Here's this week's list of recommended strength and conditioning reading:

Food is Not Fuel - This was a fantastic post from the crew at Precision Nutrition.  In it, they demonstrate that quality nutrition is about a lot more than just calories or energy.

Throwing Programs: Not One-Size-Fits-All - With a lot of our pro baseball guys starting up with throwing in mid-to-late November, it seemed like a good time to reincarnate this post from the archives.  I talk about a lot of the considerations that go into writing up a throwing program.

5 Hacks for Half-Kneeling - Mike Robertson does a good job of discussing the benefits of half-kneeling exercises, and provides coaching cues and examples you can use.

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Here's this week's list of recommended strength and conditioning reading/viewing:

Thrive on Throwing - This is an outstanding DVD set from Alan Jaeger that thoroughly teaches the science and practice of long tossing.  Alan has generously offered to provide my readers with a 25% off discount (which applies to his other products as well).  I highly recommend this throwing resource, as long toss sometimes gets a bad rap in large part due to the fact that many players and coaches implement it incorrectly.

Making the Case for Long Toss in a Throwing Program - While we're on the topic of long toss, I thought I'd bring this old article back from the archives, especially since a lot of our professional baseball clients started throwing this week.

5 Holiday Diet Tips that Don't Suck - This is a quick read from Nate Miyaki over at T-Nation, but it packs some good information and strategies for you to employ this holiday season.

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Today's guest blog comes from current Cressey Performance intern, Landon Wahl.

By its very nature, the life of a pitcher avails itself to many hours of pondering the game. Fresh out of my senior year of pitching at the collegiate level and having time to reflect upon my experience, overall I can say it was the best time of my life. However, there were many times during practice where I felt like I should have stayed home because nothing was accomplished. I would often stand in the outfield gaps behind the position players wondering: “how is this making me a better pitcher?”

After 2-3 hours of batting practice, our coach would have us bring it in and that was the end of practice. Summary: a 3-hour practice that consisted of a 10-minute warm-up, 5-10 minutes of throwing, and 2 hours and 40 minutes of standing around listening to my teammate tell me how sure he was that all of his teachers were trying to fail him (go to class, buddy). Some practices involved the pitchers more than others, but for the most part, practice time could have been used much more efficiently. Below are some ways practice time can be used to make pitchers more involved at practice as well as some things to avoid!

1. Set aside time in practice to have a proper warm up.

Too often, players come to practice and will disregard the warm-up or perhaps not warm up at all! Players grab a ball and start throwing with no physical or mental preparation. Every program is different in regard to warm ups. As a coach, make sure that regardless of what style warm-up you prefer, that you stick to it! At Cressey Performance, all athletes go through a foam rolling series as well as a dynamic warm-up before even touching a baseball, medicine ball, or weight. If you are a coach looking for inspiration, watch the video below and have your guys do it for a warm up. It almost goes without saying that it will help your guys feel and move better as well as prevent future injuries.

2. Make sure throwing - especially the long toss component - isn’t rushed.

Some programs are pretty good about this, but others aren’t. It is understandable that as a coach you have a lot to cram into a 2-3 hour practice and you want your guys to get as many swings in as possible, too. Think of long toss as a pitcher’s BP. It is important to let your pitchers get their arm speed up to help improve performance and stay healthy throughout the season. Try not to rush through the throwing to get to batting practice; it will help everyone be more prepared for your big weekend conference series.

3. Stop making pitchers stand around during batting practice.

First of all, I understand that sometimes pitchers are needed to help shag fly balls and make sure that the hitters get their work in, but this doesn’t have to be ALL the time! Sure, it’s nice to talk with fellow teammates and occasionally track down a fly ball, but overall there is little to no value to preparing your pitchers. Instead of having the pitchers stand around during the early parts of the week at batting practice, send them to the weight room for resistance training, athletic training room for manual therapy or stretching, or elsewhere on the field to do movement training or plyos.

4. Set aside time in practice to work on pick-offs, 1st/3rd defensive plays, PFP, live situations, and bunt defenses.

Too often, basic pitching defense gets brushed aside on the daily practice schedule. All of these essential parts of the game could take a full week just to cover, not master. For incoming freshman, these situations may not have been covered very thoroughly or even at all in high school! Have the coaching staff split up and cover these situations often; they may arise at any time during your important conference series! For your players to have confidence in the plays and skills that they will develop in practice is crucial, and will directly relate to confidence on the mound during in-game situations. This is also a good time to break away from the monotony of an extended batting practice session and get the pitchers involved.

