but I remember this was still to the day, Mike. I said, Dr. Mann, I want to do a job doing sports biomechanics. And he, and he laughed in my face. He said, Glen, there are no jobs doing this, you know, and so, uh, uh, but he said, I do know, uh, that there's a internship, uh, at the Olympic, United States Olympic Training Center in Colorado Springs, Colorado. And so he hooked me up with a professor there. And, uh, I went there and I worked for, Uh, for 1984, I worked under, uh, Dr. Chuck Diman, who I've mentioned already. And, um, 1984 was very exciting for the old timers who remember the Olympics were in the United States that year in Los Angeles. So it was very exciting and I worked for Dr. Diman and uh, and then I said, I want to get into baseball and do a career like this. He said, there's a young up and coming doctor named Dr. Jim Andrews, and he introduced me to Dr. Andrews in 1980. Four, you know, and, um, and I talked to Dr. Andrews in 1984 and we really hit it off on the phone. And he's telling me his vision. He was still working in, uh, Georgia at the time. And, uh, anyway, um, great. I thought I had something going here and, and at the end he said, okay, but I'm not ready to start my institute, he said. So it was kind of a way. So I hung up and went on with my life. Uh, three years later, three years later, I'm visiting my mom and dad for Thanksgiving in New York. And, uh, mom says, uh, Thanksgiving 1987 says a phone call for you, Glen, up. I'm like, who's calling me at my parents' house? I don't live here anymore. And, um, it is a, a guy who worked with Dr. Andrews and they said, we're ready. He's still interested. And I'm like, yeah. And then so I rearranged my life and dropped everything and started the Asm I with Dr. Andrews and others in 1987. I, I, I, you know, you're talking about pre-internet. Um, for when you called me, I talked to these guys in 1984 and three years later I, maybe he kept my mom and dad's phone number on a piece of paper. I mean, I, I don't know. But anyway, they found me and the rest is history. Started a nine as m i in 1987. I was 25 and it was, uh, I didn't know. I was just, I was confident and, uh, um, and, uh, we'd done well. Yeah, that's the start of asi.

Mike: 9:33

That's, that's pretty amazing. And you know, obviously you've done more than, well, I mean, I, I don't even know at this point. How many publications do you have? Do you even keep track anymore?

Glenn: 9:41

I do, well first, uh, I have to give my CV sometimes to people with all my papers and presentations and, uh, cuz I'm giving a conference talk or whatever and they're like, wow. It, my, my CV is 75 pages and so it has hundreds of presentations and, uh, thousands of presentations and hundreds of publications and. Uh, I don't know. Yeah. A

Mike: 10:03

it's, it, it's impressive. It's impressive. I, I just looked you up on PubMed to see, you know, I always like to see when people are coming on the podcast, like, obviously I follow you in your research, but I wanted to see what, what you've done in the last, you know, few months to year, just to see what's kind of like brewing in your head. And again, just like, it's, it's, it's dozens, so it's, it's, you know, so I'm like, all right, we'll stick to baseball. We'll have a fun talk on baseball cause we can talk about so many

Glenn: 10:26

one of the, one of the, uh, hidden secrets though is uh, uh, As m i, we've published a lot of things on baseball and other things, you know, and running and cutting and, and knee surgery. But, uh, one of the hidden secrets is we don't have the size of a staff of a university with, with 10 professors and 30 graduate students. We're just a handful of people with a dozen doctors, and, uh, I I, I think it's pretty efficient. While we do, we, we, we've been very productive. Yeah.

Mike: 10:54

You call it efficient, I'll call it impressive for you because I guess you can't do that to yourself. But, um, but yeah, no, I mean, super impressive. But, but more important than impressive or efficient clan. Impactful. And that's the thing, you guys started something in 1987 that, um, was so ahead of the game, which was just so different with what you did and how you analyzed things and the amount of scientific information that you started putting together in sports. Um, it, it changed the game. And I think it, it really changed a lot of people like myself in, in like the health allied fields to see differently, to see mechanically, to see stresses and the effect of the way the body moves on torque and things like that. So, uh, you, you guys have had a dramatic impact on that stuff. So again, like I, I don't want to keep thanking you for things cuz this, this is becoming a weird podcast, but, but thank you for all you've done for us.

Glenn: 11:48

Yeah, I wanna say, uh, one, one of the things we've tried to do is to be different than a university where we're not just trying to do a research that goes on some academic bookshelf or some on the internet. Uh, and we're not just trying to be a clinic like you have at, at Champion Sports Medicine. We're, we're kind of an odd bird and we, we set it up, we designed it 35 years ago to be a research center. But has practical use to clinicians, physicians, physical therapists, and, and our baseball course that you speak at every year. Um, I think that that's one of the highlights of our, our our year because we have our research. But again, we don't just want to go on the bookshelf. We wanted to get in the hands of the people listening to this podcast, uh, physical therapists, et cetera, and have it be, uh, practical and scientific.

