A progression of plyometric training meant to move from introductory weight and force acceptance. It starts with basic hopping (alternating legs and small distances), progresses to same leg hopping before moving to more advanced jumping (vertical height emphasis), then on to even greater demands of bounding (horizontal distance emphasis). ALL of these with focus on motor control and always landing in an “athletic position”. This means slightly flexed knee, flexed hip and flexed trunk – basically, trying to “catch” yourself quietly and mitigating forces.
You should start with 30 seconds of each exercise and build from there. Do NOT sacrifice speed for performance. Make sure to always demonstrate control when you land. Control and adequate “catching” yourself in an athletic position will allow you to build to greater force, power, height and distance – all with increased ability and now with a more solid foundation.
This is a shoulder and core strengthening exercise series with closed kinetic chain emphasis. Basically, that means your hand is on the ground (versus in the air holding weights or bands like most strengthening exercises). Completing exercises in this manner focuses on dynamic shoulder stability while also activating your core.
For all of the progressions in this video, start on your knees and complete 10 reps on each arm. Make sure not to let your back or shoulder blades sag down. One cue that may help with most of these exercises is to push your butt and shoulder blades to the ceiling.
Here are 2 exercises that dynamically shorten and lengthen the hamstring complex and the posterior chain musculature.
These are active mobilizations – pausing at the lengthening (tightening) phases and gradually moving in and out of these positions. You could complete 10-15 of each of these several times/day if you are looking to improve your mobility.
For anyone who is interested in youth baseball or softball, I urge you to pay attention to the numbers…some of the data is staggering. I would like to make this entire post HIGHLY based in the available research and evidence – not my opinions. I am basically summarizing what has been researched and published in this post. Of course, I will elaborate on a few things along the way, but I will mostly let the data speak for itself.
Let’s start with a little background:
- Baseball/softball remains one of the safest overall sports to play
- Nevertheless, traumatic and overuse injuries occur regularly
- More and more young boys & girls playing baseball/softball every year
- Despite pitch count rules, incidence of youth injuries and surgeries is rising
- Adult throwing injuries are being attributed to injuries suffered as youths
During the 5 years from 1994-1999 compared the 5 years from 2000-2004:
- 4x increase in elbow surgeries in college baseball pitchers
- 6x increase in elbow surgeries in high school baseball pitchers
- 5x increase for injury with pitching >8 months/year
- 4x increase for injury with pitching >80 pitches/game
- 2.5x increase for injury with throwing >85 MPH
- 36x increase for injury when throwing with arm fatigue
- Injured pitchers threw 34 warm-up pitches vs. 26 warm-up pitches of un-injured pitchers
- Injured pitchers threw in 4 showcases vs. 1 showcase of un-injured
- Injured pitchers were 4cm taller and 5kg heavier
In 2006, 450 players (ages 7-11) without elbow pain pre-season
- 30.5% reported elbow pain by end of season…of those, 72.3% had physical exam deficits…of those, 81.4% had radiographic abnormalities. This basically means kids with elbow pain actually had pathology, not just soreness!
- “Little League Elbow” – epicondylitis, apophysitis, physeal plate (growth plate) fracture, osteochondritis dissecans occurs in 20-40% of school aged pitchers
A 10-year study (from 1999-2008) 481 pitchers (ages 9-14) with an elbow injury defined as surgery or retirement due to pain
- Pitching >100 innings/year = 3.5x more likely to be injured
- Playing pitcher and catcher – 2.5x more likely to be injured
A 2015 study on 420 healthy pitchers
- 31% had a pitching-related injury (shoulder and elbow)…of those, 3 variables could predict injury 77% of the time
- Pitcher height
- Pitching velocity
- Pitching for more than one team
A 10 year study from 2002-2011 in New York State
- There was a significant increase in the number of UCL reconstructions by 193%
- Becoming more common in adolescent athletes
- The average age at surgery going down = more kids are having Tommy John surgery at an earlier age
Dr. James Andrews – arguably the most prolific orthopedic surgeon of this era – has presented numerous times throughout his career about his concerns regarding youth injuries and increasing awareness…here is a graph showing the percentage of Tommy John’s surgeries he completes each year on youth (compared to collegiate and professional athletes):
The Recommendations – Pitch Count & Playing Time
“Understanding the stresses placed on the arm, especially while pitching, led to the institution of rules controlling the quantity of pitches thrown in youth baseball and established rest periods between pitching assignments”
9-10 years of age: 1000/season, 2000/year
11-12 years of age: 1000/season, 3000/year
13-14 years of age: 1000/season, 3000/year
Pitcher-to-catcher ban: any pitcher who throws >41 pitches may not play catcher that day
The Recommendations – Throwing Guidelines
- Avoid pitching with arm fatigue!
- Avoid pitching with arm pain
- Avoid pitching too much
- <80 pitches/game at ALL adolescent levels
- <8months out of the year
- <100 innings in games in any calendar year.