5. Don’t enforce “punishment” running.

As a coach, it is understandable that players can upset you in many ways: poor play, off-field offenses, or on-field offenses. Nothing as a player is worse than hearing, “on the line,” not just because the punishment is usually miserable to complete, but also because nothing productive is being accomplished!

Consuming alcohol at the collegiate level is what unfortunately gets lots of guys into trouble. Having to participate in “punishment runs” was an absolute nightmare, usually because I was always running for someone else's screw-up. And, it didn’t matter how many times we were punished; guys would still go out to the bars later that night, not having learned a thing. It brings team moral down and creates problems between teammates. Believe me, there were some guys with whom I was not happy.

Some of the most successful teams win games because they're close-knit groups, not because they have the most talent! A prime example was my high school baseball team during my senior year of 2008. One could debate whether we were the most talented team in comparison to teams in the past, but we made it all the way to the state championship game. This was due to the fact that we did absolutely everything together as a team, and never had situations that compromised our positive team dynamic.

Punishment runs not only wreck your players physically, but also destroy them mentally. Sometimes discipline is in order, but try and find another way to do it! There is only one thing you need. Bench the player until behavior improves. Negative reinforcement such as running only deals with issues temporarily. Benching a player might cause some player-coach tension, but that’s part of being a coach. Make the best decision for the whole team and ensure that every player represents your college or university in a proper manner.

6. Don’t make pitchers catch bullpens.

This is just my personal opinion. I understand that some programs do this and others don’t. Hopefully, I can provide insight for just one coach, at any level. Coming from a previous program who endorsed this, I saw firsthand how it can really end up injuring a pitcher. I’ll relate a personal account...

One afternoon during freshman year at practice, I walked up to the field and my coach informed me that I would be catching every single pitcher, and then I would get to throw my bullpen. Unfortunately, I had never caught an inning in my entire life. Still, I suited up. The first few fastballs went well. The first curveball, however, didn't.  It bounce in front of me by about two feet and you can probably guess what happened next.

The whole team thought it was funny (and in hindsight, it was), but at the time, it was not. In the months after that experience, I was afraid of the ball, shying away whenever it got close to the mitt. This not only was physically taxing on me, but the pitchers couldn’t get in a rhythm and their bullpens suffered as a result. There is something to be said for having a catcher who sticks your pitches, moves back and forth across the plate, gives feedback on your pitches, and encourages you because they are confident; this was not happening with me. After I caught all of the bullpens, I began to throw mine. You can also be sure that another fellow freshman caught me; the practice was a total waste, for everyone.

7. Talk to each player one-on-one.

Every coach could do this more often. I know that after a game in which I performed well (or not so well), it was nice to have my coach tell me things I could improve upon while highlighted things I executed correctly. This is also important for players who are not regular starters, or kids who have never played an inning. It is essential to provide hope for these players; at any time they can be a cornerstone in the lineup! Too often, good baseball players don’t receive the proper mental reinforcement. It sounds cliché and simple, but even telling a player “good job” can carry them a long way. It is also important to have meetings with players outside of practice and listen to their thoughts and concerns, both academically and athletically.

8. Have fun.

Having fun is what the game is all about. Winning is fun. Having fun at practice is fun, too! Create competitions between the players. Let pitchers take batting practice. Create incentive for your players to be excited and ready to go when practice time rolls around! Most of all, be supportive of every player. Playing college ball and going to class is quite a workload. There is nothing better in the world that blowing off some steam and forgetting about school responsibilities by playing some baseball.

 Questions or comments?  Please post them below.  Also, Landon Wahl can be reached at landonwahl@yahoo.com.

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In the first half of this two-part installment on why pitching velocity changes during the course of a season, I outlined 9 Reasons Pitching Velocity Increases Over the Course of a Season.  As you'll appreciate after reading today's post, there are actually a lot more ways by which pitching velocity can decrease over the course of a season. Let's examine them individually:

1. Body weight reductions 

This is far and away the most prominent reason pitchers lose velocity as a season goes on.  In fact, it's so big a problem that I devoted an entire blog to it: The #1 Cause of Inconsistent Pitching Velocity.

