Sean Doolittle: Rehabbing a Shoulder

The least interesting thing about recovering from a shoulder injury might be trying to figure out how it happened. It happened, and life has to move on. In Sean Doolittle’s case, it might — might! — have happened while he was taking anti-inflammatories for his oblique late last year, meaning the pain was “slightly masked” by the drugs as the pitcher put it. Who knows.

The best you can do is strengthen the muscles around the injury and work your way slowly back to health. You can’t just start throwing. “Your instinct is to open it up as soon as you get a ball in your hand,” said Doolittle before the A’s first game this season. So the team keeps the ball away from you for a bit.

Kyle Boddy, who founded pitching development complex Driveline Baseball, isn’t surprised to hear Doolittle talk about that instinct to throw hard. “Guys literally have no idea how to play catch,” Boddy said. “They line up from 45 feet and start throwing like 65-70 MPH. This is because many pro organizations give you ten minutes to throw before taking the field, which is ultimately pretty injurious and limiting to the arm.”

So before the throwing come the strengthening exercises. These might be familiar to any pitcher, but Doolittle says he’s just been doing them more often, in more variations, with more sets.

Many involve resistance bands and shoulder and arm movements against the resistance created by those bands. Other exercises have him holding the bands in static positions as a trainer pushes in different directions on his arm. Each time his body attempts to bring the hand back to that static position, a different small muscle is activated. Even without a resistance bad at home, you can test the theory by balancing on one foot with your eyes shut — notice all the little muscles in your legs and torso that work hard to keep you upright.

The upshot is that those muscles in and around the injured rotator cuff are now stronger than they have been. “My shoulder is doing better on strength tests than it ever has,” Doolittle said, “I feel great.” There’s no official timetable, but the pitcher thought he could get back to the major league team within four to six weeks.

And yet, the team has kept him off the mound. Once he started feeling better, they handed him a sock. “Just one of those utility socks, with a ball in the end,” laughed Doolittle. If it seems strange to do everything but really let go of the ball, Doolittle agreed but said he understood once they explained. When you throw the ball normally, you can’t help but think about the release point. That means you’ll try to adjust, even without thinking, and you’ll activate the smaller muscles in your arm and shoulder. Throwing with the sock allows you to “get those muscles going” without thinking about the finer points of your mechanics.

Doolittle has graduated from the sock. He’s still got some towel throws to do before he gets a ball on any given day, but he’s actually throwing balls now once he warms with the towel. Boddy prefers to warm with something other than a towel, as he feels “it’s not a good movement pattern that chains well into throwing,” but he understands why it’s used. Driveline uses “plyometric overload balls that are not baseballs — critical so the athlete doesn’t make that mind-body connection — and have them throw at low-intensities into a wall, net, or catch play partner (sparingly).”

When he finally started throwing, Doolittle lined up 45 feet away from the catcher. He was surprised at how much he just wanted to throw the ball hard right away, but all that time off made him a little anxious to huck it, maybe. He hasn’t been a pitcher all that long — he converted from first base in 2011 at the request of the team — so some of it can be chalked up to getting the hang of things.

But, generally, much of the rehab process is built to go against the natural instincts of an athlete. You’re forced to take things slowly so that your competitive instincts don’t take over. You’re forced to throw socks and towels and stand on balls holding rubber bands because it’s important to take things slowly, and to remove your natural instincts from the muscle work that needs to be done.

So, when Sean Doolittle takes the mound again, hopefully sometime in May, you can appreciate how long he’s been waiting for that moment. And what he’s had to do to get there.

With a phone full of pictures of pitchers' fingers, strange beers, and his two toddler sons, Eno Sarris can be found at the ballpark or a brewery most days. Read him here, writing about the A's or Giants at The Athletic, or about beer at October. Follow him on Twitter @enosarris if you can handle the sandwiches and inanity.

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There are only two pitchers that I know of who have come back from rotator cuff damage are Pedro Martinez and Jesse Crain. I actually think Doolittle will be the third.

I believe in him because I bet he has very low mileage on his arm, he is a very intelligent & disciplined athlete (who did not continue as a position player once he saw he was unlikely to make it and converted to a pitcher before he got too old), and the PRI (platelet rich injections) seems like an effective treatment to help the body heal a small internal injury.

But. This exercise of trying to come back ftom rotator cuff damage doesn’t end well for most pitchers. If he makes it, it would be a significant achievement. (I think Roy Halladay was the last big name to try.

I really hope to see the paradigm of helping the body heal itself (in this case through the injections) take hold. All these surgical techniques like TJS, while they do prolong some careers, also end many others when employed too aggressively.

Too bad the PRI doesn’t seem to be working for Tanaka. Of course, his problem is in the elbow and not the shoulder.

Generally speaking, if your fantasy pitcher has a rotator cuff injury, unless it is really minor, you should just drop the player.