Mike: 12:33

Yeah. And, and, and again, to, to just harp on that one thing, but you, you, you answered clinical questions, right? And I think that's where, where the impact comes from so many times is that the, the research you published was conducted because somebody had a clinical question and then you guys sought to, to, to figure it out. Um, And, and that is, that's such a cool way of, of doing it. So, um, well, let, let's talk about that a little bit. So, o over your career, you've, I don't know, you've focused on a lot of things, but I, I think it's safe to say that you've placed a very large focus on understanding the science of baseball, but in a way so that way we can, we can hopefully reduce injury rates. It seems to be. Almost like an underlying theme in everything you've done in your career. So, um, let's start off with that, which it could be a six hour dissertation that we're about to talk about here, but that's the big question. You know, it's been 30 plus years. Can you summarize your research on what are the biggest risks, risk factors, what have you looked at? What have you identified? It's a big question. I apologize for that, but it's a good question and you're the guy to answer it.

Glenn: 13:39

Yeah. Um, okay. So, uh, baseball pitching injuries, again, the reason we it's so well set up for us to study is that it's, uh, repetition injuries and it's from essentially self-inflicted. Uh, you know, it'd be nice to prevent all the ACL injuries in football, but you, you know, the advice would be watch out for that big guy about to tackle you, you know, but the baseball pitchers essentially are, are injured often too often, and also it's, uh, from repetition of the same mechanics again, and as a biomechanist. That's why I love studying it because we could look at the mechanics, uh, uh, pitching even other things like football, quarterback or, or, or tennis, uh, ground strokes. They're not totally repeatable cause you're always in a slightly different position. But golf swings and baseball pitches are really well suited for biomechanics. Um, as far as the, uh, answer to your question about the factors, uh, related to baseball pitching injuries, There are a few buckets. One is pitching biomechanics or pitching mechanics. Uh, the other one is, uh, how often you throw and how much you rest and strength and conditioning. I think those are, um, you know, how much do you prepare your body? Uh, how much do you do and how well do you do it, essentially? Okay. And so if you look at that, strength and conditioning is, uh, super important for getting the body right, and I've seen you and. Uh, uh, Kevin and everyone, uh, over the years change how you do things evolve, which is good. We, we wanna train baseball pitchers, not football linemen who are playing baseball in the off season. I mean, um, so that's super important. The mechanics and the pitch types and the pitch amounts are important. We thought curve balls might be the most important thing for the kids, but turns out it's not. The most important thing for the amateur pitchers is amount of pitching and, uh, Uh, injuries and Tommy John's surgeries are up in high school more than ever. But the thing that's changed, you know, kids have always thrown curve balls or kids. Some kids have always had good mechanics and some had bad mechanics. But when I was a kid, you played baseball in the spring and then you play football in the fall or other sports. But now kids specialize at, at one age, and this is the single biggest issue, problem, whatever, Mike, for the amateur baseball player, which is uh, uh, single sports specialization. And year round pitching the body, uh, needs periodization, whether periodization during the week or periodization during a year. And the playing year round is the biggest problem from the pros. It's a, it is the opposite. The pros, uh, have professional, uh, people looking after them. They don't pitch five days a week on two travel teams or whatever. So the pros, uh, the pro teams are very much, uh, have a handle on, on work volume. Some people might say they're even Uh, babying them and, you know, and, and limiting their work volume. But, but they have a handle on it. They're trying to, uh, balance the work volume for the pros. I think the big thing is, uh, mechanics, which is big on both ends and, uh, and intensity. Okay. And, um, and really this love for the radar gun, whether it is high school or a kid in Latin America or the pros, uh, it's kind of flip-flop Mike. And, um, and people think the. The object to get drafted or, or recruited to a college or to get caught to the pros is whoever has the highest score on the radar gun. It used to be whoever had the lowest era A or whatever, but, um, so the pitchers are, are aiming to max out their velocity as much as possible, as high as possible. And, you know, strength and conditioning and proper mechanics, part of it's backfiring. We're giving people the proper strength and conditioning. And the proper biomechanics enabling their body to get this maximum velocity. But they're not using it, right? They're not tapping it sometimes and backing off sometimes that is, that's really their, that's gonna be the, um, secret to duration and success. Longevity and, and, and professional baseball. Uh, knowing when to go a hundred percent and went to back off a little, but people are just going max effort and through mechanics and, uh, conditioning. We're able to have the baseball pitchers, uh, get maximum velocity by, uh, proper timing of their body, proper strength and power of their muscles. And the, and the losers in all this are their ligaments and tendons, holding the joints together because all the strength and conditioning, all the mechanics, uh, they are optimizing what the muscles do, but the ligaments and tendons, um, are maxed out. And, and, and that's, that's a 30 year summary. In, uh, five minutes, I guess.

Mike: 18:29

I, I think that's, that's fantastic. And let, let, let's, let's hit each one a little bit more in detail. Cause I think people really like to hear this though, but pitch types. I think, um, there's been an evolution with pitch types. I think in the eighties it was that the split finger was evil. The nineties was the curve ball was evil. Right. Um, I, and I think you, you really started to show that really that, uh, stress just comes down to velocity almost. And when, when you have a change up or even a curve ball that maybe at a, a little bit less arm speed, for example, um, that's probably more indicative to stress than some of the, the differences in pitch types. Is that a pretty good summary?