- 2000-3000 pitches in competition/year (pending age)
The Ongoing Problem
Travel ball does not fall under the umbrella of Little League ™
Recent NATIONAL survey of 750 pitchers (ages 9-18) shows:
- 45% of youth pitchers pitched without a pitch count
- 43.5% pitched on consecutive days
- 30.7% pitched on multiple teams
- 19.0% pitched multiple games in one day
- 13.2% pitched year-round
- ~1/3 having a pitching-related injury in the past 12 months,
- 7/10 reported significant arm tiredness in the past 12 months
- Nearly 40 percent reported significant arm pain within the past 12 months.
- Arm Tiredness = 7.8x more likely to have an injury
The Lack of Evidence
- 2011 Study = Hard, flat-ground throws have biomechanical patterns similar to pitching; however, maximum distance throws produce increased torque & changes kinematics. Therefore, use caution with use of these longer throws in rehab & training
What about flat ground vs. mound pitching?
- 2013 Study = “There is NO difference in kinematics or kinetics in pitching from a mound versus flat-ground conditions in adolescent baseball pitchers.”
What about curveballs, sliders, fastballs & change ups?
- In multiple studies (2002, 2006, 2008, 2011) = conflicting information…
- Most indicate fastballs have a greater overall torque on the shoulder and elbow than any other pitch
- However, what has been shown in some studies curveballs elicit more force through the shoulder whereas the slider places greater forces through the elbow.
- The changeup is consistently shown in virtually all research to have the least amount of forces (shoulder AND elbow)
- None of the players in several studies threw anything but fastballs or changeups, so the information is lacking
The Explanation & Take Away(s)
- There is OVERWHELMING evidence that volume and overuse are single-handedly a major contributing factor to injuries in youth baseball
- Throwing with pain and/or fatigue is the fastest way to be injured
- Injuries are not always seen “in season” but the cumulative effects can negatively effect the long term health of a pitcher
- Pitch type is not as big of a concern; however, most youth do not have the appropriate control, body awareness/motor control and mechanics to throw efficiently and effectively, therefore breaking pitches are underemphasized early in youth pitching
- Watch and respond to signs of fatigue:
- Decreased ball velocity, decreased accuracy, upright trunk during pitching, dropped elbow during pitching, or increased time between pitches). If a youth pitcher complains of fatigue or looks fatigued, rest is recommended.
- No overhead throwing of any kind for at least 2-3 months per year. No competitive baseball pitching for at least 4 months per year.
- Follow limits for pitch counts and days rest.
- Avoid pitching on multiple teams with overlapping seasons.
- Learn good throwing mechanics as soon as possible. The first steps should be (1) basic throwing, (2) fastball pitching, (3) changeup pitching…breaking pitches are not fundamental and youth players need foundation first
- A pitcher should not also be a catcher for his team. The pitcher-catcher combination results in many throws and may increase the risk of injury.
- If a pitcher complains of pain in his elbow or shoulder, discontinue pitching until evaluated by a sports medicine physician.
- Avoid using radar guns.
- Avoid showcases, especially in the “off” season
- Inspire youth pitchers to have fun playing baseball and other sports. Participation and enjoyment of various physical activities will increase the youth’s athleticism and interest in sports.
I threw a lot of information at you. I want everyone to understand NONE of these are rules…just guidelines/suggestions. But I am not talking about my opinion or something I saw or heard or know a guy who said something I thought made sense. It is research. Actual evidence. Measurable data. I am not here to start a debate or judge anyone for anything. I am simply packaging the best information I could gather and put it all in one place. My final thought is this: I love baseball. I want you and your children to play baseball/softball. Let your kids be a part of arguably the greatest sport on the planet – a sport that has some of the best teaching lessons and analogies for life. Work hard to get better and be better. Strive for improvements. Just watch volume and be smart about things. Have a great season!
American Academy of Pediatricians. Policy statement: baseball and softball. Pediatrics. 2012;129:e842-e856.
American Sports Medicine Institute. Position statement for youth baseball pitchers. http://www.asmi.org/asmiweb/position_statement.htm. Accessed March 10, 2016.
Cain EL Jr, Andrews JR, Dugas JR, et al. Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: results in 743 athletes with minimum 2-year follow-up. Am J Sports Med. 2010;38:2426-2434.
Chen FS, Rokito AS, Jobe FW. Medial elbow problems in the over head throwing athlete. J Am Acad Orthop Surg. 2001;9:99-113.
Dun S, Loftice J, Fleisig GS, Kingsley D, Andrews JR. A biomechanical comparison of youth baseball pitches: is the curveball potentially harmful? Am J Sports Med. 2008;36:686-692.
Fleisig GS, Andrews JR, Cutter GR, et al. Risk of serious injury for young baseball pitchers: a 10-year prospective study. Am J Sports Med. 2011;39:253-257.
Fleisig GS, Barrentine SW, Zheng N, Escamilla RF, Andrews JR. Kinematic and kinetic comparison of baseball pitching among various levels of development. J Biomech. 1999;32:1371-1375.
