Best Pitcher Recovery Program

I'd like to throw a wrinkle into the question - should a program put together a single program (i.e. best pitcher recovery program for all) or should there be a degree of customization?  One item in particular would be icing - I get the impression that some folks benefit greatly from icing (presumably they may be more inclined to develop bothersome inflammation), but many young arms which are not too heavily taxed may get zero benefit from icing (and some would argue it inhibits recovery).

I wouldn't expect 7-8 completely different programs for 7-8 pitchers but would like to get some thoughts on perhaps the main components of a program which all would participate (stabilization exercises?) as well as some components that would only be applied selectively and the thought process on when to apply or withhold.

http://youtu.be/XO-c5PmOSMs

It's all custom based on the person. Some guys respond to heat some respond ice. Most places will use ice immediately after the game especially pitchers  and in the evening they will hit a warm hot salt bath of some kind. The day after an aggressive game practice or start we typically would pro players in the pool and have them go to routine in the pool after they had started in a hot tank. A player like Derek Jeter would come in to the ballpark get a hot tank or 15 minutes get his workout in and then after every game would hit the cold tub. Other players prefer the heat when They got home Took a hot bath with salt  so they can relax and go to bed

D8, you certainly began your OP with the right opinion that if you ask 10 different people what they considered a "best method" of treating a player's arm you'll most likely get back close to 10 different answers. I am assuming you're mainly talking about a Pitcher (or at times maybe even a catcher as they throw just as many balls the same game if not more). You said "throwing" so forgive me if my assumption is incorrect.

My son pitched in high school, college, and now in his 3rd of Pro ball. He has never iced his arm after a game he pitched in no matter how many innings. He would however find somewhere to run some poles or whatever to help work out the lactic acid buildup that occurred while pitching. A Pro that had played for the Cardinals told him back in his Senior year of high school that he discovered (for him) that icing didn't allow his arm to recover naturally. It froze or impeded blood flow and by not icing it allowed the blood and other inner-body parts (arm & shoulder region) used to heal the arm and shoulder to do so progressively. My son could explain this much more in detail than me so please forgive again if this sounds a bit empty, but hopefully it's enough for you to see another perspective nevertheless.

YGD

For the past several months my son has been following a lot of the pre-throwing and post-throwing arm care routine taught at the Texas Baseball Ranch. Different than what I was taught many years ago, which was for pre-game: play catch, maybe run and stretch, warm-up in bullpen and then take the mound. For post-game: ice. His routine involves a much longer pre-activity warm-up which includes band work, dynamic stretching routine, shoulder tube, slow warm-up through to long toss and then some bullpen. Idea is to get a good sweat going before starting the game and be fully ready (no using the game to get it going). I actually think the pre-activity warm-up has more to do with ultimate arm care than maybe the post-game routine, just because maybe you're less susceptible to injury when you're fully ready to go? Post-activity arm care for him is some running & stretching, more band work, and maybe working out any sore areas with a tennis ball or roller. They are not a big fan of ice unless there is noticeable swelling. Son says his arm feels fresh and strong so far even day after a heavy session. We'll see as the season progresses, but all things seem positive so far.  

From an article by Eric Cressey from August 22, 2012:

The current practice utilized for conditioning is for pitchers is to go for a long run the day after a game to “flush” the sore arm of lactic acid, or minimize muscle soreness to recover faster for the next game. These theories are not supported by the current literature and the physiology of the sport.

In the current research study examining the physiology of pitching, Potteiger et al. (1992) found no significant difference between pre-pitching and post-pitching blood lactate levels of six college baseball players after throwing a 7-inning simulated game. Even though during an inning there is a slight lactate production of 5.3-5.8 mM, (which is not high, considering resting lactate is 1.0mM), it does not cause a buildup of lactic acid in the arm of a pitcher after a game. As a comparative example, a high lactate response would occur from squatting for multiple reps at about 70% 1RM; this might produce a lactate level of about 8-10mM (Reynolds et al., 1997). Furthermore, jogging to flush the arm of lactic acid after a start is unnecessary and not supported by the literature, especially since we learned all the way back in 2004 that lactate was not the cause of muscular fatigue ; even the New York Times reported on this in 2007! A lot of coaches simply haven’t caught wind yet – in spite of the fact that exercise physiology textbooks have been rewritten to include this new information.

