Jan 29, 2015Amber Weaver
By R.J. Anderson
R.J. Anderson is an Assistant Editor at Training & Conditioning. He can be reached at: [email protected].
When power-hitting third baseman Amber Weaver first stepped on the softball field at Barton College for fall practice in 2011 after transferring from Louisburg College, there were lofty expectations for the two-time National Junior College Athletic Association Region X Player of the Year. But she also arrived with a sore right elbow that required constant attention. Three years and one shoulder surgery later, Weaver completed her senior season as one of the team’s top hitters, its inspirational leader, and the Conference Carolinas’s inaugural Comeback Athlete of the Year.
Weaver’s comeback story begins with the elbow pain in her throwing arm, which was diagnosed as a subluxing ulnar nerve by Mark Galland, MD, an orthopedic surgeon based in Raleigh, N.C. “It was a stabbing pain,” says Weaver. “My middle, ring, and pinky fingers tingled when my elbow bent in a certain direction. Along with ice and massage, Kinesio tape on that area really helped.”
Because it was a nerve issue, Galland was confident that continuing to play would do no long-term damage, so Weaver did. But as the season progressed, she encountered a new obstacle–her right shoulder began to ache and quickly became more painful than her elbow.
Barton Athletic Trainer Tammy Holleman, MA, LAT, ATC, who was recently promoted to Coordinator of Athletic Training Services, chalked up the symptoms to a rotator cuff impingement or tendonitis, common in softball players who have a rounded shoulder posture and sling the ball sidearm as Weaver does. Holleman also surmised that Weaver’s compensation for her elbow injury might have contributed to the shoulder pain.
Weaver remained on the field while Holleman worked to manage the elbow and shoulder pain with ice and e-stim treatments, massage, and light resistance exercises to strengthen the areas around Weaver’s shoulder and forearm. “We also modified how many throws she made during practice and how many at bats she had,” says Holleman. “We held her back as much as we could without taking her off the field. We were trying to avoid any long-term consequences.”
Then, during a mid-April game, with her team locked in a tight race for a playoff spot, Weaver dug into the batter’s box, swung at an outside pitch, and felt a pop in her right shoulder. Despite the accompanying pain, Weaver kept the development to herself for a few days. When she finally told Holleman, the symptoms had subsided a bit and didn’t get worse when she swung or threw, so she remained in the lineup. Meanwhile, Holleman focused on treating the pain with a goal of Weaver finishing the season.
The team just missed out on postseason play, despite Weaver’s efforts. She played in all but one game and finished with a .300 batting average, 22 RBIs, 17 runs, 14 doubles, and two home runs. Her average of .38 doubles per game ranked in the top 20 in NCAA Division II.
Almost immediately after the final game, Weaver had an MRI on her shoulder, which showed subtle fraying and increased intrasubstance signal at the posterior superior labrum from the 9 o’clock to 11 o’clock position. Galland gave Weaver two options for treatment: arthroscopic surgery to assess the condition of her labrum followed by a possible surgical repair if necessary, or a basic rehab and strengthening program that would theoretically get her back much sooner than surgery.
Weaver chose rehab and began working on a labrum rehab and shoulder-strengthening program that summer with Cole Vertz, MS, LAT, ATC, CES, who was Barton’s Athletic Training Services Coordinator at the time. “It was the normal labrum rehab protocol that starts with light resistance and adds intensity and weight as tolerated,” says Holleman, who had a nine-month contract with Barton and was off during the summer. “When I came back in August, I took over the rehab. However, by October, Amber was still having some pain in her shoulder. At that point, the options were more rehab and possible steroid injections so she could play her senior year, or redshirting and undergoing surgery.”
Ready for a new approach, Weaver opted for surgery. However, she had to put it off until December. “As a physical education major, I was taking a class teaching net games like tennis, volleyball, and badminton. To complete the class, I had to participate and needed to be able to use my shoulder,” says Weaver. “I had to pass that class to graduate, and it wasn’t being offered again for another two years. So I talked to Dr. Galland, and we decided to schedule the procedure for Dec. 19. I would miss the 2013 season, but it would give me plenty of time to be ready for fall ball later that year.”
The arthroscopic portion of the procedure revealed a superior labral tear from anterior to posterior, commonly known as a SLAP tear. Galland made the necessary repair, and Weaver began yet another rehab program with Holleman.
“It was a relatively straightforward SLAP tear rehab protocol,” says Holleman, who worked with Weaver nearly every day that winter and spring. “We started out addressing range of motion, then moved into isometrics and light resistance before adding plyos and eventually working our way up to a throwing program that we started that summer.