Glenn: 19:07

Well, again, we have kids and we have adults, uh, pros or

Mike: 19:10

Good point. Right.

Glenn: 19:11

we've done, uh, us our lab and other labs have done numerous biomechanic studies and let's just talk about what biomechanic studies are. Biomechanic studies are, are pitchers, Uh, we put these reflective dots all up and down their body, and we have these cameras that quantify their three-dimensional motion, and then we measure their motions and we calculate their forces as well. So that's biomechanics in a 30 seconds. But we've done biomechanic studies, uh, where we measure what are the forces on the elbow and shoulder during all these different pitch types. Um, and what we found, we did studies for youth, we did studies for high school and for pros, and what we consistently find, Is that the fastball curve, ball and slider are all high stress pitches on the elbow and shoulder. The change up consistently shows less stress on the elbow and shoulder, but the, the point is the curve ball does not show more or less on the fast ball. The curve ball, fast, fastball, and slider are all in this stress bucket. All right, and now what we also find is picture A and picture B. If pitcher A has good mechanics, he's pitching all these things with a certain amount of stress. Pitcher B, who has the same velocity, but stinky mechanics, that's a technical term, stinky mechanic. He, um, he could have the same velocity, but he's applying a lot more force on his elbow and shoulder. So your mechanics are more important than you pitch type. And the amount you pitch is more important than you pitch type. And then the last thing on this mic, uh, I, moving to the next topic, is the, uh, intensity. We've done studies looking at, uh, let's say fastballs thrown at different intensities. We, we've, uh, we have a, a number of pitchers who've thrown fastballs and just by dumb lock at their fastballs ranged about, let's say five miles per hour. They were trying to throw, throw full effort, but they didn't always. Anyway, what we found out is, uh, once again, The stress on a elbow and shoulder for pitcher A versus pitcher B is really dictated by if he has good mechanics or bad mechanics. But within a pitcher, uh, his faster throws are always more stressful always than his fast balls that are a few miles per hour slower. So if you're trying to avoid injury, you wanna avoid the accumulation of microtrauma in your elbow or shoulder, in your, in your UCL or EL elsewhere. And so you don't wanna keep doing max effort pitches that are doing the maximum attention on the ligaments and tendons. You need to mix in some, uh, lower intensity pitches.

Mike: 22:21

I, I think that's a great way of saying it too. And you've, you, you've kind of alluded to a couple things here when you're talking about in our world, in the health and fitness world, where we talk about workload and capacity quite a bit, and you started this off by talking about strength and conditioning on how we've, we've really increased our capacity as much as we can. Then we talked about overuse and, and thrown with high velocity. All year round. You talked about that workload. Um, you know, to me, I, I've always taken your biomechanical data that we've, we've learned over the years and just used it for, for exactly what you said, each person's different, right. If, if you or I throw a 95 mile per hour fastball, that's gonna be a lot stressful to our bodies, then it is that six foot, 6, 250 pound guy that's really strong, really powerful, and has much better mechanics than you and I. Right? So it's not that 95. Is is the challenge. It's just that it, it's just that pitchers are almost, uh, maximizing everything. They're maximizing their strength, their power, their mobility. They're maximizing their mechanics, and they're putting themselves at the end of their physiological limits more often. And then, They train that way all freaking winter now. Right. And that's, I think that's the part that blows my mind is that they're doing that all winter now and that that's where we're seeing so much it Does that, does that make sense to you from a biomechanical perspective? Is that in line with your thoughts?

Glenn: 23:40

yeah, a hundred percent. You know, uh, when you're talking there, I, I think that the. The expression, they're, they're redlining. They're, they're, they're pushing themselves to the red line. And I thought, if I drive my car, if you drive your car and you had your foot floored the gas pedal constantly, and the, uh, odometer is, uh, is, uh, is it called the odometer? What? Teter is all the way, maxed out the whole time. Uh, yeah. Your engine's gonna wear out. And, and, and same. So you can't drive maxed out all the time. And, and likewise. Your arms are the same way. Uh, it's different because we're alive and we, um, and, and we, we heal. But, uh, but it is the same analogy that, uh, you can't be max effort every pitch and then 12 months a year. It, it, it's that this is why people are breaking down.

Mike: 24:30

Yeah. And, and you know, to me too, I think it's important to realize this, when, when we develop our interval throwing programs and our progressions that we do, we, we understand a little bit of the data about it. Some of the newer rehab clinicians are very linear thinking and very, like thinking everything's perfect. Um, it, if you're throwing, if you throw a nine five mile per hour fastball and you are in, you're throwing program and you're throwing 80, 85 mile per hours, that is. That is a significant reduction in stress on your ligaments, your capsule, your tendons, all those things that it, it's, I don't wanna say it's not very impactful, but people don't understand that if you throw 85 miles miles per hour, that is significantly less stressful on your body. You could do that all day and not get injured. It's it. It's when you go max effort that people don't understand. So, you know, we talk about this, you and I, I think we've had this conversation. I know Kevin and I shared this, but the pictures that can sit 91, 2, 3, 4, but then reach back and throw 98 when they're, you know, when they're, you know, three, two count, or, you know, bases loaded. Uh, those pictures tend to be so much more durable than the one that their mean velocity is 97 and their max velocity is 97.5. Right. Have you looked at that at all?

