Training Considerations For Pitchers
Jul 4, 2010 John
Training Considerations for
Pitchers
John Pallof, PT, OCS, COMT, CSCS
Consider for a moment the amount of money that is invested in pitchers every year at the professional level - from signing bonuses for new draftees, to the mammoth contracts signed by pitchers like CC Sabathia (twenty three million a year - buys alot at McDonalds, by the appearance of his ahem, frame), AJ Burnett, and countless others. Also consider the number of young pitchers, from little league through college, who routinely experience elbow or shoulder pain - the age at which pitchers are being introduced to the surgeon is getting younger and younger. I’ve seen several high schoolers undergo ulnar nerve transpositions; I have a 15 year old patient who had to have Tommy John (elbow ligament reconstruction) surgery - fifteen years old!!!! Despite the large amounts of money invested in pitchers, and despite the growing epidemic of arm injuries in an ever-younger population there is an alarming dearth of sound practices being implemented to try to stem the tide of injury. The following article attempts to lay a basic foundation to build upon when training a throwing athlete - from professionals to little leaguers.
1. The core principles of training pitchers are the same as athletes of other sports. The goals of training programs are the same for pitchers as they are for athletes of other sports - improving lean mass, fitness levels, maximal strength, and explosiveness. There are a number of people out there who are under the misconception that: pitchers shouldn’t lift weights, because they will lose their flexibility; overhead movements (pushing and pulling) should be avoided at all costs as they are “unhealthy” for shoulders; training for pitchers should be done with “functional” movements - movements that “replicate” the pitching motion; pitchers don’t need to lift heavy weights; and many many more. Bottom line: pitchers need to become more athletic!! This means they need to get bigger, stronger, and more explosive.
2. Fatigue Resistance. A well-developed fitness/work capacity base is essential to the health of a pitcher. This should be high on the priority list early in the off-season - this will allow the athlete to better withstand the rigors of the off-season program, and build fatigue resistance. Fatigue is an enemy - fatigue leads to increased risk of injury. Fatigue can be further classified into two types: accumulated and acute. Accumulated fatigue being the effects of a long season full of late nights, travel, generally poor diet, and of course competing. Acute fatigue being the more traditional sense of the term - experienced while pitching, which leads to increased injury risk and impaired performance. The cardiovascular demands of the position are often overlooked - but remember that the pitching delivery is a maximal effort - so consider a starting pitcher throwing 100 pitches - compare that to 100 hang cleans - pretty tiring!!
To combat this: be sure to emphasize conditioning early on - work capacity circuits, intervals, etc. To counteract accumulated fatigue - educate!! Teach the pitcher the importance of proper sleep, nutrition, and in season programming.
4. Rest!! The baseball season is extraordinarily long - stretching from mid February training camp possibly all the way to October. An initial period of rest is important both physically and mentally. A few weeks of rest early on is extremely important - it allows the athlete to recover physically, and allows the pitcher to relax mentally - and get ready for a productive off-season. However - some light exercise, and tightening the screws up on proper nutrition can make this time productive. Make sure the athlete doesn’t enjoy himself too much though - excessive alcohol intake or poor eating will lead to digging himself a body composition hole - don’t get fat.
Also very important - the athlete MUST give themselves a prolonged period of time of NO THROWING - don’t even pick up a ball. This is essential to allow the tissues of the arm/shoulder/and neck to recover from the stresses of thousands of throws from the beginning of the off-season throwing program until the last pitch of the season - this includes long tossing, bullpens, and actual pitching. Generally, roughly eight weeks is a good place to start. This will vary depending on how much volume the pitcher accumulated in season, if they were injured, rehabbing, or perhaps playing winter ball - but the bottom line = rest is absolutely necessary after a long season and prior to initiating a graded off-season throwing program (which will be discussed later).
