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Optimizing Baseball Arm Health Through Workload Management

Kathy Ryan-Ceisel, PT MHS

Athletic Edge and Wellness

Baseball Pitcher

It is no secret the incidence of Tommy John surgery continues to trend upwards and is spiking among the 15-19 age group. However, we are now seeing an increased number of elbow (and shoulder) injuries in our position-specific players and youth players. Maybe we have to rethink the source of the problem, specifically that we have a “throwing” problem and not just a “pitching” problem. We discuss throwing workload with pitchers (with regards to pitch counts and days off rest) but there is more to the throwing workload than just pitching.  We have to be conscious of the throwing workload with all of our players, and where we may be failing is putting it in the CONTEXT of throwing.  This context must involve the coaching staff, the athletes, and their parents. So let’s examine some aspects of workload and provide context throughout a baseball season.


Let’s start with how many players do you have on your team?  Are you carrying the standard 12 or are you opting for 11 because you are looking for your athletes to gain more playing time? Do you have “pitcher only” players available on your team?  What happens when a player is sidelined with an injury? If you have someone sidelined with an injury, how long are they going to be out? A game?  A week?  Several weeks?  Is this injury related to baseball or some other factor? How do you ensure that player is game ready when they return? Do you have players to fill in when you are down players? What is the quality of arms you have on your team? Do you have depth with pitching/catching positions? Does your starting pitcher have to go longer because of team arm health? Does your closer now have to throw multiple days in a row or go more innings than before due to missing arms in the rotation? Do you bring in a regular position player to help out the pitching rotation? What implication does the team workload have our YOUR players’ arm health. A missing player for whatever reason creates arm implications and the potential for OVERUSE in the remaining players.


What else does your player have going on? Are they in other sports at the same time? Are they a multi-sport athlete or only playing baseball? Are they playing their grade appropriate level? Are they in a strength and conditioning program? Are there personal issues going on? Are there any nutrition, sleep, or recovery issues? Does this player have any previous or ongoing injuries that you are aware of? What physical build is your athlete (a big kid with slow footwork or a shorter player who is fast)? How is your player’s individual mobility? strength? athleticism? Has your athlete had a growth spurt?


What positions does your player have? Are they a Pitcher Only? Is there a rotation to pitching? Are they a starter? Middle reliever? Or closer? Do they pitch and have in infield and/or an outfield position? Do those positions differ from high school to summer ball? Are they a catcher? What is their catching volume and rotation? Catching, pitching, infielders and outfielders all throw with different arm slots. What distances is your player throwing on the mound/field? (did your team have a recent change in field size due to age or playing up a level and having to accommodate for different field size) Has there been an introduction of long toss? Do they have difficulty in making infield throws like 3rd to 1st on a consistent basis?


Are you playing tournaments only every weekend or a tournament only team? Tournament play breeds dangerous volumes of throwing. Are there strict rules regarding pitch count or loose rules such as just pitching 6 outs during a game? What is the tournament schedule? Did you play 2 games late in the evening only to turn around and play 2 more games in the morning?  No MLB does that, why is youth baseball allowing it? Is a double header better or worse than 2 games spread out during the day? How does your team manage if they make it to the championship game on Sunday and may have played 1 game Friday, 2 games on Saturday, and then 3 games on Sunday? Are there other arms available on the bench during tournament play?


What is your practice and/or game schedule like during the week? Do you continue to have practices in-season? Are you throwing bullpens? Are players getting outside lessons? How many games during the week are you playing? What position do players have during the week? Are those different than during the weekend to gain experience? Do players rotate positions or have set positions?  Does your week workload support your weekend workload? If a game is cancelled, is practice substituted or do you not do anything?


Do you practice only in preseason or is it supported in season in between games?  Does practice have a specific focus and is it productive? Are drills structured that help to develop players?  How much throwing is done? Is it infield and/or outfield? Do all players participate in all drills? Are there bullpens vs live batting practice?


What is your player’s game workload?  Are they pitcher/catcher?  Are they in a high throwing position, like shortstop, and pitching?  Are they OF? Where is your pitcher playing before or after they pitch? Are they resting before or after the inning they pitch?  Did they have any opportunity to warm up effectively before they went to pitch/play or came in cold?   What is your team’s pregame routine? Is pregame a “practice” before a game? Do athletes have a set pitching rotation? Do they designate specific roles with pitching, starters, closers, or relievers?  Does the warm up routine change when you play multiple games in a day? How much throwing is done in between innings in multiple game days? Is there a cooldown routine? How is cold or hot weather handled during game?