As for ice, Randy Sullivan, of The ARMory/Florida Baseball Ranch, wrote an excellent article on the subject.

https://armorypitching.com/ice...ls-not-for-pitchers/

I know there has been lots of discussion about icing and running on this site.  Regardless of your opinion, I would strongly suggest reading the Randy Sullivan article above (if you have not already) just to see a well constructed argument, apparently with pretty decent support, as to why icing might impede recovery.  The one thing I will note on lots of icing protocols is for the ice to be applied repeatedly for shorter periods of time.  This practice would seem to completely circumvent the "flooding" effect of longer periods of icing.

I also liked the comments from GOODTIMES above about pre-throwing taught at TBR.  I asked a few weeks back about ideas on keeping warm between innings.  The idea of working up a good sweat ahead of time is wonderful when its north of 50 degrees and sunny, but those early overcast days in the 40's seem like they would quickly cool down the arm unless the pitcher takes the necessary steps to keep warm.

Just wanted to ask a question as to the pre game/pitching routine.  We live in the Northeast and of course spring baseball seems more like winter baseball at times.  It has been known to be in the 30's when my son has a game and needs to pitch.  Last year he had a strained muscle in his back after pitching in very cold weather and wasn't properly warm. He started the game ok but as the innings progressed he would get cold between innings even with his arm covered.  He suffered the injury after a particularly long sit between innings.  My question is to get some input on any pre and between inning routines pitchers can do especially when the weather is cold? 

Long sleeve cold gear that also wicks perspiration - make sure it feels ok by using during preseason.  Longjohns of the same material can help.  Big jacket in between innings.  Get out of any wind, but try to avoid simply sitting.  Eat good meals leading up to start - takes lots of calories to keep warm.

My son had a touch of Bicep Tendonitis, a former MLB pitcher told us about MarcPro and their approach to recovery. We gave it a try and results have been amazing. It circulates blood through electrical stimulation. It also can be used prior to pitching to get the blood flowing.  I will include a link to their site and can provide more details if interested.

http://marcpro.com/

Several good tidbits in this thread. Son follows the Driveline program, at least 50 percent of which is focused on post-throwing recovery. Most of the modalities track the Texas Baseball Ranch ideals with a fair bit of post throwing activities (shoulder tube and plyocare drills, especially rebounders for the latter, band pull-aparts). Then a combination of voodoo flossing protocols and stim using the Marc Pro (which works so well I bought one and now use it myself after my powerlift and Olympic lift sessions).

As to my recovery protocols, I have been experimenting with cold hydrotherapy with extremely good results. It might not be convenient for every kid; some schools have hydro-tubs that can be filled with ice-water and some don't. I happen to own a 100 gallon stock watering tub I bought just for the purpose of longer cold soaks (up to 14 minutes). I do these within a couple of hours of lifting and have found my recovery time between high volume days and high intensity days to be declining over time. I also "cured" a fairly stubborn case of elbow tendonitis that I acquired from trying to adopt a certain type of squat grip (Rippetoe) that was killing me.

Deep hydro-therapy is not for everyone. Mammals have profound instincts that tell us to "get out now" when we jump into cold water. But after the pain of entry, sitting is very peaceful, and after full circulation is restored, my body and mind feel awesome.

FWIW, I think everything that that inures to the benefit of an old-guy lifter like me HAS to be helpful to resilient young pitchers. But I have yet to get my son to jump into that stock tank. Haha!

I second the MarcPro. It's been nothing short of miraculous. A little pricey, though.

Wanted to bump this thread along and see if anyone has anything to add about pre/post recovery, icing, running (those last two are my favorites) and other avenues (MarcPro, for instance).  Still some relatively timely info above for those who may not have seen it before.

For those who've used Marc Pro.  New or used?  TCatt - if you're still around, looking at Marc Pro site they don't seem to make any claims about tendonitis.

My first time seeing the Marc Pro, but a friend who is a chiropractor got us a very similar device for $80.  Based on the website, not really sure what else you get for an extra $500-$900.  Both my boys use it and love it.

2017LHPscrewball posted:

Wanted to bump this thread along and see if anyone has anything to add about pre/post recovery, icing, running (those last two are my favorites) and other avenues (MarcPro, for instance).  Still some relatively timely info above for those who may not have seen it before.

Here's what I do with my pitchers. Immediately after leaving the mound, they go to the bullpen area and do one set of ten "reverse throws" with a 2 lb. mini-medicine ball (this involves going to one knee and throwing the ball behind you into a wall). This is followed by about five minutes of J-Band work done at a quick pace. Then the two lb ball again for 2 sets of 15 reps doing upward tosses and side lying tosses. The first involves simply standing up and flipping the ball into the air from the waist and catching it on the way down. The second does basically the same while lying on your side. Then he will use the bands again, first grabbing them with two hands in the middle and pulling them apart two sets of 15 reps and then doing basically the same with a diagonal pattern. After that, I use a Body Blade to do three sets in a pitching motion. Then thirty minutes with the Marc Pro attached to elbow and shoulder. 

