We recently received a referral from Dr. Jeff Kindred, a primary care sports medicine physician we work closely with. A local college pitcher presented with severe medial elbow pain. He had already been working on the issue for weeks without improvement.
On examination, the problem was clear. His elbow pain was secondary. The true driver was his shoulder.
When we measure a throwing shoulder, we expect approximately 180 degrees of total arc of motion, meaning the combined internal and external rotation equals that benchmark. He was missing more than 30 degrees of rotation. That deficit dramatically increases elbow stress.
Our approach included manual therapy to restore shoulder rotation, upper thoracic spinal adjustments to improve mobility, shockwave therapy directed along the medial elbow, and progressive strengthening and neuromuscular control.
As we restored shoulder motion, elbow symptoms resolved. Now, as the season ramps up, he is pain free. This is why targeted diagnostics matter.
What Makes the ASMI Conference Special
The ASMI baseball conference is unique because it blends research and application. At the 2025 event, it was an honor to meet Dr. Michael Axe, internationally recognized for his return-to-throwing programs through the University of Delaware. Having the opportunity to ask specific clinical questions and receive honest, collaborative feedback is invaluable.
I also had the chance to speak with Dr. Keith Meister, team orthopedic surgeon for the Texas Rangers, about evolving elbow trends and surgical considerations in high-spin pitchers.
And perhaps the most meaningful moment was watching Dr. James Andrews receive a Career Achievement Award from Major League Baseball. It was a powerful reminder that excellence in sports medicine requires lifelong dedication and humility. When the best in the world collaborate openly, everyone benefits — especially the athletes.
How Active Sports Therapy Applies This Knowledge
What separates a specialist from a generalist is application. At Active Sports Therapy in Hendersonville, we focus on root cause analysis, total arc of motion testing, upper thoracic mobility assessment, scapular control evaluation, and AI-assisted motion measurement.
We are pioneers in integrating AI medical software to measure joint ranges of motion in real time. This allows us to compare before and after changes immediately and ensure meaningful progress. Throwing athletes do not have time for guesswork. They need precision.
Why Specialization Matters for Rotational Athletes
Baseball pitchers and golfers share a common challenge. They produce force through rotation. When rotation is limited in one area, another structure absorbs the stress.
In pitchers, that often becomes medial elbow stress, UCL irritation, posterior shoulder tightness, or internal rotation deficits. Treating symptoms without evaluating the entire kinetic chain leads to recurring injury. That is why athletes from across Middle Tennessee are increasingly seeking out specialists with rotational expertise.
Final Thoughts from Birmingham
Attending Dr. James Andrews’ conference reinforced something I have believed for years: Elite care requires constant education. Throwing sports are evolving. The data is evolving. The torque is increasing. Specialists must evolve too.
At Active Sports Therapy, our commitment is simple: We stay in rooms with the best in the world so our athletes can perform at their best here in Hendersonville.
If you are a throwing athlete experiencing shoulder or elbow pain, the solution may not be where it hurts. It may be in the system that drives it.
