Five Tips to Avoid Arm Injury

by Josh Kauten, CSCS
Heartland Community College Strength and Conditioning
K’s Academy

Arm health is, clearly, a hot-button topic that has the baseball world buzzing. I think it was really brought to the forefront in 2012 when a record 46 MLB players (and their ~$193.5 mil in salaries) found themselves under the knife with the dreaded ‘Tommy John’ surgery. MLB players aren’t the only ones having TJ though. American Sports Medicine Institute (ASMI), which is headed by the famous Drs. Andrews and Fleisig, reported Tommy John surgeries performed by them among HS players rose from 17 in 2000 to 41 in 2010. Thankfully, experts far smarter than myself have researched several different theories (inverted W, the Verducci effect, Elbow drag line, toe drag lines, hip to torso separation, the list goes on and on) on what is causing the UCL to tear at such a staggering rate. However, with so many theories/rules out there, how do you know which ones to follow/implement? It seems like the more you delve into it, the more your head spins! Most of the theories have validity and the people that developed them have spent years developing them, so by no means am I discounting them….rather trying to provide a means of keeping it simple. Following these simple “rules” will greatly reduce risk of arm injury:

  1. Improve your mechanics. This is a tricky, yet immensely important way to reduce a pitcher’s risk of injury. Learning how to use his lower half and core effectively, while developing a smooth/repeatable delivery is paramount to maintaining arm health. In my experience, changing a pitchers arm action is one of the most difficult things to do as it’s so engrained in the muscle memory of the player. Changing arm angles is relatively easy, but the arm action from the time the ball leaves the glove to the point of release can be a difficult task, thus it’s best to work on your mechanics at an early age. If searching for a qualified pitching coach or private instructor, it is important to do your homework on him. What players has he worked with in the past? Where are those players now? What things did you change and why? What was the result? What things does he look for? Unfortunately, there’s not one, definitive answer I can give you to these questions, which makes finding a truly “qualified” instructor a great challenge.
  2. Strengthen your body. This seems like common knowledge, but I don’t just mean be able to squat or lunge more weight (but that doesn’t hurt!). I also mean take care of your arm through an arm care program such as the “Thrower’s 10” or any other program designed by a qualified professional. I try to describe it to my pitchers like this: Each time you throw a ball at max or near max effort, you are breaking down your muscle and tendon tissue just a tiny bit. Over the course of a game or bullpen, you’ve done pretty significant damage to your arm. In fact, a study by the Nicholas Institute of Sports Medicine & Athletic Trauma showed pitchers lose between 11-18% of total strength after an average outing of 99 pitches. Think of performing your shoulder program as mending that damage one rep at a time. For each “rep” you peform when you throw, you should do 2 “reps” of shoulder care. So, let’s say a pitcher threw 30 pitches in his bullpen and 100 pitches in the game. Add in pitches between innings and any near max effort long toss throws made as well. Using that formula, you can get to 200 “reps” quite easily. Based on the 2 to 1 “rep” rule, he should be performing nearly 400 reps of corrective exercise. Eight to ten different exercises at three sets of fifteen reps should do the trick. I would actually schedule this into my practice plan if I were a HS coach rather than leaving it to the players to do on their own. College coaches have it a little easier as they typically have the staff support to ensure that it does get done.
  3. Pitch on full rest. Once again, easier said than done. As a player it’s easy to say you aren’t going to pitch on a tired arm…until your coach asks you to do just that. What are you going do then, say no? Not likely. As a coach, a good ‘rule of thumb’ is to abide by the hour per pitch rule. For every pitch a player throws in the game, he should be given an hour of rest. If a pitcher threw less than 30 pitches, I would allow him to throw again the next day, but for a max of 40-45 pitches. Then I would add the total together and give him that much rest, so 70-75 hours (3 days) for the aforementioned scenario. It is the Head and Pitching Coach’s responsibility to know his previous workloads and know when it isn’t appropriate (or ethical for that matter) to call upon a pitcher. Coaches that start pitchers on a Friday and have them come in to close on Saturdays or Sundays are criminal and have no place in the game. No ‘W’ or trophy is worth that risk. Unfortunately, I’ve seen it happen.