Often, this has to be adjusted depending on the offensive side of the situation. I like the HC to replace the pitcher in the lineup, if he can. Often, however, if it is a close game and he needs his bat that inning, the recovery may have to wait.

SSBuckeye posted:

My first time seeing the Marc Pro, but a friend who is a chiropractor got us a very similar device for $80.  Based on the website, not really sure what else you get for an extra $500-$900.  Both my boys use it and love it.

You can find a TENS unit or even a cheap eStim device that will definitely help. I've used several others and you can tell the difference when you hook up to the MarcPro compared to cheaper versions with either no wavelength adaptions or fewer adaptions. However, it is pricey and even the cheaper eStims will help, so the price difference is a personal decision. Note, though, that a TENS device isn't the same as an eStim. It helps with pain, but does little to aid in actual recovery time. I've seen other devices on the market that may be the same as the MrcPro for a better price.

Would you think that it might be a good strategy to try a TENS unit and then move to Marc Pro if that worked for you?  If so do you have a specific TENS unit recommendation?

JCG posted:

Would you think that it might be a good strategy to try a TENS unit and then move to Marc Pro if that worked for you?  If so do you have a specific TENS unit recommendation?

 

TENS units are good for pain. This is why they are used a lot by back patients. However, they contract and release muscles at a pulsed rate whereas an e-stim unit uses quick, progressive waves to contract and then (relatively speaking) gently release the contraction. This aids in pumping blood into damaged muscle. That speeds recovery, both short term and long term. I have only recently started using it personally after lifting and can say it makes a huge difference in preventing soreness, especially in my legs. Most TENS units are going to be fungible, so the only differences would be durability. You can find pretty cheap ones. You can also find much better prices on e-stim units, but I couldn't testify as to how they compare to a MarcPro. I have, in hindsight, often wondered if I shouldn't have bought a cheaper unit first.

Our recovery routine borrows from powerlifting.  Pitchers take sips of a protein+carb shake between innings and down a whole shake within 30 minutes of the end of a game, preferably right after going into the dugout.  This prevents your body for excessively consuming proteins and carbs as fuel during the game and for recovery after, preserving strength/endurance gains (pitching is a workout) and preserving normal recovery length.  Nothing else done after the game.  The day after we do active recovery while the arm is sore for flexibility and blood flow.  It consists of our stretching and warm-up throwing routine, plus a light weight (2-8lbs) and bodyweight workout.  

I found this unit that is TENS and e-stim in one.  Pretty good reviews on Amazon.

https://www.amazon.com/gp/prod...;smid=A3NVGZHRREJYT6

roothog66 posted:

2017LHPscrewball posted:

Wanted to bump this thread along and see if anyone has anything to add about pre/post recovery, icing, running (those last two are my favorites) and other avenues (MarcPro, for instance).  Still some relatively timely info above for those who may not have seen it before.

Here's what I do with my pitchers. Immediately after leaving the mound, they go to the bullpen area and do one set of ten "reverse throws" with a 2 lb. mini-medicine ball (this involves going to one knee and throwing the ball behind you into a wall). This is followed by about five minutes of J-Band work done at a quick pace. Then the two lb ball again for 2 sets of 15 reps doing upward tosses and side lying tosses. The first involves simply standing up and flipping the ball into the air from the waist and catching it on the way down. The second does basically the same while lying on your side. Then he will use the bands again, first grabbing them with two hands in the middle and pulling them apart two sets of 15 reps and then doing basically the same with a diagonal pattern. After that, I use a Body Blade to do three sets in a pitching motion. Then thirty minutes with the Marc Pro attached to elbow and shoulder. 

Often, this has to be adjusted depending on the offensive side of the situation. I like the HC to replace the pitcher in the lineup, if he can. Often, however, if it is a close game and he needs his bat that inning, the recovery may have to wait.

Root take that one step further if you will.  Lets say you are playing in a tournament.  You've most likely gotta play 3 games.  Game 1 the starting pitchers throws 75 pitches and is done pitching for the day but will hit and play OF in the other 2 games.  When do you want to do the recovery work?