Is your player helping another team? Has he been selected to play on an All Star or Tournament team? Is your player participating in college showcases? Is he taking outside lessons? Is he practicing with family members in the backyard?


How aggressive is your season’s schedule? How aggressive is your schedule in relation to their age? 60 games in a 9 year old looks different than 60 games with a 13 year old.  Is your player getting ANY time off or breaks during the season? 60 games in the northern climate is different than 60 games in a southern climate. Are games cancelled due to weather and then you are forced into a situation where multiple games are back to back? What are you doing in season do manage niggles and overuse? Are you doing any in-season conditioning or arm care? What has recovery looked like? Do you recover well? Or do you get increased soreness as the season goes on?


Does the volume of games change during summer? Are they sitting around most of the day playing Fortnight then showing up at practice/game?  Are they at camps/doing other sports during the day? Are they at a high school camp to gain exposure to the high school coaches? What are they doing in the weeks in between high school ball ending and the start of summer travel ball?


What is your coaches experience level? Do all of the coaches have a clear understanding on pitch guidelines AND days of rest? Do coaches understand signs of fatigue with each player? Who is responsible for monitoring pitch counts and are they in fact ACCURATE? Do the guidelines account for high stress innings? Are the coach’s dads, former players, or paid? How are days of rest accounted for and monitored? Does your coach have “winning” mindset vs a “player development” mind set? Does your coach play/bench the same kids?


What was done offseason to prepare your player for the season?  What did they do to (or didn’t do) to condition? Did they participate in a specific arm care program? Were players participating in a velocity enhancement program?   What qualifications are present in the individual who is training your athletes?  What training parameters and variables were they doing? In colder climates, often the workload involves a lot of infield drills and pitching due to space constraints in training facilities.  Did we ramp up throwing, pitching, and long tossing effectively or have a steep ramp up in January?  Did we really “rest” off season or play fall ball?  Will your offseason workload SUPPORT your in-season workload?

Here’s an example. My son’s 10-year old team played 3 games in less than 24 hours. We had 9 players for each of the games, with no “extra players” to call up. One of players (the coach’s son) threw 60 pitches on Saturday, then came back and threw an additional 40 on Sunday morning.  He also played catcher and short stop, both high workload positions.   Two fresh pitchers were available, but not chosen to pitch because the coach had a “winning mindset” as we were playing in a weekend tournament.  The tournament pitching rules were loose, meaning the pitchers could throw for 6 outs/ea. game.  There was no reference to number of pitches thrown during those innings.  Two of those innings- one on Saturday and one on Sunday involved high stress innings (more than 30 pitches in an inning). Further context involved inexperienced coaching across the board, poor game time management, poor warm up/cool down routines, and inadequate in-season practice. The context and workload management was wrong all across the board.

Travel baseball has evolved into a multi-factorial throwing problem with no solid solution in sight.  It is no longer just picking out 12 kids from your town to play. Coaching is no longer just showing up at the field and putting together a lineup.  It’s a chess match each game, each week, and each season. Rarely do the same kids continue to play together, so every year becomes another puzzle to put together by the coaching staff.  The coaching staff needs to share the responsibility of understanding the concept of context/throwing workload and be aware of signs of fatigue in their players. Parents must advocate for their child when being overused. Players must be taught at any early age to listen to their bodies and not be afraid to tell their coaches how they are feeling – without being perceived as mentally or physically weak. Quality healthcare providers need to partner with local youth organization to encourage safe throwing. We all must come together collectively and share the responsibility to understand the real context of throwing workload and keep our children safe and healthy!

Athletic Edge and Wellness, Illinois Baseball Edge, and 1Top Prospect in Algonquin IL are your professional throwing partners in elite baseball/softball performance and arm care through the continuum of ages and competition levels.  We offer team and hyper-personalized private instruction to help players move better, maximize training progressions, and more efficiently navigate the college recruitment process.  Our services include player centric training on elements such as velocity, command, secondary pitch, arm care, recovery (including Normatec), physical therapy, performance therapy, strength and mobility, and consulting that provides personal attention to student-athletes on their collegiate recruiting journey.  These services are offered under one roof.  Come experience the difference with a professional staff that is world class, tightly aligned, and able to collaborate for superior results.

Located at 1213 S. Main St. Algonquin, IL @ 224-505-3343

Athletic Edge and Wellness, Illinois Baseball Edge, and 1 Top Prospect


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