2. Strength loss

As I discussed in my first book, The Ultimate Off-Season Training Manual, strength is an important foundation for power.  And, taking it a step further, power is certainly an important part of pitching.  As the season goes on, many guys just don't get in the quality weight room work they need to maintain strength, and power on the mound tails off.

3. Injury

It goes without saying that if you're hurt, you won't throw as hard. This isn't just a shoulder or elbow thing, either; sprained ankles, sore hips, tight lower backs, oblique strains, and stiff necks can all wreak havoc on velocity. If something is bothering you, get it fixed before it causes you to develop bad habits.

4. Loss of mobility

When people hear the word "mobility," they typically just of tissue length.  However, mobility is simply one's ability to get into a desired position or posture.  In other words, it's a complex interaction of not just actual tissue length, but also strength/stability, tissue quality, and kinesthetic awareness.  If you don't continue working on mobility drills, static stretching (when appropriate), foam rolling, and your strength training program, one of the components of this equation can suffer.  

Obviously, as I wrote previously What Stride Length Means and How to Improve It: Part 1, Part 2, and Part 3, stride length is the best example of this phenomenon.  However, what happens at the shoulder is another great example, too.  One who loses thoracic mobility or scapular stability may stiffen up at the glenohumeral (ball-and-socket) joint; it's possible to gain range of motion without even stretching at the "stiff" joint!

5. Excessive workload

This is the time of year when a lot of guys start hitting all-time highs for innings in a season.  And, with the games getting more important at the end of the high school and college seasons, pitch counts often rise when the innings really matter.  It's very simple:

Fatigue masks fitness.

If you're dragging and the velocity is down, a short-term reduction in throwing volume is often the quickest path to getting velocity back - particularly in pitchers who are throwing more innings than ever before.  Throwing an easy flat-ground instead of a bullpen between starts is one way to stay fresh, or you may opt to alternating higher pitch counts with shorter outings.  If I hear about one of our high school pitchers who has an exceptionally high pitch count (105+), I usually tell him to make sure the next one is in the ballpark of 80 pitches.  At that age, arms always seem to be dragging if kids go over 100 pitches in back-to-back outings.

6. Cumulative effect of bad throwing programs

This is best illustrated by a "hypothetical" example that actually happens far too often.

a. Pitcher makes great velocity gains in an off-season with comprehensive throwing program that includes long toss.

b. Pitcher goes in-season and encounters pitching coach that doesn't believe in long toss as part of a throwing program.

c. Pitcher has a velocity loss.

This scenario doesn't just happen because a specific modality (long toss) is removed, but also because of the effect it has on a pitching routine.  This, for me, is why it's so important to have conversations with pitchers on what throwing programs they've done in the past.  What's worked?  What hasn't? It's all about tinkering, and rarely about overhauling.

7. Cumulative effect of distance running

This 2008 study might be the greatest research that has ever been performed on baseball players - mostly because it reaffirmed my awesomeness by proving me right: Noncompatibility of power and endurance training among college baseball players.

These researchers divided a collegiate pitching staff into two groups of eight pitchers over the course of a season, and each group did everything identically – except the running portion of their strength and conditioning programs. Three days per week, the “sprint” group did 10-30 sprints of 15-60m with 10-60s rest between bouts. The endurance group performed moderate-to-high intensity jogging or cycling 3-4 days per week for anywhere from 20-60 minutes.

Over the course of the season, the endurance group’s peak power output dropped by an average of 39.5 watts while the sprinting group increased by an average of 210.6 watts.  You still want to distance run?

Of course, there are still the tired old arguments of "it flushes out my arm" (much better ways to do that), it clears my head (go see a psychologist), "it keeps my weight down" (eat less crap, and do more lifting and sprinting), and "it helps me bounce back better between starts" (then why are so many players in MLB living on anti-inflammatories?).  The system is broke, but instead of fixing it based on logic, many coaches continue to change the oil on a car with no wheels.

8. Insufficient warm-ups

While there are definitely some outstanding opportunities out there to develop in the summer, the truth is that summer baseball is notorious for sloppy organization.  Guys are allowed to show up ten minutes before game time, do a few arm circles, and then go right to it.  If you're walking directly from your car to the mound, don't expect your velocity to be too good in the first few innings.