Glenn: 25:43

A hundred percent, no. Uh, I, uh, some of the MLB teams have talked to me about this and they have data analytics people looking at it, but I, I, I, this is what I've proposed. I haven't looked at it. Um, it's not just maximum effort. I, I would look at a standard deviation or, or the range of your fastball velocities as much as what your top festival velocity is and, and the guys with the bigger range or standard aviation, I would suspect, I haven't looked at it, I would suspect they're more durable. For this very reason, you know, you're talking about, um, the ligaments and tendons and, uh, they're, they're really elast, aplastic, uh, uh, tissue and which is like a rubber band basically. And if you had a rubber band and you were stretching it at max effort a hundred times, um, that's a lot more stress on the rubber band than's stressing it at half effort, fif, uh, 200 times. Uh, you could do it all day. You could stress a rubber band at half effort all day. And just like you said, the, the pitcher. At reduced effort, his ligaments and antennas could take that, and I can't say all day, but a lot with, with very little accumulate damage from reduced effort throws.

Mike: 26:53

Yeah. And, and I'm seeing, uh, kind of a flip here too with, with a lot of the coaches, most of the skill development coaches, but also some of the younger, you know, rehab and, and performance people. You know, the concept that a ligament like the Tommy John ligament, your ucl for example, that it needs stress to get more resilient. Um, it, it's, it's taking the model for muscle mass development where you have to break down the muscle to build it back up more and applying it to a, a ligament, it doesn't work that way. Right, right. So now I'm just a rehab guy, but can the biomechanics guy explain that?

Glenn: 27:26

You totally right. You're, you're a medical guy and, uh, the vascularity and the healing of the ligaments and tendons is a different model than the muscles. It is poor vascularity compared to the muscles, and it doesn't work on that. Uh, That hill model, uh, approach where you, uh, have damage to the muscle and then it heals and that's how the muscle, uh, adapts and becomes stronger. The ligaments and tendons, I don't see it that way. I see it that they are getting damage and they, uh, uh, uh, uh, ligament tendon tear is when you've had damage adding up quicker than you've allowed time for it to heal because it heals slower than muscle.

Mike: 28:05

That, that, that's perfect. And, and we, we see a lot of people that are trying to take that model and say, well, that's why we want to stress them so aggressively all winter is cuz we wanna build up capacity to that ligament. And what it's actually doing is backfiring. It's doing the exact opposite. Um. One of the best studies I think that came out, you know, no offense to all your amazing research, but was a charmer's study with the ultrasound of the ligament over the course of a season, and then after the subsequent off season that showed that over the course of a season, your ligament got loose, it got swollen. Over the course of the winter, it actually got tighter and less swollen. It healed. It healed up a little bit from that acute trauma. And if we don't do that, I'm really scared that you're just gonna have this ligament getting looser and looser and looser and then just having this micro damage. And I, I think that is probably single-handedly the most, uh, important thing that we need to change right now is that people need to understand that adding stress to a ligament isn't, uh, it, it's not the same as a muzzle. I, I don't know how else to say it, but I think that's huge right now.

Glenn: 29:06

I, I completely agree. Completely agree.

Mike: 29:09

Yeah. Love it. Oh, let, let, let's talk Tommy John just for a second, because I do know that's huge right now. Tommy John injuries are through the roof. You know, we always joke, you know, you and I, we speak at a lot of baseball conferences, right? And I usually get up there in one of my first intros if it's a new crowd, right? Um, I'll say like, you know, this has been an amazing conference. Uh, we've been doing this for decades and injuries seem to get be getting worse, so I don't know what we're doing wrong. Right. But let, let's talk UCL in, uh, specifically, just because again, they're going through the roof. I think we know that it's this combination of velocity and it's this combination of, uh, workload. Management where, uh, people are just doing too much. But what I want to hear from you is what specifically mechanically are, are we doing to put extra stress on the ligament? Are there certain things mechanically that we should work towards improving that we're, we're almost putting too much stress on the ligament with certain types of mechanics.

