During the midst of this global pandemic, it is easy to become complacent; it is okay to feel anger, frustration, and sadness. I feel those emotions, not for myself, but for the senior baseball players who may not have another chance to play the sport they love again. My heart is especially heavy for two senior baseball pitchers. They have trained with me the past year-plus to be ready for their senior season following surgeries that ended their junior campaign.
Arm injuries have grown at exponential rates, especially among our youth athletes. There are many contributing factors. Note contributing factors to be the longer seasons, playing multiple seasons, limited offseason, and pitching in various leagues. There is much gray area lingering surrounding this time, these athletes, and their futures. This article is intended to debunk some of the common misconceptions needed for our baseball athletes, especially pitchers, regarding their arm health and longevity.
Misconception #1: More is better.
Little League baseball and other corresponding leagues have done an excellent job with pitch count limitations. However, many of these metrics fall short of the actual number of throws. The areas to improve upon regard to tracking. Such as a kid who plays local recreational ball and travel ball is not throwing more than is suggested weekly and per season. It is our job to educate coaches and parents to ensure that these athletes are protected.
Alternative Approach #1: Be your own advocate.
Start by logging your pitch count and training sessions, including team practices, games, and individual instructional sessions. Gain a better understanding of the areas where the athlete has the potential for overuse and can address them for the upcoming schedule.
Misconception #2: Throw to warm up.
How often do you hear the coach tell his players to go to the outfield and start throwing to warm up for the practice/game? This idea can be misleading and add unnecessary throws on the youth arm.
Alternative Approach #2: Warm-up to throw.
When collecting research for our Doctoral of Physical Therapy degree, we observed the number of pitches thrown by youth athletes who were the starting pitchers for that day. Despite the pitch count being 85 pitches during an in-game situation, many of these kids exceeded that through warm-ups, bullpen before the game, and between-inning warm-up throws, not to mention the number of throws completed while fielding. On several incidents, we recorded over 200 plus throws. We did not calculate situational pitches, as some can be higher stressors than others. For example, facing the opposing team's best hitter or pitching with the go-ahead run in scoring position.
One area to improve upon is through a dynamic warm-up. The purpose of a dynamic warm-up is to promote blood flow, increase neural excitement, and prepare the tissues/body for the task ahead. This can be achieved through slow progress jogging into a callisthenic, such as high knees, tuck jumps, and skipping, progressing to task-specific demands, such as lunges, reverse throws, and external/internal rotation isometrics.
Misconception #3: Ice, NSAIDs, and pole running
Ice is used for pitcher's shoulders and elbows following a game. It is often used to speed up the recovery process, but in turn, can slow it down. Ice causes blood vessels to shrink or constrict, which slows the movement of blood flow and restricts the nutrient-rich blood to the area that experienced trauma or needs to recover.
NSAIDs are commonly used to stop the onset of inflammation. But inflammation is our body's response to healing an injured area. Every injured tissue goes through the healing process of inflammation, repair, and remodeling.
Pole running has been described to rid the body of lactate acid buildup, thus decreasing associated soreness after pitching.
Alternative Approach #3: Active Recovery
First, if ice or NSAIDs are used to treat pain after pitching, then consult your local Physical Therapist for an evaluation. Pain is not a normal response to pitching. Soreness and stiffness can follow but will be addressed better through suggestions below.
The first step of active recovery is to develop a plan. Understanding the starting point will assist in the development of needs. This goal is achievable through a movement assessment, such as the Functional Movement Screen.
Following a pitching outing, the athlete can partake in a dynamic recovery, which includes aspects of mobility, soft tissue work, and active movement. For example, set up a recovery circuit that incorporates about 20-30 seconds of work, followed by 20-30 seconds of rest, continuing for 20-30 minutes in total time.
The athlete needs to achieve adequate sleep and consistent sleeping patterns, proper hydration, and nutrition for recovery. Advancements in technology allow us to track heart rate at rest, reserve, and healing. It is also important to track weight fluctuations following sporting events to ensure the athlete replenishes what was lost during the event. Depending on the athlete's training age, in-season and off-season workouts can be modified to meet the needs/demands.
The sport of baseball relies more on the ATP-Creatine Phosphate Systems, so sprints and tempo runs are better alternatives to sport-specific and recovery. Sprints can be utilized for force output, where temp runs can be used for more recovery, working in the desired effort range, and allowing for adequate recovery between exercises/repetitions.
Conditioning is meant to improve the baseline aerobic pathway/energy system and help recover from glycolytic activity. This clears metabolic waste from the body that causes fatigue and interferes with muscle contraction and increases heart rate efficiency, so the heart does not have to work as hard to pump oxygen and nutrient-rich blood, and restore the body to parasympathetic response, rest and digest to aid in recovery.
During this downtime, there are two options. One can become bitter, or one can choose to become better. The best ability that any athlete can possess is availability. An athlete's health is to extend far more than between the white lines.
Read More: How to Deal With Common Baseball Injuries