9. Cumulative effect of altered sleep patterns

Early in my training career, I realized that missing sleep the night before a training session really didn't have any effect on my next training session.  However, if I had consecutive nights of little to no sleep, it crushed me.  I know of a lot of people who are the same way.

Now, imagine an entire season of red-eye flights, 3AM bus departures, and going to bed at 1am every night.  Beyond just the sleep deprivation component, you have the dramatic change in circadian rhythms that takes place.  Just head over to Pubmed and look at the hundreds of studies examining the health impact of working night shifts (shift work disorder); you'll see preliminary research linking it to increased risk of cardiovascular disease, cancer, and a host of other issues. I firmly believe it's one of many reasons injuries in baseball are on the rise - and certainly one potential culprit when velocity declines as a season progress. 

10. Pitching off a crappy mound

Many players wind up pitching off terrible mounds during summer ball, and when the mound isn't groomed nicely, you get into "oh crap, I don't want to get hurt" mode with your landing leg. If you aren't comfortable landing, you shorten your stride, or reach for a "safe" part of the mound, messing with your mechanics in the process. Additionally, velocity is going to be lower when the mound height isn't as elevated; it's just how gravity works.

11. Mechanical tinkering for the bad

In part 1, I noted that mechanics changes in the summertime can be a source of velocity improvements.  They can also, however, be a reason for guys losing velocity.  Not all changes are new changes, and it's important to be careful about overhauling things on the advice of each new coach you encounter. Repetition is important, and it's hard to get it if you're always tinkering with something.

12. Dehydration

Dehydration can have a dramatically negative effect on strength and power.  Most athletes are chronically dehydrated at rest, and certainly during pitching outings in the summer heat.  Hydration status is an important thing to monitor if you want to throw gas.

13. Throwing to a new catcher

Being comfortable with the guy who is catching your pitches is a big part of success on the mound.  When the catcher is constantly changing, there is more hesitation - especially if his pitch-calling tendencies are different from those of your previous catcher.  If you're constantly shaking him off, it'll mess with your pace on the mound and slow you down.

14. More erratic throwing schedule

One of the biggest adjustments a pitcher will ever have to make is switching from starting to relieving or vice versa.  While going to the bullpen can often lead to an increase in velocity, it can make other guys erratic with their delivery, as they've learned to rely on the pre-game period to get everything "synced up."

Meanwhile, thanks to an increased pitch count, guys who go from the bullpen to the starting rotation sometimes see a drop in velocity.  As examples, just compare John Smoltz or Daniel Bard out of the bullpen to what they have done in the starting rotation.

The only thing tougher than making that switch is to constantly bounce back and forth between the two, as it really hurts your between-outings preparation.  How you prepare to throw seven innings is considerably different than what you do if you're just going to go out and throw 10-15 pitches.

These are only 14 reasons velocity may dip, and their are surely many more.  Maybe your girlfriend cheated on you with the bat boy and you got distracted, or you decided to just throw knuckleballs.  The point is that - as if the case with many things in life - it's a lot easier to screw up (lose velocity) than it is to thrive (gain velocity). Plan accordingly!

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Everyone wants to improve pitching velocity, but unfortunately, the answer to the question of "how" is different for everyone.  To that end, I pulled together a quick list of 101 strategies you can use to improve pitching velocity.  They aren't the same for everyone, but chances are that at least a few of these will help you.  I'd encourage you to print this off and highlight the areas in which you think you can improve.