5. Proper Nutrition. Generally, as with most athletes, baseball players’ nutrition is less than optimal, at best. Part of the blame falls at the feet of their teams’ staff, and with various personnel they come into contact with along their path. Example, from an MLB team’s off-season manual: bagels are good for you; pizza is OK as long as it is vegetable. Minor leagues are horrifying - chick-fil-a sandwiches for lunch in camp (along with bags of potato chips) and soft drinks; huge bowls of Doritos and cheese poofs in the club house pre game. Plus, the amount of traveling with baseball requires alot of eating on the fly - so the athletes’ nutritional options will frequently be limited, and will often be heavier on convenience and lighter on nutrition.
6. Off Season Throwing Program. Perhaps the most important component of any off-season program. There is no substitute for throwing. This is how the pitcher develops arm strength, and “calluses up the tissues” in the limb. I had the opportunity to listen to Rick Knapp, former minor league director of pitcher development for the Twins (good track record there), present pitching coach for the Detroit Tigers (has done well there so far this year). His presentation made a real impact - because he keeps things beautifully simple. He made a comment the seems simplistic, but is remarkably accurate, and just about impossible to argue with:
“If a guy can throw the ball far, I’m pretty sure he’ll be able to throw it hard...”
How does one argue with that? So, the necessity for a highly structured, well thought out off-season throwing program becomes apparent - the goal is to be able to throw the ball hard over a long distance. Programming should consist of long tossing first and foremost, and bullpens. And the process is very similar to training: volume, frequency, and intensity are the variables that are manipulated to attain the desired results - sound familiar?
There are many many philosophies out there regarding how to go about this - and many of them work equally well, even with pretty divergent approaches. A few of my own observations:
1. Volume: Remember, the baseball season is extremely long, and throwing is not a natural activity for the arm. So - the trick is doing enough early on, but not too much. And definitely not too little. A pretty basic principle - gradually build volume to gradually strengthen connective tissues. Wolff’s Law (don’t quote me, but this is the gist): tissues will respond accordingly to the stresses that are placed upon them. Most long tossing programs I have seen build volume by increasing frequency, not by just building volume within sessions. So, going from 3x/week to 5x/week for instance. The biggest problem I see is a lack of a structured approach - going out and just throwing and throwing some more (too much too soon - remember you need to save bullets), or throwing too little - just throwing when the athlete feels like it, or when it is convenient.
2. Frequency: A good way to add volume without overstressing the arm too early. And it is necessary to get to the point where the athlete is throwing 5-6x/week, as this is what will be happening come spring training. A good starting point is 3x/week, building upwards.
3. Intensity: Two factors at play here: distance (the farther out you are, the more effort it takes to get the ball there), and the trajectory of your throws - “on a line” vs. with some arc. So common sense dictates that this should be gradually increased as well - perhaps progressing in distance if you have the space, or gradually throwing more hard from a limited distance. How much distance? Some teams advocate going all the way out 300 feet. If space is limited, 150 feet is plenty - throwing on a line. This is important, because it can be a fairly accurate indicator of arm strength - a borderline hall of fame pitcher known for his meticulous approach (and large appetite) won’t get on the mound to throw a single pitch until he can get out to 240 feet on a line - then he feels as though he is at an adequate point with regards to arm strength.
4. Bullpens: A bullpen is a throwing session that closely mimics the intensity of actually pitching. It is done on the mound, and is limited and intense. Pitching off of the mound is more stressful on the shoulder due to the downhill nature of the mound - this increases the external rotation type stresses on the shoulder due to the downhill trajectory of the pitcher’s delivery/stride. Generally not until at least 4 weeks of long tossing. And again, gradually building in intensity/volume. Start with straight fastball/change ups for first 3-4 sessions, then adding in breaking pitches gradually. Generally two bullpens a week, starting with say 25 pitches, perhaps building to 40-50 - no more.
One last important point: make sure EVERY THROW has a purpose!!! The arm can withstand only so much of such a stressful activity, so every throw in a program must have a purpose - save the bullets for when you need them!!
