The Thoracic Outlet Syndrome T -- or, more simply, the TOS-T -- is the term I use to refer to what I believe is an extremely dangerous position and movement pattern.

Josh Beckett Pitching Mechanics

Josh Beckett

I define the TOS-T as both upper arms elevated with the pitching arm side humerus at more than 90 degrees of abduction (aka Hyperabduction), minimal external rotation, and pronation into -- or worse at -- foot plant.

Matt Harvey Pitching Mechanics

Matt Harvey

The position that Matt Harvey is demonstrating in the picture above used to be called and taught as the Flex T. However, it is now referred to as the...

These positions, which are encouraged through the use of The Most Dangerous Cue, are problematic because, in my opinion, they don't just significantly increase the risk that pitchers will have elbow problems. Instead, by creating a serious Timing problem, they significantly increase the likelihood that pitchers will have shoulder problems and, even worse, Thoracic Outlet Syndrome.

Flex T

I also call it the Terrible T because, while it will often yield a short-term velocity boost, there is an EXTREMELY high likelihood that it will cause elbow and then shoulder problems.

Terrible T

The Terrible T is what caused Matt Harvey's elbow and shoulder problems and will continue to cause problems, and likely end his career, if he doesn't change anything after coming back from Thoracic Outlet Syndrome.

Matt Harvey Demonstrating the Terrible T

This is a summary piece, but I discuss a number of related topics in these pieces...

As the case of Matt Harvey sadly demonstrates, the lethality of the Terrible T is increased even further when it is accompanied by cues like...

Thoracic Outlet Syndrome T

The key attributes of the Terrible T are that...

  • Both arms are extended and at or just above the level of the shoulders.
  • Into, and in the worst case at, foot plant.

Terrible T

The same basic movement pattern is sometimes using the term Power T.

The Problem

The problem is that the Terrible T is widely advocated and taught, including as part of the Mayo Clinic power position; they believe the Terrible T is one the keys to the mechanics of a safer fastball.

It's not.

Terrible T

Part of what makes the Terrible T just that is that you can find examples of it all over the Internet as part of articles that purport to teach proper or safe pitching mechanics.

Terrible T

The Stakes

I believe the incidence of Pitching-Induced Thoracic Outlet Syndrome (piTOS) is hockey-sticking. There were...

  • 7 cases of TOS in M/MiLB pitchers from 2001-2015
  • 6 cases of TOS in M/MiLB pitchers during 2016 alone.

I discuss why that is a problem in...

The Alternative

I believe that Terrible T results in part due to a misunderstanding of how Roy Halladay (actually) threw the ball. As a result, the alternative is to study Roy Halladay and understand what I call the Ready Position.