Fixing Pitchers

Preventing and Evaluating Baseball Pitching Injuries

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What Baseball Pitchers Should Do Between Seasons

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When the school season has ended and summer ball has not yet begun, what should a pitcher be doing? Rest? Throw? Lift weights? Run? Something else?

Angel Borrelli shares her recommendations and the program that her pitchers follow in between seasons in this episode of The Fix.

Show Notes

With high school and college seasons ending and summer or travel ball beginning,what should pitchers be doing in between seasons, if anything?

Watch out for head/neck tilt and learn how it can rob a pitcher of velocity and possibly cause injury.

Pitching injury trends are moving beyond shoulders and elbows and into other parts of the body, such as blood clots and thoracic issues – why?

How Major League Baseball teams are managing injuries — are they on the right track? How can they do a better job of preventing baseball pitching injuries? There is a key missing piece that needs to be included — a qualitative piece that can connect the dots.

MLB pitchers mentioned: Shelby Miller (Tommy John surgery), Aroldis Chapman (rotator cuff inflammation), Wei-Yin Chen (elbow, PRP), Phil Hughes (shoulder), Nate Karns (forearm), Jeurys Familia (arterial clot), Dillon Gee

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This One Exercise Can Help Prevent Elbow Injury

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Elbow joint integrity: protect the inside by training the outside

It is common knowledge that the medial (inside) portion of the elbow joint is where the vulnerability lies in regard to injuries causing epicondylitis, UCL sprains, and UCL tears. In addition to directly maintaining the integrity and strength of the inside of the elbow to offset those injuries, giving the outside of the elbow attention in the gym can provide the elbow with an ally to assist it during challenging times.

The brachioradialis is an elbow flexor that, in studies on muscular activity, has shown itself to be the most active when throwing the fastball. It is located on the lateral (outside) of the elbow joint, and because of its structure, it is a major contributor to elbow stabilization during the moments when the medial side of the elbow is stressed. Training it and making it strong is a huge a protective measure for this vulnerable joint.

The hammer curl is the exercise that shows the greatest activity in the brachioradialis muscle. This is a curling exercise performed with dumbbells and a “hammer” grip (just as you would use when using a hammer) is maintained throughout the performance of the exercise. They can be performed two arms at a time, single-arm, or alternating arms. During the season, my pitchers do this exercise at least twice a week and use either the single-arm or alternating-arms method.

Always remember that by virtue of the nature of pitching, there are many things that can happen to your arm over which you have no control. That is why you must always focus on the one thing that you always have control over — which is your level of strength and conditioning for the skill.

Give hammer curls a try and notice the increase in the integrity of the elbow joint — you’ll likely feel it immediately.

The 3 Body Parts Every Pitcher Should Priority-Train

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Getting through the hard work required in the pre-season and the seasons that follow requires that you know how to train in the gym and what to prioritize for special care. While the entire body is important, make “The Big Three” your priority now and see the difference for yourself. From a complete game to a complete season, get ready for big results.

Number One: the rear deltoid
The rear deltoid’s integrity is so important for so many facets of shoulder health and integrity but its special role in deceleration is where it can take the greatest beating.

Number Two: the elbow extensors (triceps and anconeus)
The triceps are extensors of the elbow and its long head is an extensor of the shoulder. Because of this dual role, it plays a huge role in the health of both joints. The anconeus is a small muscle above the posterior elbow that works with the triceps and plays a special role in rapid elbow extension.

Number Three: the forearm
I can’t say enough about the importance of the forearm and maintaining its integrity throughout the performance of a game as well as throughout the entire season. The effectiveness of its musculature to handle the stresses of the pitching motion can make or break your plan for elbow health. Its strength is the number-one weapon against UCL injuries. Because of the forearm’s complexity, it requires different movements to keep it strong.

Here are my pitchers’ favorite exercises for these body parts:

The rear deltoid: side-lying reverse fly (eccentric emphasis)

The elbow extensors: reverse-grip “w” bar pushdowns and cable kickbacks

The forearms: cable wrist flexions and extensions, forearm pronation and supination, and reverse curls using the EZ-curl bar.

Ask your strength coach for additional ideas for priority training these body parts.

3 Vulnerabilities That Cause Baseball Pitching Injuries

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Aches and pains you are having in the pre-season are signals that something is off; it can be that you don’t have good warm-up habits, that you threw too much too soon, or that your mechanics need adjusting. In any case, your body has only way to get your attention and unfortunately soreness is its loudest voice.

The three areas that are the most vulnerable this time of the year are your biceps, the rear of your shoulder and your forearm. Pain or unusual soreness in any of these areas should be a signal to you to pay attention.

Here are some of the most easily recognizable causes of problems with these sensitive areas of a pitchers arm:

Biceps and or rear shoulder: these two body parts work together in the deceleration phase of the pitching motion. Make sure you well warmed-up in the shoulder and arm musculature before you throw a ball. Make sure you are finishing your pitching. Make sure you are releasing your elbow at the end of the arm path as you complete your follow-through.

Forearm: Make sure you are not introducing pitches other than a fastball too soon. Even though a change-up is easy on the elbow, it is more challenging to the forearm because of the spread-out position of the fingers for most of the popular grips. Having a program that maintains and improves the range-of-motion of the wrist for the different pitches is critical to forearm health. Remember that the forearm muscle is an endurance muscle; if you are not recovering or experiencing tightness in this part of the arm, something is not right as it is designed to endure.

How To Get Game-Ready With Preseason Bullpens

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Are your pre-season bullpens really getting you game-ready?

The challenge of the pre-season is that in your bullpens you have to now be thinking “pitching” while at the same time continuing to work technically on your “pitching motion”. “Pitching” is a combination of the pitching motion, a variety of effective pitches, and pitch/game-strategy. It’s easy to get caught-up in working technically on your motion and forget to get back to the art of pitching.

It is important that every athlete learn how to think technically, let the thinking go, and perform. It is also important that he learn how to self-correct during a performance and get back again to “pitching”. At this stage of your bullpen calendar, your pitch counts should be high enough to where you can practice this type of multi-tasking and keep your progress moving forward as you approach your season.

Construct some of your bullpens like this: take a break after you have thrown what represents your game warm-up pen pitch count and then return to the mound and complete your pitch count for the day in sets of 12 to 15 (taking a break after each set). This prepares you numerically and physically for the timing of a game.

In the above scenario, during the pitches that are thrown in your simulated warm-up pen before your sets, practice thinking technically about some of the adjustments you have been working on and then not thinking technically. Once you get used to thinking and not-thinking, it will become easier to remain present with yourself as well as the task at hand. I watch my highly skilled pitchers practice this way and it is truly a sight to behold.

Another plan is to proceed as above with your warm-up pen number, take a break, and then have your catcher call balls and strikes and take a break after the three outs. Simulating an innings format helps to start to build your confidence and again provides you with the learning environment where you can develop the skill of thinking, self-correcting, letting all that go…and just pitching. When possible, have a hitter stand in. This format gives you great feedback about the effectiveness of each of your pitches.

Embrace this time of the year. Learn to trust the work you have done and put it to the test. Never be afraid to self-evaluate and correct. When the season starts, be ready to trust yourself and your pitching — which is the number-one prerequisite for a solid pitching performance.