1. Optimize mechanics (this could be 100 more ways in itself; I will leave it alone for now).

2. Gain weight (if skinny).

3. Lose weight (if fat).

4. Get taller (shorter throwers can’t create as much separation, and are further away from homeplate)

5. Get shorter (taller throwers have more energy leaks).

6. Long toss.

7. Throw weighted baseballs.

8. Throw underweighted balls.

9. Improve thoracic spine mobility.

10. Improve scapular stability.

11. Improve glenohumeral joint stability (rotator cuff strength and timing).

12. Improve glenohumeral joint range of motion.

13. Regain lost elbow extension.

14. Improve hip abduction mobility.

15. Improve hip rotation mobility.

16. Improve hip extension mobility.

17. Improve ankle mobility.

18. Activate the deep neck flexors.

19. Extend your pre-game warm-up.

20. Shorten your pre-game warm-up.

21. Increase lower body strength.

22. Increase lower body power.

23. Train power outside the sagittal plane (more medicine ball throws and plyos in the frontal/transverse plane).

24. Speed up your tempo.

25. Slow down your tempo.

26. Get angrier.

27. Get calmer.

28. Get more aggressive with your leg kick.

29. Get less aggressive with your leg kick.

29. Don’t grip the ball as firm.

30. Throw a 4-seam instead of a 2-seam.

31. Get through the ball instead of around it.

32. Improve balancing proficiency.

33. Throw out all your participation trophies.

34. Do more unilateral upper body training.

35. Recover better (shout-out to my buddy Lee Fiocchi’s Accelerated Arm Recovery DVD set on this front; it’s good stuff).

36. Throw in warmer weather.

37. Wear warmer clothing under your jersey.

38. Change footwear (guys usually throw harder in cleats).

39. Throw less.

40. Throw more.

41. Pitch less.

42. Pitch more.

43. Politely ask your mom to stop yelling, “Super job, kiddo!” after every pitch you throw.

44. Do strength exercises outside the sagittal plane.

45. Take all the money you were going to blow on fall/winter showcases and instead devote it to books, DVDs, training, food, and charitable donations.  If there is anything left over, blow it on lottery tickets and sketchy real estate ventures, both of which have a higher return-on-investment than showcases in the fall and winter.

46. Switch from a turf mound indoors to a dirt/clay mound outdoors.

47. Get a batter in the box.

48. Get more sleep.

49. Sleep more hours before midnight.

50. Stop distance running.

51. Improve glute activation so that you can fully extend your hip in your delivery.

52. Stop thinking that the exact workout a big league pitcher uses is exactly what you need to do.

53. Subcategory of #52: Remove the phrase "But Tim Lincecum does it" from your vocabulary. You aren't Tim Lincecum, and you probably never will be.  Heck, Tim Lincecum isn't Tim Lincecum anymore, either. You can learn from his delivery, but 99.9999% of people who try to copy his delivery fail miserably.

54. Read more.  This applies to personal development in a general sense, and baseball is certainly no exception.  The guys who have the longest, most successful careers are usually the ones who dedicate themselves to learning about their craft.

55. Stay away from alcohol.  It kills tissue quality, negatively affects protein synthesis, messes with sleep quality, and screws with hormonal status.

56. Incorporate more single-leg landings with your plyos; you land on one leg when you throw, don't you?

57. Be a good teammate.  If you aren't a tool, they'll be more likely to help you when you get into a funk with your mechanics or need someone to light a fire under your butt.

58. Respect the game.  Pitchers who don't respect the game invariably end up getting plunked the first time they wind up going up to bat.  Getting hit by a lot of pitches isn't going to help your velocity.

59. Train the glutes in all three planes (read more HERE).

60. Remember your roots and always be loyal.  You never know when you'll need to go back to ask your little league, middle school, high school, or AAU coach for advice to help you right the ship.

61. Get focal manual therapy like Active Release.

62. Get diffuse manual therapy like instrument-assisted modalities or general massage.

63. Make sweet love to a foam roller.

64. Throw a jacket on between innings to keep your body temperature up.

65. Pitch from the wind-up.

66. Drink magical velocity-increasing snake oil (just making sure you were still reading and paying attention).

67. Pick a better walkout song.

68. Get on a steeper mound (expect this to also increase arm stress).

69. Train hip mobility and core stability simultaneously.

70. Get around successful people in the pitching world and learn from them.  Find a way to chat with someone who has accomplished something you want to accomplish.  If you hang around schleps who complain about their genes and have never thrown above 75mph, though, expect to be a schlep who throws 75mph, too.

71. Pick the right parents (sorry, genes do play a role).

72. Recognize and get rid of pain.

73. Throw strikes (more balls = higher pitch count = lower average velocity)

74. Get 8-12 weeks off completely from throwing per year.  Read more about why HERE and HERE.

75. Be candid with yourself about how hard you’re really working (most guys talk about working hard when they should actually be working hard).

