This joint is jumping

Sox get results from shoulder program

By Amalie Benjamin
Globe Staff / March 1, 2009
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FORT MYERS, Fla. - It was less than three years ago when the gasp went up, when "subluxation" entered the vocabulary of a baseball player and a team and a fan base. All watched as Jonathan Papelbon's prized arm came out of its socket and were left to wonder whether he would ever be right again. Since then, the closer has 78 saves, one World Series ring, and a shoulder that has remained healthy in each of the last two seasons. He knows why.

"I think it's been the No. 1 key," Papelbon said of the role the organization's shoulder program has had in keeping him on the mound. "For me, it's just part of my routine every day to get ready. It's just what I do. It just comes like I'm putting on my cleats."

The Red Sox shoulder program, which has been given much ink and little explanation this spring, starts early, almost from the moment pitchers are drafted by the organization. Prospects are evaluated, analyzed, and immediately given a set of exercises. "Shoulder program," in fact, is a misnomer. It's an entire arm program, designed to slow injury from the forearm to the shoulder.

And it's something that was mentioned early by two free agents signed by the Sox this offseason, both Brad Penny and John Smoltz speaking glowingly of the team's commitment to its shoulder program. But, general manager Theo Epstein cautioned, there isn't a whole lot different in the Sox' program than in the programs of the rest of baseball's clubs. The fundamentals, he said, are the same everywhere.

"Unfortunately, baseball's a pretty self-destructive sport for your body," said Mike Reinold, the Red Sox assistant trainer who has helped create and implement the program. "I think it's inevitable that these players are probably going to get injured at some point in time. We like to think that we're prolonging their careers and we're maximizing their years of effectiveness."

It would be impossible to document the entire shoulder program. Not only are the Sox loath to give specifics, but the program is individualized for each player, and even then, it's not the same every season.

"It's always evolving, and that's the beauty of it," Papelbon said. "It's not just set it stone. You can always tweak it here and tweak it there."

Weights are a help
For about 15 minutes a day, three times a week in the offseason, Papelbon acts as if he's in a rehab facility. He will lie, face down, on a training table and lift small weights.

He starts slowly in the beginning, at just two pounds, with the goal of reaching eight pounds by the time he heads to Florida for spring training. The weights, clutched in his closer's hands, will go out straight from his body. Or he'll bend at the elbow, in something akin to a biceps curl. Papelbon says this season might bring an added twist of the wrists at the end of the arms-straight-out exercises.

With the combination of an offseason program in which he builds strength and an in-season program designed more to maintain that strength, Papelbon and Reinold have fashioned a program that, they hope, will keep him pitching for the Sox. During the regular season, he does the exercises most days before he heads out on the field before the game.

But there are no eight-pound weights at that point. And every day is not exactly the same. Reinold will say only that the program is "consistent."

"It's a daily routine," Reinold said. "They don't do the same thing every day, but there's a daily routine to it."

If that sounds like code, it is. With teams doing anything and everything they can to get ahead, the Sox think, in the words of Reinold, "There's a chance at maybe a competitive advantage."

And because of that, information is difficult to come by. Yet the impact is there. Not only has the program helped ease injuries in pitchers like Papelbon and Josh Beckett, and helped Curt Schilling get back on the field with a torn labrum in 2007, it also perhaps has become an additional incentive for players to sign with the Sox.

"When you understand the money that you commit to these guys, it makes no sense not to have someone work with those 10, 11, 12 [pitchers]," Schilling said. "It's a daily eight-month-a-year [program] every single day for an hour or two. If you're investing $11 million in a pitcher, you can't let him do as he pleases. I think they've become very proactive in that."

Expertise developed
Snatched from Dr. James Andrews's American Sports Medicine Institute in Birmingham, Ala., in 2005, Reinold has worked with Sox trainer Paul Lessard and team doctor Tom Gill to protect arms and prevent injuries on the team. Reinold had seen hundreds of players come through Andrews's offices, different types of arms with different types of injuries, and it was there that some of the expertise was born.

"It takes putting how we understand just how the shoulder works itself, which isn't as simple as it sounds, and then how the shoulder works in a baseball player," said Reinold, who has a doctorate in physical therapy from Massachusetts General Hospital. "Then how a shoulder gets hurt in a baseball player. It takes really putting those together to develop the exercises.

"So the exercises are based on that background knowledge and then it's based on biomechanical and research studies that show which muscles are active while you're throwing, then some biomechanical research studies . . . to determine what's the best exercise position to strengthen a muscle."

Or, as Papelbon explains it, "You go in a gym and you lift weights and that really hits all your major muscle groups and these little weights and these little movements that you're doing are really trying to hit all your fast-twitch muscles, your smaller muscle groups."

The reason Reinold believes the program is so helpful and perhaps slightly different from that of other organizations is that he spends the offseason doing original research at Mass. General with Gill, on both "normal" shoulders and those of pitchers, from major leaguers on down. Penny, for one, said he is on a significantly expanded workload than ever before in his career, with exercises that he hadn't been taught at any other point.

"My duty to our team is we're never done striving to perfect the program," Reinold said. "So it's changed every year. Every year I've been here it's been slightly different. As new information comes out or new research becomes more prominent, we adapt the program.

"We always try to stay one step ahead. I think one of the benefits we have as the Red Sox organization is that we don't have to wait for research to be conducted and presented for us to adapt our program. We're the ones doing a lot of the research. We're the people that try to solve the problems first."

Flexibility built in
The changes can be subtle, but necessary. If a pitcher is overly fatigued, like a reliever working three straight days, the program is altered. A pitcher can feel good and do three sets of a particular exercise, or dial back and do two sets. He can seem strong and use five-pound weights, or feel weak and use three-pound weights.

That's where the communication comes in, between the pitcher and the trainer, the pitcher and the pitching coach, the pitcher and himself.

"On any given day, our communication on individual players can be anywhere from three to five times," pitching coach John Farrell said. "First when you get to the ballpark, after their early work, once we get on the field and go through throwing programs, the follow-up to that. Our communication is frequent and consistent."

Throwing programs, too, are a group effort between the training and coaching staffs, as they work to alleviate stress on the arm and stress on the mind of pitchers.

"It makes you confident, it does," Papelbon said. "This is just one little thing to prevent injury. You know you can't sit here and say I'm never going to get hurt or nothing because you just don't know about that. But it's something that you know is not going to hurt you. Even if you get a little amount of gain from it or a little bit of strength or any little tiny benefit from it, it's effective."

As Schilling said, "One of the things I think that made me pitch well consistently was I would get on the mound, there's no question I did what I needed to do to get ready. You put your confidence in people like that, and you're basically handing them your career in that sense. There's a lot that goes with that."

When Schilling was 19 and in the Red Sox organization, he said, he didn't even have a pitching coach. There was just a roving instructor. Now, even players straight out of the draft are being monitored and encouraged to be diligent in a program designed specifically for them. The hope is that by the time they sit next to Papelbon in the bullpen or pitch behind Beckett in the rotation, they will be indoctrinated into the program.

And instead of talking about torn labrums or rotator cuffs, the talk will be of starts and strikeouts.

"You're going to have your ups and downs in the season," Reinold said. "You're going to have your bumps and bruises. There's no other sport that plays as many games as we do. It's inevitable. But I think that success, it doesn't have to be for one particular player . . . if we get through a season healthy, then that's the success."

Amalie Benjamin can be reached at

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