Why Stephen Strasburg Is Injured Again

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Nationals pitcher Stephen Strasburg was recently put on the 15-day disabled list with an oblique strain. This is his second stint on the list during the 2015 season, which is at the midway mark. After the game, he told reporters that, “[The left side is] pretty tight. Don’t really have an explanation. Everything felt pretty good. I just threw a pitch to [Buster] Posey there. He grounded out and I just felt it grab.”
We can tell you that everything happens for a reason in the body. His oblique didn’t just “grab” out of the blue. It wasn’t an aberration. He hurt himself pitching, a motion he had done since he was a boy and countless times throughout his career. Why was this one pitch different? His body wasn’t able to maintain the compensatory pattern to make up for imbalances and inefficiencies in the kinetic chain.
In the complex motion of pitching — especially at a pro level — nearly all of your muscles are working together to create the power and precision. The kinetic chain needs to work in synchronicity and sequentially to generate the arm speed, and really whole body speed, needed for pinpoint location and speed. When Little Leaguers learn to pitch, they learn to focus on the legs, hips, and arm. The lower body loads before the pitch and drives toward the mound, creating the power base. And the arm will follow, acting like a whip. What people often skip is the core, which creates power and stabilization in all three planes throughout the pitching motion.

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According to the National Institute of Health, the time elapsed between front foot contact and ball release is only 0.145 seconds. Blink your eyes three times, and that is the time needed to create incomprehensible speeds of up to 101 mph, putting a huge amount of stress on the body. To make this work, each muscle has a specific task. When your muscles don’t do the task they are assigned to do, another muscle has to step in to compensate. And the compensating muscle isn’t designed for that task and will break down faster. You wouldn’t have your right fielder come in and pitch in a close game, and you can’t replace your lats with your obliques.
His first time on the disabled list was due to a tight neck. Now it is the oblique. The body is amazing and will compensate for as long as it can. And when it can no longer compensate, it breaks down.
For long-term health, pitchers need to address muscle imbalances in order to remain durable and withstand the massive forces that are translated through the body. In Strasburg’s case, I see three positional faults:
Head Position: He has a forward head posture. This creates passive insufficiency, meaning his muscles are too long and cannot contract properly, of his posterior chain (the lats and lower trap) and active insufficiency, meaning his muscles are too short and can’t contract properly, of his anterior chain (abdominals).  
Forward shoulders: I see upward rotation, anterior tilt, and elevation of the scapula, which also creates passive insufficiency of his lats, lower trap, and serratus anterior, causing him to overuse his pecs, biceps, forearm, tricep, upper trap, and levator scapula.
Increased torsional force: He is unable to control his follow-through and ends up with his head outside his center of gravity. If the right lat isn’t working properly, then the left glute doesn’t engage at full capacity and creates a lack of torsional-force absorption and increased rotation. This has worsened over the years due to continued compensation strategies.

David Reavy, founder of Chicago-based React Physical Therapy, is the creator of the Reavy Method, a whole body approach to physical therapy and exercise. Reavy works with numerous pro athletes from the NFL, NBA, MLS, and the WNBA.

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