Glenn: 30:06

Yeah, good question. So proper mechanics, we've done a lot of studies on this and, uh, it's kind of a double-edged sword. Sometimes, uh, we have people optimize or fix their mechanics and they get more ball velocity, but it, it is putting a high stress on your whole body. Uh, it's a tough question to answer, Mike. I could say some of the major flaws I could explain real quickly some of the major flaws. Or a, a late arm, in other words, at foot contact, uh, when the, when the front foot contacts, the throwing hand should be, uh, raised above the elbow. Shouldn't be vertically above the elbow, but it should be on their way up. And, uh, um, a lot, some pitchers who are late for whatever reason, where their wrist is still below their elbow at foot contact, first foot touch, um, they, their arms playing catch up, and that's gonna be extra loader on their elbow and their shoulder. To try to basically catch up and throw. Uh, another thing we see, especially in the kids, is not using their trunk. Uh, little kids, not, not even little high school, let's say pre-pubescent especially, uh, they don't have a core trunk strength, so they essentially rotate their hips or pelvis at the same time as their upper trunk. They just rotated his one unit versus the, uh, skilled adult pitcher rotates his pelvis below his shoulders, keeping his shoulders. Uh, in line with, uh, the throwing target and then have, then the, the trunk, uh, contributes energy as well. Um, those are a couple of the things, and then also the front knee. Um, when gonna pitch it pitches properly. The more, more important than stride length. Mike is, uh, foot position, and I want the foot a little to the closed side. So for right-handed picture a little. A little to the, the third base side and, and point it a little inward as well because that puts the foot in a strong position to land, kind of catch your weight. And then if the pitcher is strong enough and has good mechanics, they will actually, their knee will bend a little when they catch your weight, but then they extend their knee or straighten their knee a little, passing the energy up their lead hip and up their body. So those are some of the key mechanics that if you don't do that, you end up essentially just throwing with your arm.

Mike: 32:18

I, I think that's a great way of saying it too. Uh, especially with the youth, right? Just you, you've studied that specifically. You can look up those articles, but you know, to, to see that. I think that's probably one of the bigger things we do with our youth in the gym. Is we teach them how to disassociate. We teach them how to separate, um, not just, Hey, work on this mobility. It's actually more learning how to like, hey, keep your shoulders back and fire your hips forward, for example. Right? There's, there's like a motor control patterning that they need to develop to be able to do that. Um, so it, it, you know, it's really interesting that. To see that in the youth model when we get to the adults, it's kind of funny. I feel like we're, we're pushing the envelope as a profession to increase velocity and almost everything we do to increase velocity seems to also increase stress, right? So if you're trying to bring your, your elbow inside 90, for example, or you're trying to be a little bit late, almost like that inverted w um, you, you know, we all get to ball release at the same time. Right. So if you have more time from foot plant to ball release and you have more angles to get through, you'll have more angular velocity. And that's how we try to explain it to the kids about, like these things like, you know, inside 90 where we're bringing the ball by the air, it just makes it seem like everything we're doing to just get a half tick of a, of a mile per hour or a mile per hour or anything. It could be, um, we're increasing stress and then you again, you do it over and over again. That workload capacity equation that seems to be. You know, some of the problems we're seeing is that we're trying to eek out everything. So I, I know we're, we're kind of, we're saying the same thing over and over again, but hopefully that'll help, uh, deliver the message, right, Glen?

Glenn: 33:51

I, I, I do, I do wanna add, uh, you, you did point out one more flaw that's, that's kind of in vogue these days, which is the short arm for the pitcher, meaning, uh, they're bringing the ball there, the throwing hand closer to the ear, uh, and flexing their elbow more. And our studies have shown that that is not optimal, that the elbow should be flexed about 90 degrees. Not more than 90 degrees where you hold it. And so even though that's being taught a lot, I biomechanically it's not as good.

Mike: 34:18

And, and so shortsighted to me. So what's the benefit of that? So, okay, you increase angular velocity of elbow extension by a little bit. I mean, that is so low on my list of important things to develop in a baseball pitcher, right? Is, you know, uh, is elbow extension angular velocity? It just seems

Glenn: 34:38

not even sure. I'm not even sure it does that. Uh, there there are a couple anecdote. There are a couple anecdotal guys in Major League Baseball who have done well and then everyone's kind of jumped on the bandwagon. But I think it's a mistake. I've tested, I've tested thousands of pitchers, hundreds of pro pitchers, Cy Young Award winners, and, and you, and they've bend their elbow 90 degrees. The successful ones, not more.

Mike: 34:59

That's exactly right. You know, and, and I hate to say it, I have to admit, I do work with a couple of those guys, so I know who you're talking about. And, and yes, they were successful, got popular people looked at it. Uh, to me I almost think it's more about, uh, hiding the ball longer than it is anything else. I think that's why they were successful from it. Um, but that was just because it was helpful for them to hide the ball. Right. That doesn't mean it'll be helpful for you to hide the ball. So, you know, again, it's, it's everybody has to develop their own thing. The worst thing we could possibly do for pitching development right now is Instagram. Right. Um, and it's just, you know, if you're trying to do something that worked on somebody else, it's probably not gonna be optimal for you. Right. I'm guilty of that with my golf swing. Right. So it's the same thing.

Glenn: 35:40

Yeah. Again, uh, on the internet there are a lot of, uh, pro, uh, experts. I'm doing my quote. You can see with the fingers who, uh, who say, here's how, here's how so-and-so pitches, and they show, uh, Uh, photograph a photograph of one particular major league pitcher and say, therefore do this. And the photograph sometimes is not taken at the exact time. They said like, here's picture A and picture B in comparison, but they're not taking at the exact same time. It's just, it's not full scientific data that we, we have. It's just a blip and an anecdotal observation.

