Baseball Arm Care for Pitchers – The Complete Guide

Baseball players are susceptible to injury no matter what position they play. We hear all the time about major league players going onto the disabled list for moderate to severe muscle strains or sprains,  hamstring injuries, or lower back injuries such as Spondylolysis. Knee injuries can also be quite painful and will take players off the field for extended periods. Players who don’t succumb to injury are fortunate, and some in their entire careers never missed a game due to being hurt.

Pitchers, on the other hand, without proper care of the throwing arm and back, are most likely to be injured and then taken out of rotation. Pitchers are injured more frequently than any other position player in baseball. For them, the journey back to full health can be a long and arduous one, often requiring surgery and long term physical rehabilitation.

These injuries, although common, can be prevented when pitchers do the proper preventive exercises to keep the affected areas in the best possible condition. This article will describe in non-medical terms the most common pitching injuries that occur due to the manner in which pitchers throw a baseball, and from the repetition of throwing itself. Next, we’ll discuss what you can do to prevent injuries from happening in the first place. Lastly, exercises are provided which focus on the part of the body pitchers use the most that will help strengthen those areas.

5 Most Common Pitching Injuries

GIRD (Glenohumeral Internal Rotation Deficit)

Orthopedic doctors and physical therapists use medical terminology to describe the muscles that are used when throwing a baseball. GIRD in medical terms means, “loss of internal rotation of the shoulder while positioned in 90 degrees of abduction.” In simple English, abduction is when you move your limbs away from the midline, or center,  of the body   So when a pitcher swings his hands from the side of his body and up to his shoulder or higher, it is called abduction.

Internal rotation means rotation toward the center of the body. When a ball is pitched, the shoulder muscles are used to move the throwing arm toward the center. An athlete who can’t move his arm from up behind his shoulder and then down through the center of his body may suffer from GIRD.

Labral Tear

A labral tear is a shoulder injury. There is a ring of fibrocartilage which surrounds the shoulder socket. When the cartilagetears, the shoulder area becomes loose and the entire joint becomes unstable. Pitchers lose control of their throws when they have a labral tear.

Oblique Muscle Strain

In the throwing motion, pitchers rotate their bodies sharply and this will have an impact on the outermost abdominal muscles, the external oblique, from the lower half of the ribs and down to the pelvis. These muscles help pull the chest downward, and that downward pull compresses the abdomen.

 

Rotator Cuff Injuries

The rotator cuff is a group of four muscles that coordinate the movement of the shoulder. The pitching action is referred to as overhead throwing. Repeated overhead throwing (in the majors, up to 100 pitches per ballgame), causes the rotator cuff tendons to compress as they pass through the shoulder joint. This will gradually become painful.

Rotator cuff injuries are the most common in baseball, and can affect every player, but especially pitchers due to the repetitive overhead movement.  If not addressed it can progress to the more severe tendonitis, a condition which will require pitchers to rest for a period of weeks to months.

UCL Elbow Sprain

UCL stands for “ulnar collateral ligament.” The UCL is located on the inside of the elbow joint. The UCL provides stability for the throwing arm. Also because of the repetitive pitching motion, it can become strained and affect the elbow joint.

UCL sprains are also highly common. Symptoms include loss of control of pitches, pain in the inner elbow and joint instability.

Treatment of the Most Common Pitching Injuries

Some of these injuries, as they worsen, will often require surgery. Left untreated, rotator cuff injuries and labral tears will need surgical intervention. Depending on the severity, they can mean the end of the season and, in the most severe cases, the end of a pitching career.

However, once one of the injuries described above is sustained, there are conservative medical approaches to improving them.

• Splint: Wearing a splint on the affected areas to stabilize them so the affected muscles, cartilage and joints can heal.
• Rest: There is not a better cure for sports injuries than making a full stop. Since it is the repetition of the same movement throughout the game that causes the injury, then stopping the movement for a period of time will help heal the joints.
• Ice: Acute injuries are painful, and ice helps reduce the discomfort.
• Compression: As soon as you feel the first acute onset of pain, wrap an elastic bandage around the area right away, around the elbow or the shoulder.
• Elevate: Elevate the arm where the injury occurred above the heart to reduce swelling. In general, the less swelling, the less pain there will be.

