2. Konin ©2009 Jeff G. Konin, PhD, ATC, PT Associate Professor & Vice Chair Department of Orthopaedics & Sports Medicine Executive Director The Sports Medicine & Athletic Related Trauma (SMART) Institute Preventing Injuries in Throwers with the Core and Hips

3. Konin ©2009 Serape  Draped loosely and crosses over the front of the body in an “x” shape  The concept has been translated to muscle function reinforcing the muscles of the core as a connector  The serape muscles are considered to include:  the rhomboids, serratus anterior, external obliques and internal obliques Logan, G., & McKinney, W. 1970. The serape effect. In Anatomic Kinesiology (2nd Ed., pp. 154-561). New York: William C. Brown, Co. a colorful garment worn by the people of Mexico

4. Konin ©2009 Serape Effect  In ballistic actions such as throwing and kicking, the serape muscles add to the summation of internal forces. They also transfer internal force from a large body segment, the trunk, to relatively smaller body parts, the limbs  Hip to shoulder relationship

5. Konin ©2009 Logan, G., & McKinney, W. 1970. The serape effect. In Anatomic Kinesiology (2nd Ed., pp. 154-561). New York: William C. Brown, Co

6. Konin ©2009 Deficits in measurable active & passive hip extension, active hip flexion with pain (Kouvalchouk Rev Chir Orthop 1998) Serape Effect Konin et al ATT 2003

7. Konin ©2009

8. Preventing Injuries in Throwers with the Core and Hips LE Flexibility (Used as part of an overall warm-up) Ipsilateral hip extension Hip IR/ER (Lack of IR will force truck to open early and increase stress on medial Elbow and /or anterior shoulder) Core Training for Throwers Abdominal Bracing /Drawing in maneuver Prone Cobra Progression LE Balance/Proprioception* Standing Pulls - ant/post/lat pull (Weak gluts cause the hip to drop leading to drop of shoulder) LE Functional Strength Training** Wind-Up/Lunge with twist Lunge with twist Step-Ups with twist *Functional exercise that is multiplanar, incorporates the lumbo-pelvic-hip core complex and can be challenged with proprioceptive input from unstable surfaces, eyes closed, etc ** Lunge strength will help deceleration injuries to the shoulder

9. Konin ©2009 Preventing Injuries in Throwers with the Core and Hips LE Flexibility (Used as part of an overall warm-up) Ipsilateral hip extension Hip IR/ER (Lack of IR will force truck to open early and increase stress on medial Elbow and /or anterior shoulder)

10. Konin ©2009 Preventing Injuries in Throwers with the Core and Hips Core Training for Throwers Abdominal Bracing /Drawing in maneuver Prone Cobra Progression

11. Konin ©2009 Preventing Injuries in Throwers with the Core and Hips LE Balance/Proprioception* Standing Pulls - ant/post/lat pull (Weak gluts cause the hip to drop leading to drop of shoulder) *Functional exercise that is multiplanar, incorporates the lumbo-pelvic-hip core complex and can be challenged with proprioceptive input from unstable surfaces, eyes closed, etc

12. Konin ©2009 Preventing Injuries in Throwers with the Core and Hips LE Functional Strength Training** Wind-Up/Lunge with twist Lunge with twist Step-Ups with twist ** Lunge strength will help deceleration injuries to the shoulder

13. Konin ©2009 Summary An example of a program that can be implemented to maximize performance and reduce injury