7. Pitchers need to be good “pullers”. As a rule, pitchers should be strong in pulling movements, and be able to do lots of it. Why? These are very important muscles in both acceleration and deceleration of the arm complex - and play an enormous role in scapular, thoracic, and cervical stabilization during the very violent action of pitching. So, a few rules of thumb:
-Pitchers should be able to do an appropriate volume/load for chin ups. Great lift for pitchers. I like chins vs. pull ups because I believe the closed grip lessens the potential for excessive stresses to the anterior shoulder/anterior capsule. Injure this, and you have big problems. Also - when coaching them, I prefer the athlete stop just short of the absolute bottom - that way the supporting musculature is always engaged, and should lessen the stresses on non-contractile (e.g. ligaments, labrum, etc.) tissues in the glenohumeral joint. So - if a pitcher is large, bodyweight should be a good measure of strength; otherwise, add external load.
-I generally like to see symmetrical horizontal pulling and pushing strength. A good, if non-scientific measure - unilateral bent over dumbbell rows vs. dumbbell bench. While the numbers will probably trend towards the pushing being a bit stronger, it shouldn’t be dramatic- no more than twenty pounds.
-Do lots of pulling - these muscles handle an extremely high volume of work while pitching/throwing. So I like to skew the overall weekly volumes a bit more towards pulling, especially early on in the off-season.
-Don’t neglect pushing too. The muscles involved with pushing, be it overhead or horizontal, are important for overall stability as well - serratus anterior, and the pec complex for example. So be sure to make sure they are strong here as well.
8. Vertical pressing is OK (well, sort of..). I do believe that overhead pressing trains some important movement patterns - think scapular and thoracic stability. However, there are limitations. Some rules of thumb:
-Dumbbells, not barbells. Having your grip fixed to one bar can force your shoulders into positions they don’t want to be in, and doesn’t allow for a more natural movement trajectory. And I prefer neutral grip to avoid stress on anterior capsule.
-Unilateral motions for overhead dumbbell pressing. This allows significantly more thoracic mobility - sidebending and rotation. This will allow the scap to move better through space, decreasing impingement type situations, by maintaining the subacromial space.
-High incline dumbbell presses. This exercise is a good alternative because you can closely control the angle of the press - so you can keep it in a healthy range (say 130 degrees of shoulder flexion for arguments sake), and still train an appropriate movement pattern. Very safe alternative.
However, some exercises are not OK in my book when working with throwers. Reason being: increased stresses on the cuff tendons (supraspinatus, infraspinatus) which can lead to injury; and the potential for increased stresses on the anterior joint capsule - if this tissue loses its integrity, even to a small degree, the shoulder becomes unstable. This leads to pain, progressively decreasing velocity, and eventual tissue failure. In most cases, a thrower with glenohumeral instability due to capsular compromise should consider a career change, because it is almost certain that they will never return to pre-injury status.
So: overhead olympic lifts (snatches, even dumbbell snatches), and overhead pressing with a barbell, and especially pressing behind the head (pretty sure most people avoid this now, but one should never assume) are all to be avoided. And although not completely related, pay attention to depth with horizontal pressing - this can subject the anterior shoulder to increased stresses as well. Cue scapular retraction in the downward phase of the horizontal press.
9. Maximal strength is very important. The pitching delivery is an extremely violent, explosive movement. From a physics perspective, a very large amount of force is generated in a very short period of time. So, it makes sense to me that the pitcher should be able to generate a large amount of force - to impart velocity on the ball, and especially to stabilize the body to avoid injury - during acceleration and while decelerating the body after release. So - programming shouldn’t neglect absolute strength development, when considering lift selection, and set/reps schemes. Don’t be afraid to load them up - without sacrificing safety of course (carefully considering risk/benefit when choosing which lifts to load).
10. Pitchers need to be explosive!! “We don’t do medball throws so as to avoid oblique injuries.” Huh? I haven’t trained as many folks as many coaches out there, but I’m sure that I’ve just about never seen anyone injure an oblique doing medball throws. To the contrary, medball throws train the athlete to generate force rapidly, while teaching stabilizing musculature how to recruit rapidly and forcefully. Medball throw variations, loaded squat jumps, plyometrics, vertimax resisted jumps, power cleans - all valuable in off-season programming. I find power cleans useful if the athlete can execute them well - provides a valuable plyometric type stimulus to the scapular and glenohumeral stabilizers. Medball circuits for conditioning can be a very useful tool, allowing for some variation in programming.