How to Prevent Overhead Throw Injuries

Your Practice Regimen and Drills

There are thousands of sources online and in book form that talk about the best pitching drills to improve the speed of the ball, your throwing accuracy, and how to throw different types of pitches like curveballs, sliders, and cut fastballs. However, it’s

rare to find in any of these articles anything about the injuries that can occur to the pitching arm. The articles talk about  drills, after all, so the focus is not on arm care but on doing what it takes to reach your goals as a pitcher.

The first thing to keep in mind when doing any kind of pitching drill is to be aware of how much you’re using the shoulder and elbow of your pitching arm.  The human body is a living organism and as such it’s not indestructible.

The body needs constant care and maintenance. Pitching machines can throw hundreds, even thousands of pitches every day at the batting cages. But if they aren’t maintained on a regular basis, or if their electrical system isn’t taken care of, it will break down and be out of service. The human arm contains joints, cartilage, bones and tendons and is much more complicated than a machine, so extra care needs to be taken.

Here are things you can do every day to keep your arms and body healthy while taking steps to avoid serious and debilitating injuries.

1. Warm Up Properly

Before baseball practice, a player’s body is going from an inert state to an active state. Pro athletes know this. Before they begin practice, their bodies were in a period of inactivity, so they know they need to ease into the workout. For pitchers, it’s great to first stretch your arms, shoulders, back and legs.

When you start to throw, ease into it slowly. Don’t overuse your arm prior to performing pitching drills. Warmups are just for loosening up.

2.   Don’t Pitch on Consecutive Days

Youth players have a ton of energy and it’s easy to feel that you have the reserves to pitch several days in a row. If you do, though, you’re overusing your throwing arm and at some point in the future you will feel the effects of overuse no matter how much energy you have.

The reason for this is that action of throwing an overarm pitch at high speed is not something the body does naturally or with ease. Your shoulder and its tendons are stretched and compressed beyond their natural range of 180 degrees. This is why a rest period is so critical, and with down time after pitching a game, the shoulder and elbow joints have a chance to recover so you can throw again as effectively the next time.

3. Don’t Pitch Year Round

For much the same reason just mentioned, the arm and the parts that are used in pitching go through extremes for which they were not designed. You can work out your throwing arm to become durable and able to withstand high pitch counts with the right exercise (discussed next in the section below).

If you want to play baseball during the off-season, strongly consider playing at a different position. Not only will you give your shoulder and elbow a rest, but playing an infield position lets you work on your fielding and your hitting. You can become valuable as a utility player capable of good hitting and fielding at multiple positions.

4. Talk to the Coach

There’s nothing gained by keeping the pain you may feel in your elbow or shoulder from your coach.  In the end, you will become less helpful to the team if the pain worsens and you can’t play.

Maintain communication. If the coach asks, “How does your arm feel?” he’s asking because he’s aware of how much pitching impacts the arm and its parts. If you discuss arm discomfort openly, you may still be able to continue in spite of it, or you might have to take a break. Coaches have a better idea from their own experiences with players what certain pains signify, and it may be serious or may be nothing at all. When you talk about it, you get the value of a second opinion.

Most important, don’t ever practice or pitch in a game if you’re experiencing any type of pain in your shoulder, elbow, or the muscles in your abdomen. You may want to be heroic, but if, and when, the pain becomes too intense, you may be out for several games, if not the rest of the season. See a doctor if the pain persists.

5. Age Appropriate Pitching Skills

Veteran pitchers who have been throwing for years in pro baseball are better physically conditioned than youth players, making it easier for them to pitch deeper into games. Your size and how much you workout when not pitching will also determine how many pitches, and what types of pitches, you should throw.

For example, pitching a fastball causes the least strain on the arm. On the other hand, the mechanics necessary to throw a good slider, requires a violent arm motion, as it’s a combination of a curve and a fastball.

