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With a lot of injuries, rest and therapy can produce great results.  Shoulders seem to be an exception.

I wonder if it's because the shoulder joint is not really a ball and socket.  The ball is there but the socket is jury-rigged.

If you think of the primordial mammals, they didn't need to move their forelimbs through 360 degrees.  Mammalian forelimbs were never designed to do the things that we humans and our ape cousins do with our arms.

With a lot of injuries, rest and therapy can produce great results.  Shoulders seem to be an exception.

I wonder if it's because the shoulder joint is not really a ball and socket.  The ball is there but the socket is jury-rigged.

If you think of the primordial mammals, they didn't need to move their forelimbs through 360 degrees.  Mammalian forelimbs were never designed to do the things that we humans and our ape cousins do with our arms.

So in other words...

throwing underhand > throwing overhand

not for velocity, but for long-term structural integrity

So in other words...

throwing underhand > throwing overhand

not for velocity, but for long-term structural integrity

As the father of a softball pitcher, yes.  You don’t have to worry nearly as much about wearing a softball pitcher’s arm out.  Little league baseball will have pitch counts on boys. Softball has nothing like that for girls.

No, not at all.  I just don't like taking oxy.  They were impressed my heart rate going into surgery was 47.  They asked me if that was normal for me.  I remember your flt phys.

I just went to give blood and was rejected because my pulse was 49.Even went for a walk and drank some coffee - still 49.Has to be 50,I have to wait a week.happened once last year also

I had to get allergy shots when I was a kid.  I hated the shots and hated needles for decades after that.

And some of the needle experiences I had just made it worse.  Like the time I was getting my blood drawn to get my flight physical updated so that I could go to flight school, the nice young E-4 doing the bloodletting left the needle stuck in my arm while she went to answer the phone.

In about 1/3 of the annual flight physicals I took, I passed out after giving blood.  Vesovascular (?) syncope, I think it was called.

The first time I voluntarily donated blood I was about 40, and I passed out.

Next time, I forced myself to do all the right things about keeping my hand squeezing on the little ball, etc.  I conquered the beast.

Having done all that, after getting to where it does not bother me to give blood anymore, after having done so regularly for over ten years, I have recently found that I am testing positive for hepatitis (B, I think).  This is probably from the gamma globulin shots we got for the disease when we entered mission cycle (every 18 weeks)in the 82nd Airborne.

I don't test positive when I get my annual check-up at the doctor's office.  But the Red Cross must have started using a more sensitive test, because I now show up as having had hepatitis after giving blood to them.

Side note:
I actually liked the obese surcharge more than the smoker surcharge because I think it would have been MUCH more effective at encouraging healthy lifestyles. 

Smoking surcharge:
Have you ever read the way this question is usually phrased?  It sounds like the McCarthy hearings where they asked "Are you now or have you ever been a member of the Communist Party?"  The smoker question typically is phrased as follows:
"Have you used any tobacco product within the last twelve months?"

I have several issues with that.  First, a guy who smokes cigars a few times a year isn't actually costing us anything on the healthcare.  A couple cigars a year aren't a problem. 

More importantly this provides little-or-no motivation to quit because the payoff is so far away.  If you are a smoker you have to quit, then wait a year, then you get a break on your healthcare.  I just don't think that feels very tangible to the smoker because it is so far away. 

Unfortunately, with smoking, there isn't a good way to measure and enforce an incremental charge.  Ie, assume the percentage for non-smokers is 25% then you could have increments of:

• Somebody who smokes a few times a year pays 27%
• Somebody who smokes up to 1/2 a pack a day pays 30%
• Somebody who smokes a pack a day pays 35%
• Somebody who smokes a pack and a half a day pays 40%
• Somebody who smokes two or more packs a day pays 45%

There isn't any good way to police that.  All your smokers could just claim that they are only occasional or 1/2 pack a day smokers and pay 27% or 30%. 

Back to motivation for a minute.  I quit smoking a few years ago.  When I started a pack was well under $2.  You only paid $2 if you ran out at a concert or something.  I remember when I was at Ohio State there was a store across the street from my dorm that sold pizza, beer, and cigarettes.  They were open really late and even they only charged $2/pack.  I quit buying them and started rolling my own when the taxes pushed it over $3/pack.  The last time I bought a pack I think it was $5 (I had run out of pre-rolled and didn't have time to roll more).  At this point a pack-a-day smoker is paying ~$2k/yr for smokes.  H/she already has a $2k/yr motivation to quit and that one is immediate.  Quit (or even just cut back) and start saving money immediately.  A few dollars off on healthcare that you will not actually get until you are a full year clear isn't going to move the needle for them. 

Obesity surcharge:
This works much better incrementally and therefore provides a great tangible motivation for people.  The model I was advocating would have used a baseline when we started.  If you were overweight then each year going forward you would pay:

• 25% if you were no longer overweight. 
• 27% if you lost at least 75% of the amount by which you had been overweight. 
• 30% if you lost at least 50% of the amount by which you had been overweight. 
• 35% if you lost at least 25% of the amount by which you had been overweight. 
• 40% if you neither gained nor lost more than 25% of the amount by which you had been overweight. 
• 45% if you gained more than 25% of the amount by which you were previously overweight. 

Ok, this might make more sense with an example.  I'm 6-2 and I currently weigh 226 lbs.  The CDC says I should weigh 186 lbs so I'm overweight by 40 pounds (226-186=40).  Thus, 25% of the amount by which I am overweight is 10 pounds. 

• If I get down to 186 lbs by next year I pay 25%
• If I get down to 195 next year I pay 27%
• If I get down to 205 next year I pay 30%
• If I get down to 215 next year I pay 35%
• If stay between 216 and 235 next year I pay 40%
• If I weigh more than 235 next year I pay 45%

I REALLY like this idea.  It creates a tangible and achievable goal for every employee. 

Another example:
I had an employee (he recently finally retired after milking BWC for all of his weight-related injuries for YEARS) who was morbidly obese.  He is about my height so we'll say 6-2 but he probably weighs 400+ so call it 402 lbs.  Even for him, there would be achievable goals.  Using my proposal above, he would be overweight by 214 lbs (402-186=216).  Thus, 25% of the amount by which he is overweight is 54 pounds:

• If he gets down to 186 lbs next year he pays 25% (lose 216#)
• If he gets down to 240 lbs next year he pays 27% (lose 162#)
• If he gets down to 294 lbs next year he pays 30% (lose 108#)
• If he gets down to 348 lbs next year he pays 35% (lose 54#)
• If he stays between 349 and 456 lbs next year he pays 40%
• If he weighs more than 456 lbs next year he pays 45%

My point is that if I told this 400# guy that he'd get a break on his healthcare if he got down to 186# that would provide literally zero motivation.  I might as well tell him that we'll give him a break if he jumps over the moon.  However, even for a guy THAT obese, losing 25% of the excess in a year is a plausibly achievable goal.  Look, I understand that 54 lbs is a LOT of weight to lose in a year and for a guy my size it would be nearly impossible but for a guy who starts out at 400+ that is achievable. 

I'm wondering @bwarbiany if you or anyone else has any thoughts on this?  How would you feel about it as an employee if you were a smoker or overweight or both?