“There were some issues along the way, though,” Holleman continues. “As we began rehabbing Amber’s shoulder, her elbow, which had calmed down after the season, began hurting when she did certain strengthening work, like push-ups. So there were exercises I had to modify to minimize her elbow flare-ups.”
When it came to choosing rehab exercises, Holleman checked in with Galland every couple of weeks. “He gave me feedback and provided some ideas on what I might try in the rehab,” Holleman says. “He was really good about giving me free rein to tailor the rehab to what I was seeing with Amber but also offered ideas if I got stumped or she had a small setback.”
Holleman also had another great resource in a very convenient place–at home. “My husband is an athletic trainer at North Carolina State University and worked with baseball for a number of years, so I pick his brain a lot when it comes to rehabbing throwing athletes with arm injuries,” she says. “I always try to tap into my network of resources when doing long-term or complicated rehabs. My husband and I talked about different exercises to try with Amber and how her posture and throwing biomechanics might have contributed to her injuries.
“For example, I noticed she dropped her elbow when she threw, which places a lot of strain on the elbow and shoulder,” Holleman adds. “So later in her rehab, when we progressed to throwing, I worked with her on practicing with her elbow coming over the top.”
Along with the physical and mechanical aspects of the rehab, Holleman focused on keeping her patient in the right mindset. “I loved working with Amber because she was very motivated, but there were times when I worried that some minor setbacks like post-session soreness or a slow progression would get her down,” says Holleman. “With long-term rehabs, the psychological component is one of the biggest hurdles. As a college soccer player, I tore my ACL during my senior year, so I know how hard the process can be.”
Weaver appreciated Holleman’s perspective, motivational tactics, and bedside manner. “Tammy and I had a lot of long talks about staying motivated through the tough times, and she really helped me stay levelheaded and understand that tough days happen during rehab, but you have to push through the discomfort,” says Weaver. “She got me to dig deep, work through adversity, and stay positive.”
During those talks, Holleman encouraged Weaver to stay connected with her teammates. “I told her that as much as it killed her to not be out on the field, she had to do everything in her power to remain part of the team,” says Holleman. “And to her credit, she was there cheering and offering tips at almost every practice and game.”
Weaver says not being on the field was the hardest part of the entire process–especially when the team struggled. “It was the first time I had been out with an injury in my career, and I couldn’t believe how tough it was going from playing every inning of every game to not playing at all,” she says. “But I’m an encourager by nature, so I did my best to help my teammates from the sidelines.”
By June, Weaver was ready to begin a throwing program. “Even though I wasn’t working at the school over the summer, we kept in touch while she was doing the program I gave her,” says Holleman. “Sometimes she would feel a little sore afterward and come to campus to work with the athletic training coordinator. He would have her back off on the program until the pain subsided.”
That fall, Weaver was cleared to play and more than ready to go. Holleman, meanwhile, spent the semester on maternity leave. After returning in January, she began working with baseball instead of softball. Still, she kept up on Weaver’s progress.
“Even though I was working with a different sport, I talked to Amber whenever I could,” says Holleman. “When the softball team started its season, I was always checking her stats.”
Holleman also communicated with the softball team’s new athletic trainer, Kate Kautzky, MEd, LAT, ATC, about Weaver’s rehab history. “I gave her some insight on things we had done–what worked and what didn’t,” says Holleman, “But at the same time, I didn’t want to step on her toes and tell her how to do her job.”
Batting third in Barton’s first game of the 2014 season, Weaver struck out in her first plate appearance–a result she was not used to. In her second at bat, however, she displayed the resilience and mental toughness that defined her rehab.
“After that strikeout, I refocused and told myself, ‘This isn’t how you play ball, and this isn’t what you worked for,'” Weaver recalls. “Then, I dug in for my next at bat and hit one out of the park. It felt great to touch home plate. Everybody in our dugout was fired up and high-fiving.”
Despite some reoccurring shoulder and elbow soreness that was managed by ice and e-stim, Weaver completed a memorable senior season. She played 39 of 40 games and batted .299 with 17 RBIs, 17 runs, seven doubles, and four home runs. Among the team leaders in nearly every offensive category, Weaver ranked in the top 10 of Conference Carolinas in home runs and was in the top 25 in five other categories.
Proud and satisfied with the way her college career turned out, especially because of all the adversity she overcame, Weaver says Holleman was a major contributor to her success. “Not only was she my athletic trainer, she was my mentor and role model,” says Weaver, who hopes to work as an elementary or middle school health and physical education teacher and continue with softball as a coach. “Being able to knock on Tammy’s door whenever I was having a rough time was critical to me staying positive.
“She cared about my feelings and emotions and knew how to pick me up when I was having a bad day,” Weaver continues. “Knowing that my athletic trainer cared so much for me not only on the field, but off it as well, meant everything to me.