It’s been proven that sidearm pitchers are more prone to injuries than pitchers that throw over the top. That’s because throwing a sidearm pitch puts a lot of strain on the elbow and shoulder when throwing from the side.  Interestingly, college and pro scouts tend to avoid recruiting pitchers who mainly throw sidearm pitches. Their experience informs them that such pitchers succumb to injury later in their careers.

Your focus should be on fastballs, curveballs and a good changeup pitch. Once these are mastered, by performing the exercises below you can start throwing breaking balls.

6. Watch Your Pitch Count

The establishment of a pitch count limit became popular in the 1980s, and it has been shown that, despite the views of those who are against a pitch count system, two out of three pitchers are still playing since it began to be enforced, contrasted with 1 out of 2 pitchers in the early 1980s.

Pitch count limits are not imposed to coddle pitchers in any way. Their true purpose is so pitchers can play the game much longer and contribute much more than they would if there was no pitch count limit. With only a few exceptions, most major league teams have set a pitch count limit of 100 pitches in a game, relying then on their relief squad to finish out the game.

Little League imposed a pitch count system that applies to all the youth players in their league up to age 18. Staying within these guidelines has yielded positive results that are indisputable.

Age                  Max Pitches/Game                  Max Pitches/Week

8-10                 50                                            75

11-12               75                                            100

13-14               75                                            125

15-16               90                                            2 Games per Week

17-18               105                                          2 Games per Week

 

Shoulder and Arm Care Conditioning Exercises For Pitchers

The following exercises are designed to condition your arms, shoulders and elbows. In the event of injury, performing these exercises regularly, after the acute pain phase has passed, will help get your body back into performance condition. They’re also extremely helpful in preventing arm injury.

1. Sleeper Stretches – Lying on the Side

Sleeper stretch is a shoulder stretch exercise that you do to increase the range of motion in your shoulder, and increase flexibility in the shoulder. This exercise specifically addresses shoulder stiffness, tight shoulder, or “frozen shoulder” (marked

by pain and stiffness, making it hard to move).

When the shoulders are “tight,” it means that the posterior capsule becomes tight. Think of the posterior capsule as a sheathing that covers important shoulder joints. When  you experience shoulder pain, usually it’s coming from the shoulder capsule.

There are three types of sleeper stretch exercises: lying on your side, regular standing, and standing in a corner. The exercise discussed here involves lying on your side.

1. Sleeper Stretch Lying on Your Side

Step 1:

Lie down on the floor or a hard, flat surface longer than the length of your body. Now, move sideways towards your throwing

shoulder. Put as much of your weight as possible onto your ribcage. Weight can be pressed only to the outside border of your shoulder blade. To do this, roll forward towards your arm and off your shoulder, then move back onto the outside part of your shoulder blade.

Next, make sure that your body is not straight up and down.  Fold up your knees so that most of your body weight is against your arms and the outside of your shoulder, right tricep, right hip and right knee.

Step 2:

Make sure your right elbow is facing straight in the opposite direction of your head and your fingers are pointed straight towards the ceiling. Do not try bringing you elbow closer to your body. By doing this, there will be increased tension put on the posterior capsule and musculature, making it stretch.  Your head is unsupported. Try keeping your head neutral.

 Step 3:

Next, with your right wrist and left hand together, slowly push down in the direction of the right palm until you can feel a gentle shoulder stretch.  Maintain this position for at least half a minute. Make sure that no excessive tension is put on the front part of your

shoulder. Don’t push too hard.

The main purpose of the sleeper stretch exercise is to create mild stretch at the back of the shoulder. Perform it a few times, (position, hold, position, hold), and you will definitely notice a difference. At first the improvement of the internal motion of the shoulder may not be that much but gradually this will improve.

2. Arm Swing Exercise

Arm swings are a dynamic stretching exercise that engages the muscles in the upper body. This is a great warm up exercise that stretches the shoulders, arms, chest and upper back. It also prepares the muscles, tendons and joints for a workout. This exercise also gives you a great cardio boost and increases flexibility.