Taking the rest time a step further, I highly recommend learning how to individualize, not generalize. What I mean buy that is every player is different. Some recover well, some don’t. Some have clean mechanics, some don’t. Some throw hard, some don’t. Some need more mobility work, some need more stability work. (That is an entirely different topic altogether, but a very important one.) If a player has “herky-jerky” mechanics, throws hard and throws a lot sliders(which I’ll cover in my next point)…then said player is at a much higher risk for injury than the guy who is smooth, maybe doesn’t light up the gun and relies more on sink and location rather than his slider/curveball. Logic would tell us the player that throws harder with poor mechanics may need more rest…yet it’s likely that he’s on the same schedule as the other player. Maybe this player’s mid-week bullpen becomes a light flat ground instead, thus giving him some more rest between starts. Have some awareness of each player’s ability to recover and the indicators that may cause injury (i.e. herky-jerky mechanics, high velocity, high usage of SL/CBs, poor mobility, SICK scapula, etc).

Finally, my first tip of improving mechanics directly affects this area of pitch count/rest time as well. Cleaning up mechanics tends to increase strike percentage, which in turn typically reduces pitch counts. As for pitch counts themselves, ASMI has set forth rather specific guidelines for youth pitch counts that would be worth researching if you are a youth coach or player.

  1. Limit the amount of sliders and curveballs thrown. There are a few different reports out there, but all seem to agree that increased SL and CB usage increases the risk for injury. One such report from Jeff Zimmerman showed that if a MLB pitcher threw his slider more than 30% of the time there was a 46% chance that pitcher landed on the DL in the subsequent season. Using the same model with curveballs thrown greater than 25% of the time, MLB pitchers landed on the DL 51% of the time the following year. It would be wise to take this ratio in to account when calculating rest time. If a pitcher throws 80 pitches, but 30 of them were SLs or CBs, it would be advised to allot for extra rest time. Better yet, don’t allow that ratio to happen.
  2. Don’t specialize too soon and give your arm a break. One of the major contributors to the rash of arm injuries in baseball today is players who decide they are baseball players only at an early age. By competing in sports other than baseball, youth greatly increase their overall athleticism, which is very important in baseball; where the motions are so repetitive and unilateral. The sport of baseball lends itself to being strong in some areas and weak in others, the perfect recipe for injury. The role of developing general strength and muscular symmetry is vastly underrated in maintaining arm and total body health for the long term. In addition, when you are participating in other sports, you tend to give your arm a break. A 2012 study by Dr. Andrews and Dr. Fleisig showed that a pitcher who pitched more than 8 months a year was five times more likely to be injured in the subsequent season. Yet, there are showcases and camps galore that High School players attend year ‘round. Assuming most HS pitchers start up their pens in January, they should be “shutting it down” around August. However, I still hear of tournaments going on as late as late October and “Unsigned Senior” showcases in January where players are expected to “max it out” and “show them what you have in the tank.”

It’s not just HS players that are at risk. Take a look at a typical college program: Bullpens start in Nov/Dec and go through Feb until season starts. They (hopefully) pitch all season until June, then likely head straight into summer ball. After summer ball, they may have a couple weeks to rest before returning to their respective schools, only to crank it back up for intrasquad games or actual games until mid-October. If pens start back up again in late Nov/early Dec….the math doesn’t quite add up. Colleges are, perhaps, as guilty as anybody of abusing pitchers. I know it doesn’t leave much time to build up pitch counts for the start of the season, but that is why I never had pitchers start into their pens until January. That still doesn’t add up to the recommended 4 months, but it at least gives them a couple months to re-strengthen and re-mobilize. I’m not sure what gives first…summer ball, fall ball or starting pens later, but in my opinion one of them needs to.

As you may have gathered from the length of this article…arm care is a topic I’m very passionate about! A big “Thank You!” to Jack Warren and entire the Top Coach Podcast crew for allowing me this opportunity to contribute to the coaching world. I never could’ve reached the level of baseball I did if it weren’t for the fortunate coaching I had along the way. I’m not sure if I’ll ever get the chance to thank all them properly, but I’m going to take this opportunity to try: Coaches Jim VanScoyoc, Jim Struve, Gordy Nordgren, AJ Sager, Rohrk Cutchlow and John Matlack…thank you for passing your knowledge and passion onto me and everybody else you’ve ever worked with. Your guidance and mentorship truly impacts me on a daily basis. Coaches everywhere, thank you for all of your sacrifices for the sake of this game and it’s youth.


Coach Kauten was our guest on podcast episode 6 and episode 63.

You can follow K’s Academy on Twitter.

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