Mike: 36:11

Right, right. It's tough to draw a conclusion from that. I agree. So, um, well, you know, one other thing I wanted to touch upon in this podcast before we get going is, um, the future. Um, more and more teams, both pro and college. They're, they're building labs. They're hiring, hiring biomechanists. So, Remember, go back to your professor from 1984 that laughed at you. Okay. It, it took 40 years, but we got it. We're hiring Biomechanists now within pro baseball. It's a thing now. Uh, but we're pushing that envelope with that biomechanical data. Um, the stadiums have built in biomechanical. Cameras everywhere. It's, it's, it's amazing the tech and baseball. Uh, can you share with us, I know you're involved at MLB at a higher level with, with stuff, but what, what are some of the exciting things coming in the future for, for biomechanics, maybe even tech and baseball, but what's really exciting you right now,

Glenn: 36:59

All right, Mike. Uh, I, I saw this coming five or 10 years ago. I have this, when I gave one of these speeches here, they said, what do I think of in the future? I said this like 12 years ago, and I said, I think what's gonna come is a markerless motion capture. Uh, that's what I'm excited about. And, and it has come. And so one day, Dr. Andrews and I are noticing here at a S M I, many years ago, five or 10 years, five years ago, Um, that, uh, less and less teams are sending pictures to us here in Birmingham. And, uh, and, uh, I'm thinking what, so we could either stick our head into the mud, I figured at this point, and try to be stubborn and stay where we are or see what's happening. And I'm so excited now and glad I chose this to, um, to embrace that we're not the only show in town that biomechanics is coming throughout baseball. The markerless motion capture that it just alluded to is a big reason. And so what it is, is, like I just said earlier, um, biomechanics is typically you put these reflective markers up and down your body just, just like they do when the video games or, uh, or special effects for movies. And, and then you, you wear special clothes and you have, uh, reflective markers, special cameras, computers. But the technology now, the markerless motion capture, there are a few companies that are doing, uh, multiple camera or single camera. I'll touch on this in a second, but essentially, They are allowing people to do it who have less biomechanics expertise. Plus it's more versatile. You could actually get in-game data cuz very few of the pros are wearing little silver dots up and down their body, you know. So, uh, we saw this coming and, uh, so one thing we did, uh, we started what's called the American Baseball Biomechanic Society. We started this in 2020. At the beginning of 2020, we had no idea a pandemic was about to start. But we started a society called the, uh, uh, American Baseball Mechanic Society. Anyone listening here can join, uh, my treat. I'll pay for your membership because it's free. Okay? And, uh, and, uh, you don't have to be a biomechanist to join it. And so this society is trying to, uh, standardize and share the knowledge, uh, of what's happening in baseball biomechanics. In addition, the markerless motion capture systems has enabled teams to have their own equipment. And hire biomechanist. Again, with the abbs, with the society, we're trying to, um, standardize or coordinate a thing. So, um, this is what I'm really excited about, that Biomechanists, uh, is a profession now baseball biomechanist, like you said, my professor wouldn't laugh at me. Now, uh, there are jobs doing this and I'm very excited that through this A, B B S, we're trying to, um, uh, share knowledge and, uh, really help everybody.

Mike: 39:48

That's great. That's awesome. And it, and it's a great society that you guys started. Um, I'm a member. You should join too. Um, I think that's, uh, an important thing to do. So, um, yeah, the future's exciting. Um, all right, last question. And it goes back to the beginning, right? We're gonna come full circle, just like a Seinfeld episode, but. Pitch clock, what do we got? Is it good? Is it is? Is it gonna harm people? What do you think? Is there gonna be an injury risk on the pitch clock? Because the satisfaction of the games, from the perspective and from the players, everybody loves it. But is there a concern? Is this, you know, fatigue unit that we should be looking at with people pitching so rapidly? Are you worried about it in.

Glenn: 40:25

well, you know, in 1968 they lowered the mound and they gave it a try and, and things worked out well, you know, and, uh, and so, but we we're live in a different time. Now, you don't just kind of say, Hey, let's give it a try. So Major League baseball has systematically got to this place. They've asked myself and other scientists to try to study some of these things. There've been some studies on, uh, whether, uh, it, whether timing affects pitchers. Uh, plus then it, major league baseball, professional baseball starts slowly and does it in minor league baseball before major league baseball. So it's not just willy-nilly. It's um, It's systematically gone about it in minor leagues. I don't have the data in front of me, but I, my understanding is it really did not have an effect on the injury rates to minor league pitchers. If it did, they'd back off before we put it in pro, in major league baseball. But in major league baseball, there's not enough data yet. It's just been a few months and, uh, and it's not, it's been an adjustment period. Obviously we see it from a performance point of view with the, uh, umpires calling, um, Pitch, pitch time or violation on batters and pitchers. It's a learning thing. Bottom line is I am confident, uh, that it will not have an effect on the risk of injuries, uh, for pitchers, for, uh, and the intangibles. I think, um, the position players and everybody, uh, shorter games, less time standing out there. I think, uh, for the health of everybody, mental, physical health, I think the shorter games are gonna be good.