Stand up straight with your knees bent slightly, your feet shoulder width apart and your arms stretched horizontally to the sides. Cross your arms at the front and quickly bring them back as far as you can. Repeat this back and forth movement for about one minute.

Keep your abdominal muscles tight and your back straight. Face forward, breathe slowly and use your muscles to propel your movement. Your arms should swing in a steady, fluid motion and as wide as their full range of motion can go.

3. Rotator Cuff Exercises

The rotator cuff is a group of four muscles that stabilize the shoulder and allow it to move. Try to  visualize the head of the arm bone as a golf ball, and the area of the shoulder blade as a golf tee. The rotator cuff acts as a sleeve that enables the ball to spin and roll while remaining on the tee.

The four muscles that make up the rotator cuff are the supraspinatus, infraspinatus, teres minor, and subscapularis. The way the rotator cuff is formed allows for a wide range of movement at the shoulder, but also because of this, the shoulder is dislocated more than any other part of the body.

Doorway Stretch Exercise

This exercise helps strengthen the anterior (front part) of the shoulders. If you’re now unable to stand flat against a wall with both your arms at 90 degree angles flush against the wall, this rotator cuff exercise will help you to flex better.

Stand in a doorway and raise your arms up to 90 degrees with your arms against each side of the door frame. Stand with your right foot forward and your left foot back. Now, lean your weight forward until you feel a stretch in your chest and at the front of your shoulders.

Wall Press Rotator Cuff Exercise

This is a great exercise to warm-up your shoulder muscles and also help you focus on your form. Work on it until you can feel your upper body flexing.

Stand with your head, upper back, and tailbone against a wall with your feet about 6 inches in front of you. Bending your elbows, bring your arms to touch the wall so that both your hands and your elbows make contact.

Now, keeping your hands, elbows, head, and back against the wall, begin to raise your arms overhead by sliding them up against the wall. Then pull your arms down until your hands are at the same height as your head. Continue to slide your arms up and down the wall without losing your points of contact. Imagine angel wings spreading.

Perform this exercise twice per day, 45 to 60 seconds each time.

External Rotation Rotator Cuff Exercise

Lying on your Side

Place a towel roll under your throwing arm while keeping your elbow flexed at 90°. Next, rotate your shoulder and then slowly return it to the starting position and repeat. Externally rotate for a 1 second, then lower your weight in a 2 count.

Lying on your Abdomen

Lay flat on a table high enough so you can extend your arm fully without contacting the floor. Start by hanging your arm and shoulder off the end of the table.

1. Pull back (retract) your shoulder.
2. Abduct (pull up) the end of your arm up to the elbow 90 degrees.
3. Pull your arm up by your abducted elbow which is at a 90 degree angle at your elbow.
4. Extend your thumb, then rotate your shoulder, pulling up your arm to the table.
5. Hold the position for 2 seconds
6. Return to the starting position, reversing each step.

Y Position on Table

On the same table, lay flat on your abdomen. Pull your body forward so your shoulders are over the edge of the table. Using a light weight dumbbell, grip it in your palms.

• Extend both arms over the table end in a “Y” position.
• Thumbs out on each hand, tips of thumbs touching.
• Pull up your arms slowly holding the dumbbells until your arms are parallel to the table, palms down.
• Move arms back down, with hands facing.
• Now pull up your arms using your bicep muscles all the way up until they are at the same height as the table

T Position on Table

• Grip the dumbbells in your hands. Your hands are in a natural position sideways, facing each other. Extend your arms fully.
• Pull your arms apart and bring them all the way up to the level of the table. Your shoulders, arms and body should be in the “T” position.
• Move your arms back down, extended fully, and turn your hands holding the dumbbells so they are facing you.
• Pull your arms and shoulders up again to table height, thumbs extended and pointing outward to the sides.

I Position on Table

Shift your body to the right side of the table so your shoulder is over the edge. Right arm is extended fully down to the floor but not touching.

• In your hands neutral position and gripping the dumbbell, pull your arms and shoulder back and up until your arm is level with the side of your body.

Hold each of your final positions for 2 seconds, then repeat three times each. As you gain strength form this exercise, increase the number of repetitions.