76. Take the stupid sticker off your hat.

77. Stop thinking so much.

78. Think more.

79. Stop stretching your throwing shoulder into external rotation (read more on that HERE).

80. Get in a better training environment.

81. Surround yourself with unconditionally positive and supportive people.

82. Talk to a different pitching coach to get a new perspective.

83. Stop talking to so many pitching coaches because too many cooks are spoiling the broth.

84. Lengthen your stride (learn more HERE, HERE, and HERE).

85. Shorten your stride.

86. Get your ego crushed when you realize that no matter how strong you think you are, there is a girl somewhere warming up with your max. And, my wife might even be able to do more pull-ups than you!

87. Stop trying to learn a cutter, knuckle-curve, slider, and “invisiball” when you can’t even throw a four-seam where you want it to go.

88. Play multiple sports (excluding cross-country).

89. Stay healthy when other pitchers are getting hurt.

90. Stop pitching for five different teams in the same season.

91. Pre-game routine: dynamic warm-up, sprinting progressions, long toss, pull-down throws, flat-ground, bullpen. Post-game routine: make out with prom queen after complete game shutout.

92. Do rhythmic stabilizations before you throw (if you’re a congenitally lax/”loose” guy) to "wake up" the rotator cuff.

93. Hydrate sufficiently.

94. Quit worrying about the damn radar guns.

95. Wear a posture jacket/shirt.

96. Drink coffee or green tea (you get antioxidants and a decent caffeine content without all the garbage in energy drinks).

97. Get in front of a big crowd.

98. Find a better catcher.

99. Throw more to and get comfortable with the same catcher.

100. Tinker with your pre-throwing nutrition to ensure consistent energy levels.

101. Tinker with your during game nutrition to sustain your energy better.

102. Tinker with your post-game nutrition to recover better.

103. Improve core stability (more specifically, anti-extension and anti-rotation core stability).

104. Breath better (less shoulder shrug and more diaphragm).

105. Train the rotator cuff less.

106. Change the day on which you throw your bullpen.

107. For relievers, stay loose and warm throughout the game (read more about that HERE). Staying entertained is also important, as CP athlete Joe Van Meter demonstrates.

108. Here and there, between starts, skip your bullpen and throw a flat-ground instead to give your arm a chance to bounce back.

109. Consider creatine (the most researched strength and power supplement in history, yet surprisingly few people in baseball use it)

110. Work faster (the fielders behind you will love you).

111. Work slower (recover better between pitches and self-correct).

112. Stop ignoring your low right shoulder and adducted right hip.

113. Pick a college program where you’ll have an opportunity to play right away and get innings.

114. Move from a 5-day rotation to a 7-day rotation.

115. Decide to wake up in the morning and piss excellence!

These are really just the tip of the iceberg, so by all means, feel free to share your own strategies and ask questions in the comments section below.

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With an old post, Strength Training for Pitchers, I *thought* I had put to rest the silly idea that strength training doesn't help with improving throwing velocity.  Unfortunately, some pitching gurus are still insisting that weight training is the devil when it comes to pitching velocity.

To that end, I thought I'd use today's brief post to highlight some newly published research from (among others) the bright folks at the American Sports Medicine Institute (ASMI).  This research showed that strength training doesn't just improve throwing velocity, but also that ANY type of strength training does!

Researchers looked at the effects of three different six-week strength training programs on velocity in 14-17 year-old baseball players, and found that all three programs led to significant improvements (1.2-2.0%) in throwing velocity over controls.  

And, as is usually the case in the research, the programs were less than comprehensive.  Just imagine if you borrowed the best bits and pieces from several programs and put them together in a comprehensive program that lasted an entire career, rather than just six weeks! 

So, the next time you hear a pitching coach say that strength training for pitchers doesn't work, please rock a "face palm" and then inform him that even crappy strength training works in most scenarios (especially high school athletes). 

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Last week, I contributed on a pitch counts roundtable for ESPN Boston. You can read it HERE.

I'd love to hear your thoughts on the matter in the comments section below, as it is a certainly a heated debate that has come to the forefront in recent years with pitching injuries on the rise.

Related Posts

Why Pitchers Shouldn't Do Year-Round Throwing Programs: Part 1 and Part 2
Baseball Showcases: A Great Way to Waste Money and Get Injured
7 Weeks to 7 Pounds of Lean Mass and 7 Miles Per Hour

In a recent presentation in front of a bunch of baseball coaches, I made the following statement - and it turned a lot of heads:

I think most people overtrain the rotator cuff nowadays, and they do so with the wrong exercises, anyway.