Mike: 42:02

Yeah, that's, I, I, I think that's enormous. And I would say just anecdotally from one team experience, it's been, you know, a couple months into the season now, this is when Glen and I are recording this. Um, I don't think anybody has any impact right now. Um, at the beginning there, it was an adjustment. There. It was, it was rapid. So they, you know, they were a little fatigued going through it the first few times, but we trained that way. We did our bullpens that way this winter. We got spring training going that way, and I, I think they, uh, you know, they acclimated to the, to the stress. So I think it went, um, You know, really well. Um, but, you know, I, I remember, you know, to your last point, I think that was a great point, is the position players too. And not everybody realizes that, but I remember one year with the Red Sox, we had a decent amount of, of injuries and I was trying to do some risk analysis stuff and try to figure out what this was. Um, and I remember this, the Red Sox were the number one team. In minutes played per game, you know, because they led the league, I think that year in pitches per played appearance among other things. But that was a big thing. But we had the longest games. The shortest team, I think that year was the Baltimore Orioles and I did the equivalent of the Major League mean, uh, minutes per game. And the Red Sox played the equivalent of 16 more games than the Orioles by minutes. That's crazy, right? So think about that. Every, every pitch the second basement has to. Do a squat, right, like a mini squat to get in that position. You know, they, you know, their knees start to get banged up. It, it was impactful. So, um, but that's great to hear. I'm glad you don't think that there's, uh, you know, a negative effect because it seems like it's really helping the game. So, um, you know, appreciate people like yourself being involved with that because it's, it's been great. All right, before we let you go, the high five, we're gonna end five quick questions, five quick answers, kind of learn a little about, about, about you, an experienced, established leader in this field. I, I, I want to hear a little bit more about you. So first question is, what are you, Glen, currently doing yourself for your own professional development? What are you working on? What are you reading? What are you trying to get better at? Where are you right now?

Glenn: 44:00

Yeah, uh, um, I'm trying to get better. Uh, I'm, I'm really this marvelous motion capture. I'm really studying it from top to bottom. Not only is it used in baseball, it's gonna be used in physical therapy. And I, I alluded to it before, there's multi-camera and there's single camera systems. A multi-camera system essentially works like the multi-camera marker system where, um, where it tries to figure out in three dimension space where they are. The single camera systems are pretty interesting. They're artificial intelligence and, um, they're gonna be using physical therapy clinic. You basically set up a, a cell phone and try to do things. So I'm really trying to learn. How that's, uh, working, not just trust the people making it, that it works. I'm trying to validate it and understand how it works. Uh, I guess that's one thing I'm working on. Another thing I'm working on, uh, that's new in our lab is, uh, you alluded to it before about the big guy versus the little guy pitching. We're one of the studies we, we started here at Asmis in our cadaver lab where, as you know, we do research on cadavers and elbows and shoulders and knees and stuff. And we're, I'm trying to see if, um, If, if, uh, body height and weight, uh, are proportional to UCL strength, your ligament strength, uh, if a guy is 30% bigger, uh, was his ligament 30% stronger or is it unrelated? Because, um, in biomechanics we scale the forces and torques by weight and height. But, uh, but should we be doing that? I don't know. I don't know. If a guy is 30% bigger, has a bigger ligament, A strong, a ligament or not. So that's one thing we're working on also.

Mike: 45:37

Yeah, that's a good question. Everybody's different, right? I mean that, that's a good question. Um, I know this is supposed to be like the fast, lightning round, but I got another question I gotta ask. So are, are iPhones ever gonna get to the point where we can measure depth? Is it gonna be there?

Glenn: 45:49

Yeah. So that's what's happening. These, these, uh, some of these markerless single camera thing? Yeah. It, it, um, it measures depth only. If the cell phone has a body of knowledge in it, in other words, it can't look at the first baseball pitcher or a first fisherman or first person balling or whatever, and know what, but if, if it has a database of knowing what a, a baseball pitcher looks like, then it could look at a new baseball pitcher and figure out the three dimensional angles. Uh, that, that, that's the artificial intelligence. It's called a neural network or, or deep learning. And that's what's. Some of the technology companies are doing, and Mike, I'm really pretty impressed. I, I've been trying to validate, uh, the three dimensional, the multi-camera and the single camera ones and even the single camera ones are, are working pretty good.

Mike: 46:36

Right. Right. Especially if you ask the right questions and you know, the limitations. Right. And I, I think that's, I think that's awesome. So, uh, exciting stuff for sure. Um, second question. What's one thing you've recently changed your mind about professionally? Not the Mets. That the, they don't count that, that more professionally.

Glenn: 46:53

Um, you know, uh, recently, uh, we, we talk about a lot about, uh, strengthening the shoulder, the, the flexibility and the strength of the shoulder muscles to get our basal pitchers ready because the shoulder and elbow essentially mechanically are related and connected. But recently I'm thinking, I think we need more emphasis. I think we need more focus also on the forearm muscles. The flexor pronator, mass. The, the, the, the finger flexors and the, uh, forearm wrist flexors. I, I think, uh, not for the wrist point of view, but I, I think, uh, for the elbow point of view, I think we could put more emphasis on having those muscles, uh, strengthen.

