Those familiar with my work know I believe we can stop much of the UCL epidemic with proper screening, training, and logical progressions for athletes.


UCL Reconstruction Chart

Camp, C. L., Conte, S., D’Angelo, J., & Fealy, S. (2017). Epidemiology of Ulnar Collateral Ligament Reconstruction in Major and Minor League Baseball Pitchers: Comprehensive Report on 1,313 Cases. Orthopaedic Journal of Sports Medicine, 5(7 suppl6).


Looking at the current research on valgus stress levels that the ulnar collateral ligament is up to 3 times weaker than the amount of force is exerted on a throw with a baseball.


UCL Valgus Stress


Based on our current understanding that a UCL cannot alone handle the force that throwing a baseball puts on it, we can make the case for muscular size and strength (within the specificity of the throwing motion) as main factors that protect the UCL from being strained or torn.


With 1100 baseball players having tested the criteria of the 90MPH Formula and only having 2 reported cases where an athlete could hit the metrics of the formula and needed UCL reconstruction (worth noting neither of these were our athletes local or remote clients). We have had close to 50 as of this post that reported unable to hit the parameters and had UCL reconstruction. Although the collection of the data was not done in a formalize setting, we are working on a formalized study so we can draw better correlations with quality research.


The 90MPH Formula by Dr. Josh Heenan


With all of these data points, we can start to draw correlations:⠀
-If you can hit the metrics, you can throw 90mph (or harder).
-If you can’t hit the metrics but can throw 90mph, you are exponentially more likely for an elbow or shoulder injury (UCL surgery most often reported).

Correlation to increased velo (in order):
1) bodyweight
2) reverse lunge
3) chin-up
4) deadlift

Correlation to decrease risk of injury (in order):
1) chin-up
2) reverse lunge
3) deadlift
4) bodyweight

My current thoughts:
-Long toss is still an underrated tool.
-Weighted balls should be used minimally prior to mastering a reverse lunge with your bw on the bar and 10 perfect bodyweight chin-ups.
-Optimal bodyweight is 2.75-3.25 x height in inches
-A 1.5x bodyweight reverse lunge is likely a replacement for 10 reps with bodyweight on the bar.
-Position players that reverse lunge 1.75x bodyweight (1rm) can run a 6.5 or less if they incorporate hill sprints and plyos as they are reaching those levels of strength.
-PO don’t sprint enough to have those strength gains carry over to elite level speed.
-Reverse lunges seem to be HIGHLY correlated to mound velocity, exit velocity, and 10/20/40/60 yard dash times.
-People seem to think I only like reverse lunges which is untrue. There are a ton of ways to increase your reverse lunge. Use what you need to get the reverse lunge to increase.
-Squatting (esp a true box squat) offer a ton of pros to getting you stronger and more athletic, they just don’t correlate to increased velo or decreased sprint times as well as lunges.
-Most high level athletes can achieve many of these numbers with one solid year of training year round. And yes, if you are not training year round I think you are going to spin your wheels for most of your career.
-Deadlift doesn’t seem to correlate well to injury prevention, but I do see a great value for it in terms of force production and adapted muscle mass. However, a 600lb deadlift doesn’t mean you should throw 110mph.

We may not have all the answers, but these correlations should allow athletes, coaches, and parents to utilize the above information in a progressive manner to start to reduce the UCL surgery epidemic we are seeing.