To illustrate my point, I'm going to ask a question:

Q: What is the most common complication you see in guys as they rehabilitate following a Tommy John Surgery?

A: Shoulder problems - generally right around the time they get up to 120 feet.

Huh?  Shoulder pain is a post-operative complication of an elbow surgery?  What gives?

First, I should make a very obvious point: many of these guys deal with shoulder stiffness as they get back to throwing simply because they've been shut down for months.  That I completely expect - but remember that it's stiffness, and not pain.  They always throw their way out of it.

The more pressing issue is what is taking place in their rehabilitation - and more specifically, what's taking place with the synergy between their rehabilitation and throwing program. Let me explain.

Rehabilitation following a UCL reconstruction is extensive.  While different physical therapists certainly have different approaches, it will always be incredibly heavy on rotator cuff strength and timing, as well as adequate function of the scapular stabilizers.  Guys always make huge strides on this front during rehab, but why do so many have shoulder pain when they get further out with their long tossing?  The answer is very simple:

Most people don't appreciate that throwing a baseball IS rotator cuff training.

Your cuff is working tremendously hard to center the humeral head in the glenoid fossa.  It controls excessive external rotation and anterior instability during lay-back.

It's fighting against distraction forces at ball release.

And, it's controlling internal rotation and horizontal adduction during follow-through.

Simultaneously, the scapular stabilizers are working incredibly hard to appropriately position and stabilize the scapula on the rib cage in various positions so that it can provide an ideal anchor point for those rotator cuff muscles to do their job.

A post-op Tommy John thrower - and really every player going through a throwing program - has all the same demands on his arm (even if he isn't on the mound, where stress is highest).  And, as I wrote previously in a blog about why pitchers shouldn't throw year-round, every pitcher is always throwing with some degree of muscle damage at all times during the season (or a throwing program).

Keeping this in mind, think about the traditional Tommy John rehabilitation approach.  It is intensive work for the cuff and scapular stabilizers three times a week with the physical therapists - plus many of the same exercises in a home program for off-days.  They're already training these areas almost every day - and then they add in 3-6 throwing sessions a week.  Wouldn't you almost expect shoulder problems?  They are overusing it to the max!  This is a conversation I recently had with physical therapist Eric Schoenberg, and he made another great point:

Most guys - especially at higher levels - don't have rotator cuff strength issues; they have rotator cuff timing issues.

In throwing - the single-fastest motion in all of sports - you're better off having a cuff that fires at the right time than a cuff that fires strong, but late.  Very few rotator cuff exercise programs for healthy pitchers take that into account; rather, it's left to those doing rehabilitation.  Likewise, most of the programs I see altogether ignore scapular stability and leave out other ways to train the cuff that are far more functional than just using bands.

Now, apply this example back to the everyday management of pitchers during the season. Pitchers are throwing much more aggressively: game appearances, bullpens, and long toss.  They need to do some rotator cuff work, but it certainly doesn't need to be every day like so many people think.

I'll cover how much and what kind in Part 2.  In the meantime, if you'd like to learn more about the evaluation and management of pitchers, check out Optimal Shoulder Performance.

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In Part 1 of this series, I outlined the first three reasons that I'm opposed to baseball pitchers using year-round throwing programs.  Here are the next four:

4. They need to get their shoulder and elbow range of motion back.

As I noted in Part 1, throwing a baseball is the single-fastest motion in sports.  With the crazy arm speeds one encounters, you have to keep in mind not only the muscles trying to accelerate the arm, but also the ones trying to slow it down.  This "braking" challenge is called eccentric stress - and I'll talk more about it in a second.

What you need to know now, though, is that when left unchecked, significant eccentric stress can lead to tissue shortening.  If you need further proof, Reinold et al. reported that immediately after a pitching outing, pitchers lose an average of 9.5° of shoulder internal rotation and 3.2° of elbow extension - and that these losses persisted at 24 hours post-throwing.

Now, imagine these acute range of motion losses being left unchecked for an entire season - or a season that simply never ends because pitchers are always throwing.  That's how elbows wind up looking like this:

(For more information, I'd encourage you to check out my Everything Elbow In-Service Video.)