Mike: 47:36

Yeah. I love that. That's great. And we've, we've, we've evolved that thought as well over the last, like, probably five to 10 years too. So it looks like we got another episode to talk about in the future, is how that works out. But, um, what's your favorite piece of advice that you give, uh, early career professionals? You have a lot of fellows, orthopedic surgeons, and rehab professionals that you see. What, what, what's your best piece of advice that you like to give new people?

Glenn: 47:59

Uh, I'd say two things. One, one, be confident in yourself, but don't be cocky. Okay? And, and, um, And that speaks for itself. I mean, uh, be confident yourself, but don't be a jerk about it. And the second one is basically be a, a team player. And, uh, what I mean by that is when the young guy starting, whether for a major league team or in a clinic or in a research lab, uh, listen to other people, you get a lot to learn. I, I have a lot to learn. Uh, and, um, and, uh, you know, we don't do it in politics or whatever, but in, in science, we should do it. Listen to other people with other views. And learn from other views and, and not be stuck in our thoughts. And really, um, I think that's how science works together, especially the scientists and the clinician working together. We, we see things the same things from different perspectives and, uh, I think really listen to each other and work together.

Mike: 48:51

I think that's great too. And I, I bet you that's something you take for granted too, because you've worked in such a dynamic environment for so long that that's just normal for you. Right? That's, that's something that you're used to.

Glenn: 49:00

I, I wanna say I also saw that from Dr. Andrews over the years. He was always famous and great from the beginning, but he was never so cocky that he didn't think he could, couldn't learn from other people, and he listened. And I, I listened still to other people and try to work as a group. Yeah.

Mike: 49:18

That's great. Awesome. Uh, what's coming up next for you?

Glenn: 49:22

I got, I got a couple things coming up. First of all, in, um, we're recording this right now in May, but in June I'm gonna go to the MLB combine and Major League Baseball started this combine a couple years ago, like the other sports do. And it's really exciting and I'm involved, uh, with Major League Baseball to try to help see how we're testing the athletes. The other thing is, this summer I'm going to Korea, I'm going to, um, Give a, we're going on a family vacation, but we're also, I'm giving a couple of speeches at, uh, two different Korean orthopedic society meetings, and I'm really excited about that. I've been to Korea and Japan before, but uh, baseball is big in America, but in Korea and Japan, uh, uh, I'm a rockstar there. They, they love our stuff and, uh, and uh, they're really excited about all science and baseball and, um, yeah. So those are the things coming up now. Yeah.

Mike: 50:13

That's fun. And you're a rockstar here too,

Glenn: 50:15

Okay. Thank. Thank you, Mike.

Mike: 50:16

uh, so, uh, I, there's a lot of things. I'm gonna put some links in the show note. I'm gonna put link to the, uh, American Baseball Biomechanic Society. Obviously asm, I, the, uh, ASMI Injuries in Baseball course is, is one of the highlights of my year of the course every year in late January. I, I, I know that's great. Um, but where else can we learn about you, Glen? I. Think you've, you've started something new recently that it would probably be worth people learning about, but where else can people find more about you?

Glenn: 50:46

And this is, this is an example of learning from other people. I learned this from you and Kevin Wil at our as m i Baseball course last January. You and Kevin, each independently said Glenn. Glenn, you gotta, besides giving these presentations in this conference, you gotta get on Instagram and other things like that. And really, Uh, that's totally true. So, um, I'm on Instagram now. I'm having so much fun doing it, Mike, and what I'm doing is I'm breaking down my years and years of studies into 92nd blips. Okay. And, uh, on Instagram, I'm the biomechanical man, uh, the underlying, biomechanical underlying man. And I'm posting again, you know, what's the difference of some of these things we're talking about throwing in full effort or, or, uh, fast balls versus curve balls. And, uh, I, I think the thing is Asmi and myself, I've done a wonderful job of reaching sports medicine clinicians who read our articles or comp to our courses, but we have not done as good a job yet at reaching the millions of people, uh, whether moms and dads or the physical therapists at this clinic here or there, or you know, the type of people listening to your podcast. And so with Instagram, the biomechanical man, I'm trying to do this and having a good time.

Mike: 51:58

That's awesome. And when Kevin and I first said that to you, right? I, we meant to share your research and your education. We didn't mean start a TikTok and explore new dance routines and all those things, but you're doing, you're doing a great job. But, uh, no, I, I, to me it's the power of social media. Right, you're, um, it's you, your account's amazing because it's authentic. It's you, it's your personality, it's your humor, which like, it, I, I think that's what makes it awesome and that's what makes social media so special is that you get to put yourself out there and, and share and, and you're doing a great job. So it's awesome to see that. You gotta follow Glen and Asm I, SMI is also now in the game, which is probably you, but that's fine. Um, uh, also in the game on Instagram, so, so definitely check them out. Um, and follow some of those links in the show notes to learn more about Dr. Fleisig and some of the things you can see, uh, from him in the future. But again, thank you so much, Glen. Uh, I can't thank you enough for being on the show again today, taking out time and your day to do this. Uh, that was an absolute blast. So appreciate it.

Glenn: 52:56

I always enjoy it, mate. Always enjoy it.