Olsen SJ, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med. 2006;34:905-912.
Fleisig GS, Bolt B, Fortenbaugh D, Wilk KE, Andrews JR. Biomechanical comparison of baseball pitching and long-toss: implications for training and rehabilitation. J Orthop Sports Phys Ther. 2011;41:296-303.
Fleisig GS, Kingsley DS, Loftice JW, et al. Kinetic comparison among the fastball, curveball, change-up, and slider in collegiate baseball pitchers. Am J Sports Med. 2006;34:423-430.
Fleisig GS, Phillips R, Shatley A, et al. Kinematics and kinetics of youth baseball pitching with standard and lightweight balls. Sports Engineering. 2006; 9:155-163.
Fleisig GS, Weber A, Hassell N, Andrews JR. Prevention of elbow injuries in youth baseball pitchers. Curr Sports Med Rep. 2009;8:250-254.
Fortenbaugh D, Fleisig GS, Andrews JR. Baseball pitching biomechanics in relation to injury risk and performance. Sports Health. 2009;1:314-320.
Little League Baseball. Protecting young pitching arms. http://www.littleleague.org/Assets/old_assets/media/pitch_count_publication_2008.pdf. Accessed February 12, 2016.
Nissen CW, Westwell M, Õunpuu S, Patel M, Solomito M, Tate J. A biomechanical comparison of the fastball and curveball in adolescent baseball pitchers. Am J Sports Med. 2009;37:1492-1498.
Nissen CW, Westwell M, Ounpuu S, et al. Adolescent baseball pitching technique: a detailed three-dimensional biomechanical analysis. Med Sci Sports Exerc. 2007;39:1347-1357.
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Stop Sports Injuries. http://www.stopsportsinjuries.org. Accessed on March 19, 2014
https://mikereinold.com/tag/weighted-ball-program. Accessed on March 10, 2016
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First, I think we need to talk about why a prevention/prediction model is difficult and what has to be accounted for if we wish to eventually build one. While injury prevention is our long term goal, we have too many variables to control for at this point. Here are a few points highlighted by Kitman Labs, which I will elaborate on, that speak directly into this topic:
- We cannot really know that injury prediction works – it relies on an event to actually happen AND for the predictor to demonstrate that they knew about it beforehand.
- If we are going to try to “predict” injury beforehand, how often were we right vs. how often were we wrong…false positives, so to speak. If we predict an injury will happen, did we predict this 10x and get it right 1x? Not good odds, right?
- What “types” of injuries happen? Contact vs. non-contact? Soft tissue or skeletal injuries? Do we account for spine injuries or upper extremity injuries or only focus on lower extremity injuries at this time? Is an injury categorized strictly by “time loss”? If so, what counts as time loss? If not, how do you categorize it?
- The prior point leads to this one: We have to store injury data accurately and regularly. Athletic trainers seem to have a system for this…PTs do not, really. So, before moving forward with a prediction model, we need to know if the old data is still relevant? Maybe it is, but only in that prior injuries often increase the risk of future injuries – so, we would know who has been hurt in the past to maybe factor that into our equation(s)?
- Sample size – needs to be large enough to be statistically significant and showcase an accurate ability to “predict” without large false negatives
THESE are the things that it will take to build a prediction model. We have to know which key markers of what is tested actually allows us to adequately address the needs of an uninjured population and reduce injury? Even saying that is going to be tough without upfront data & robust tracking (those that we predicted and were right, those that we predicted and were wrong, those that we didn’t predict but were injured anyway, those that we did not predict and did not get injured). Then, see how our prediction model stacks up. MOSTLY, I think we need to temper our claims for injury prevention and injury prediction and hopefully be able to get by with words like injury risk.
Risk is more associated with things like high blood pressure, smoking, being overweight. These things place people at a higher risk of conditions like heart disease, strokes, cancer. So, to even start with the categorization of risk, we need to try to determine what is a correlation and what is causation. Not to get scientific or overly dorky, but that matters with making claims on how we operate in the rehab/fitness/sports world. Are our findings just linked in some way or does one cause the other? For example, maybe those who eat bacon for breakfast score 5 points higher on an IQ test. Can anyone say that eating bacon makes you smarter? Maybe you are smarter and so you eat bacon…this is just a silly example (because, why not bacon), but it illustrates that one does not CAUSE the other. They are just linked. Correlated.
So, let’s forget the bold claims about prevention…that word muddies the good work being accomplished in sports medicine. Instead, we should focus more on injury risk. Which things are simply correlated and which things cause consequences to be more likely to happen? For that, we need to determine the questions we need to ask (and attempt to answer) to address any risk. The top questions, in my opinion, are:
- What makes a given athlete more susceptible to a given injury?
- How do we best assess this?
- What factor(s) can be modified to minimize that susceptibility/risk?
These are questions for another post – stay tuned to dig into this further…