Fortunately, we can prevent losses in range of motion during the season with appropriate mobility exercises, manual therapy, and breathing exercises - but the truth is that not everyone has access to these initiatives in terms of expertise, finances, or convenience.  So, while we work to educate the masses on arm care, emphasizing time off from throwing programs is also a key component of an overall strategy to reduce injury risk.

One last thing on this topic: it is a nightmare to try to improve shoulder or elbow range of motion in a pitcher during a season, as the very nature of throwing works against everything you're trying to achieve.  The off-season is "where it's at" in terms of optimizing range of motion in throwers.

5. They need to “dissipate” eccentric stress.

Okay, here's where I take #4 and geek out a bit.  I apologize in advance.

Sometimes, you have to get away from the baseball world in order to learn about the baseball world.  To that end, I need to think Mike Reinold for bringing this great 2004 study from Tomiya et al to my attention.

These researchers created eccentric stress in muscle tissue of mice using an electrical stimulation model, and monitored blood markers of muscle damage for a period of time thereafter.  What you'll see in the graph below is that myofiber disruption really peaks at three-days post-exercise, then start to return down to baseline, yet they still aren't even there at seven days post-intervention.

Source: Tomiya A, et al. Myofibers express IL-6 after eccentric exercise. Am J Sports Med. 2004 Mar;32(2):503-8.

Now, let's apply this to the world of pitching.  Every single pitcher who throws more than once every 7-10 days is surely pitching with some degree of muscle damage.  And, I can tell you that the two toughest challenges pitchers have reported to me are:

a) moving from starting to relieving

b) going from a 7-day high school or college rotation to a 5-day professional rotation

I'm firmly believe that pitchers need to throw in-season to stay strong, but I also know that we can't trump physiology.  Sure, we need to have optimal nutrition and regeneration strategies in place, as we can't just baby guys and expect them to get better.  However, make no mistake about it: high-level pitchers simply have to get good at pitching at 90% capacity (at best) if they are going to succeed.

If I already have a guy whose arm is working at a deficit for 8-9 months of throwing, the last thing I want to do is beat him up for the other three months with the same kind of volume and stress.

6. They need to allow any undetected low-grade injuries to heal.

As I discussed in an old blog, Pitching Injuries: It's Not Just What You're Doing; It's What You've Already Done, most injuries (especially ulnar collateral ligament tears) come from the accumulation of chronic, low-level stress.  Maybe you get some calcification on your ulnar collateral ligament or a low-level rotator cuff tendinosis, and it takes a few years and hundreds of innings before something finally "goes."

Old, low-level injuries are less likely to reach threshold if you give them some downtime and work on redistributing training stress.  By strengthening the rest of your body in the off-season, you're dramatically reducing the demands on your rotator cuff with throwing.

You can't teach other joints to share the burden if the burden is never removed temporarily.

7.  They need a chance to prioritize other competing demands.

Throwing is a good 20-30 minute endeavor each time you do it - and possibly even more.  When I think about all the things that pitchers can be doing to get better in the off-season from a strength and conditioning standpoint, I have a really hard time justifying giving away that much time and recovery capability.  There are other things that need to be prioritized at this time - and year-round throwing is an especially tough pill to swallow when you know that throwing is working against many of the very qualities - rotator cuff strength, scapular stability, mobility, and tissue quality - that you're trying to establish.

Closing Thoughts

The lack of downtime from throwing is especially problematic in younger populations, as they are skeletally immature and weaker.  I’d argue that a really weak 15-year-old kid throwing 74-76 mph does far more damage to his body on each throw than a moderately strong professional player throwing 90-92 mph, especially given that the pro pitcher’s mechanics are more optimized to protect the arm.  This underscores the importance of "syncing up" mechanics, throwing programs, and the overall baseball strength and conditioning program.

Last, but certainly not least, remember that two weeks doesn't constitute "time off."  Rather, I firmly believe that pitchers need the ball completely out of their hands for at least two month per year, preferably continuously.  In other words, eight one-week breaks throughout the year is far from ideal, as it doesn't really allow for positive adaptations to occur.

If you're interested in learning more about managing the throwing shoulder, I'd encourage you to check out our DVD set, Functional Stability Training of the Upper Body.

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