Trey Lance and the mystery of ‘arm fitness’

Can arm fitness really be a problem for NFL QBs? We asked Associate Professor of Orthopedic Surgery at UCSF @DrNiravPandya.

The 49ers’ offseason quarterback conversation took a new twist when a former NFL offensive lineman introduced a new variation of criticism of Trey Lance coming vaguely from within the 49ers organization. “Arm fitness” was the phrase du jour Wednesday as fans tried to decipher exactly Altitude Sports Radio’s Ryan Harris used it to describe some of the organizational misgivings about San Francisco’s young quarterback.

To get to the bottom of what that might mean, we spoke with Associate Professor of UCSF Orthopedic Surgery and Director of Sports Medicine at Benioff Children’s Hospital, Dr. Nirav Pandya about the idea of arm fitness for a quarterback.

Here’s what Harris originally said on CBS Sports HQ:

“From players I’ve talked to and coaches I’ve talked to who are at the 49ers, Trey Lance is really leaving a lot to be desired in terms of the fitness of his arm, whether or not he can digest the playbook, and can really start to process the game at a high level.”

He elaborated on Twitter that arm fitness meant “the ability to consistently throw the football all season long and beyond to the playoffs.”

Lance threw just 318 passes in college, and 71 last season.  While processing and playbook knowledge are common quarterback critiques, and critiques Lance will have to answer, the arm fitness portion is a new one. It’s so new, in fact, Dr. Pandya has never heard the term used for a QB.

“I have never heard that about a QB, only pitchers,” Pandya said. “QBs can definitely hurt their shoulder, but in the absence of some structural issue, they don’t throw enough or fast enough to have general durability issues. That’s why you don’t see QBs getting Tommy John surgery.”

The throwing motion for a quarterback and the volume of throws a quarterback makes don’t put the same stress on the arm that throwing a baseball does. That’s why not even a long, grueling offseason training program would be enough to wear out a QB.

A study conducted by Jacob M. Kirsch, M. Tyrrell Burrus, and Asheesh Bedi that explored common injuries for pro quarterbacks found that any issue with a QB’s arm tend to come from impact, not because of use:

Shoulder injuries are the most prevented upper extremity injury among professional football quarterbacks. The quarterback position is disproportionately impacted by shoulder injuries when compared to professional athletes at other positions. Moreover, contrary to other professional throwing athletes, the majority of upper extremity injuries in the professional quarterback result from direct contact as opposed to the throwing motion.

There are plenty of questions Lance will have to answer on the field, but the fitness of his arm isn’t likely to be one of them. While Harris said Lance could fix the arm fitness problem with offseason work and commitment, Dr. Pandya is less concerned that it’ll even be an issue.

“Unless there is some arm injury we don’t know about, I wouldn’t worry about it at all,” Dr. Pandya said.

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