11. The Rotator Cuff. It is extremely important to have a well functioning, strong rotator cuff to maintain long-term shoulder health. While the cuff does play an important role in actually generating movement, its primary function is to stabilize the glenohumeral joint. Consider the surface area ratio of the glenoid to that of the humeral head - the humeral head is way bigger than the glenoid - so there is minimal joint stability provided by bony congruence. The cuff’s job is to maintain proper glenohumeral arthrokinematics - keep the ball centered in the cup, for simplicity’s sake - counteract the strong translatory forces that occur with throwing. Example: when transitioning from cocking to maximal external rotation to acceleration, the humeral head experiences strong anterior translatory forces - the ball wants to pop out of the front of the joint. The posterior cuff (infra/supraspinatus) fires very strongly to resist these forces, maintain good glenohumeral alignment, protect the anterior capsule, and preserve the subacromial space to avoid impingement.
One doesn’t need to go overboard - cuff work twice a week, with occasional cuff exercises supersetted into the body of the workouts should be adequate. And the cuff should be trained in a manner similar to that of other muscle groups - vary volume, load, and exercise selection. Generally, I like to do more volume, lighter load once a week, and moderately increased loads with less volume/shorter worksets once a week to shift the emphasis towards force production. Other points: remember that cuff muscles have a relatively low threshold for recruitment - so if you load too much, you will blow through the cuff muscles and utilize larger muscle groups; scap positioning and tempo matter - in order to effectively target the cuff musculature, the tempo should be slow and controlled, with an emphasis on maintenance of proper scap positioning.
As I mentioned above, yes, you can increase loads with your cuff work - they experience a huge peak in force with the delivery, so they need to be able to develop an appropriate spike in force to counteract this. It is a waste of time when you see a pitcher performing cuff exercises with a puny band providing no resistance, or a 1-2 pound weight (for a healthy athlete) - performing prone rows off of a table with a 5 pound weight will not build strength in a healthy athlete. While I’m not advocating ridiculous loads, it is OK to progress gradually with more resistance in a graded fashion - the cuff muscles have the same physiology as other muscles - so they will get stronger when some of the same principles are applied.
Seated dumbbell external rotation, sidelying dumbbell external rotation, external rotation/internal rotation in neutral/or 90 degrees of abduction all have value. I utilize a series of six exercises called the push/pull series (creative, I know) to emphasize cuff strength along with scapulo-humeral rhythm, and isometric endurance of the periscapular musculature. I prefer performing cuff work utilizing the keiser machines, as they provide a smooth, uniform, even quality of resistance throughout the entire range of motion - very shoulder friendly.
The Push and Pull series are broken down into six exercises, all done in half kneeling; all should be done with controlled tempo, a little faster with the concentric part of the movement; be sure to engage cervical stabilizers with slight chin tuck for all movements:
1.External Rotation in abduction: emphasizes posterior cuff, with isometric periscapular stabilization. Arm is at ninety degrees abduction, scapulae depressed and retracted. Should be close to pure rotation, with resistance angled downwards for proper resistance through the movement.
2.”Reverse Fly”/Horizontal abduction: emphasizes scapulohumeral rhythm, while adding strong cuff recruitment to resist glenohumeral internal rotation. Scapular protraction and retraction should be emphasized along with the humeral horizontal abduction/adduction. Good scapulohumeral rhythm is the main priority here. Be sure to maintain a vertical forearm. Resistance should be angled upwards.
3.Elbow flexion in abduction: ninety degrees of abduction, with elbow slightly behind shoulder. Emphasis on scapular retraction and depression; nothing should move from elbow in.
Pull Series
4.Internal rotation in abduction: strengthens internal rotators while emphasizing scapular stability. Slow tempo, shoot for pure internal rotation with scaps set down and back. Resistance should be angled downwards.
5.”Flys”/Horizontal adduction: again, emphasize scapulohumeral rhythm, with strong internal rotator recruitment to resist external rotation moment, with resistance angled downwards.
6.Elbow extension: shoulder flexed, with slight horiz abduction. Emphasis is on scapular retraction and depression through the entire movement; no movement from elbow in.
Push Series
Another point of contention: while doing ER/IR in neutral is not as challenging to the glenohumeral joint when compared to performing in an elevated plane - I do believe they are still useful, as it doesn’t compromise the sub acromial space. More friendly for athletes prone to impingement or recovering from injury.
12. Maintenance Work. This topic for another entire discussion, but in short order, these are some areas that should be paid special attention when programming for the off-season.
-Cervical spine segmental mobility: while often overlooked, many pitchers experience cervical spine pain and dysfunction. Sometimes the injury is severe - example being an anterior cervical fusion in a pitcher in his early thirties. The reason? There is a tremendous amount of “body on head” rotation - head is stable, body rapidly moves beneath - primarily a combination of extension, rotation, and sidebending. Over time, this can cause discs, soft tissue, and joints to degenerate. The cervicothoracic junction, and upper cervical spine are common areas to see segmental dysfunction. Find a qualified therapist to manually mobilize these areas.
-Cervical stabilizer strength/endurance: primarily deep flexors. See above paragraph for reasoning. A stable cervico/thoracic spine is very important for proper shoulder function as well - it is the base upon which the shoulder complex rests.
-Thoracic mobility/stability: the delivery requires quite a bit of thoracic segmental mobility - again, extension, rotation, and sidebending. This allows proper positioning of the scapula, and therefore glenohumeral joint. Thoracic stiffness shouldn’t be overlooked for pitchers with impingement problems for this very reason. Add active and passive thoracic mobility exercises to your programming; emphasize unilateral upper body movements to train thoracic stability - one arm pulls or pushes place a strong rotational force on the thoracic spine.
-Hip Mobility: multiple reasons for this. It allows for a longer stride with the delivery. Important for positioning of drive/back leg. Important for deceleration/efficient follow through. Combination hip extension/abduction/ external rotation from back leg provides huge push from the hips - this drives the ball.
-Soft tissue quality: just like any other sport, pitchers tend to have a characteristic pattern of poor soft tissue quality in specific areas. Adductors, hip rotators, lower thoracic/lumbar paraspinals, infraspinatus, teres group, lat (esp between attachments at inferior angle of scap and humerus), subscapularis, and hand/wrist flexors are all areas for special attention. The wrist flexors are an extremely important muscle group for the pitcher - they are responsible for stabilizing the wrist/elbow complex, providing protection for the passive structures in the medial elbow. A very common area for severe soft tissue dysfunction, and can contribute to ulnar nerve dysfunction, as it is sandwiched between the flexor carpi ulnaris and flexor digitorum profundis, wrapped in thick fascial bands (visit www.pallofpt.com to read my thoughts on conservative treatment of ulnar neuropathy in pitchers).
I personally utilize graston type soft tissue mobilization - a very gentle means of improving soft tissue quality.... not really, but brutally effective. There are many effective approaches, from ART to ASTYM, to positional release - which tool to employ is determined by the nature of the dysfunction.
Overall, pitchers are a horribly underserved population. The result of this benign neglect is injury, impaired performance, sometimes derailed careers. I have long held that major league baseball lags far behind its peers when it comes to athlete maintenance - obviously not in every instance, but in an alarming number of instances. It is surprising to me that in these times of economic belt tightening teams haven’t realized the economic value of investing heavily in strength and conditioning, athletic trainers, and physical therapists. In dollars and cents: “dead” money tied up in players on the disabled list, money spent on salaries for replacement players, putting fannies in seats (people pay money to come see their favorite players), wins and losses, and sometimes playoff money - a few losses due to the team’s starting pitching spending time on the DL can lead to the team missing the division title by a few games. Consider the number of big bonus high round picks that never maximize their potential due to injury - wasted money. In my mind: a relatively small investment can lead to a manifold return over the course of several years.
So, when your baseball athletes start rolling back in the door this off-season, keep in mind - they aren’t a whole lot different than the other athletes you train. Just remember the points discussed earlier in this article, and perhaps try to incorporate some of these in your programming. Over the years it will pay off in the form of less injury and improved performance - and hopefully decrease the incidence of being forced to watch horribly obese pitchers sweat through their uniform on a hot summer night.