$tinky posted:

roothog66 posted:

2017LHPscrewball posted:

Wanted to bump this thread along and see if anyone has anything to add about pre/post recovery, icing, running (those last two are my favorites) and other avenues (MarcPro, for instance).  Still some relatively timely info above for those who may not have seen it before.

Here's what I do with my pitchers. Immediately after leaving the mound, they go to the bullpen area and do one set of ten "reverse throws" with a 2 lb. mini-medicine ball (this involves going to one knee and throwing the ball behind you into a wall). This is followed by about five minutes of J-Band work done at a quick pace. Then the two lb ball again for 2 sets of 15 reps doing upward tosses and side lying tosses. The first involves simply standing up and flipping the ball into the air from the waist and catching it on the way down. The second does basically the same while lying on your side. Then he will use the bands again, first grabbing them with two hands in the middle and pulling them apart two sets of 15 reps and then doing basically the same with a diagonal pattern. After that, I use a Body Blade to do three sets in a pitching motion. Then thirty minutes with the Marc Pro attached to elbow and shoulder. 

Often, this has to be adjusted depending on the offensive side of the situation. I like the HC to replace the pitcher in the lineup, if he can. Often, however, if it is a close game and he needs his bat that inning, the recovery may have to wait.

Root take that one step further if you will.  Lets say you are playing in a tournament.  You've most likely gotta play 3 games.  Game 1 the starting pitchers throws 75 pitches and is done pitching for the day but will hit and play OF in the other 2 games.  When do you want to do the recovery work?

I go ahead and have them do the recovery immediately after pitching. We usually try to only use our starting pitchers as DH's in any game before or after pitching in doubleheaders (we play mostly doubleheaders as a matter of fact). We play one "tournament" per season where we play three games in two days, but have never ran into three in a day. 

roothog66 posted:

$tinky posted:

roothog66 posted:

2017LHPscrewball posted:

Wanted to bump this thread along and see if anyone has anything to add about pre/post recovery, icing, running (those last two are my favorites) and other avenues (MarcPro, for instance).  Still some relatively timely info above for those who may not have seen it before.

Here's what I do with my pitchers. Immediately after leaving the mound, they go to the bullpen area and do one set of ten "reverse throws" with a 2 lb. mini-medicine ball (this involves going to one knee and throwing the ball behind you into a wall). This is followed by about five minutes of J-Band work done at a quick pace. Then the two lb ball again for 2 sets of 15 reps doing upward tosses and side lying tosses. The first involves simply standing up and flipping the ball into the air from the waist and catching it on the way down. The second does basically the same while lying on your side. Then he will use the bands again, first grabbing them with two hands in the middle and pulling them apart two sets of 15 reps and then doing basically the same with a diagonal pattern. After that, I use a Body Blade to do three sets in a pitching motion. Then thirty minutes with the Marc Pro attached to elbow and shoulder. 

Often, this has to be adjusted depending on the offensive side of the situation. I like the HC to replace the pitcher in the lineup, if he can. Often, however, if it is a close game and he needs his bat that inning, the recovery may have to wait.

Root take that one step further if you will.  Lets say you are playing in a tournament.  You've most likely gotta play 3 games.  Game 1 the starting pitchers throws 75 pitches and is done pitching for the day but will hit and play OF in the other 2 games.  When do you want to do the recovery work?

I go ahead and have them do the recovery immediately after pitching. We usually try to only use our starting pitchers as DH's in any game before or after pitching in doubleheaders (we play mostly doubleheaders as a matter of fact). We play one "tournament" per season where we play three games in two days, but have never ran into three in a day. 

Yes, I understand.  Ideally I'd do the same thing.  I'm not coaching HS ball though.  We are just a 12u travel team.  So our schedule unfortunately involves several 3 game days and even some 4 or 5 game days.  Our roster isn't large enough to sit pitchers once they are done pitching.  Thanks for the reply. 

Boone156 posted:

From an article by Eric Cressey from August 22, 2012:

The current practice utilized for conditioning is for pitchers is to go for a long run the day after a game to “flush” the sore arm of lactic acid, or minimize muscle soreness to recover faster for the next game. These theories are not supported by the current literature and the physiology of the sport.

In the current research study examining the physiology of pitching, Potteiger et al. (1992) found no significant difference between pre-pitching and post-pitching blood lactate levels of six college baseball players after throwing a 7-inning simulated game. Even though during an inning there is a slight lactate production of 5.3-5.8 mM, (which is not high, considering resting lactate is 1.0mM), it does not cause a buildup of lactic acid in the arm of a pitcher after a game. As a comparative example, a high lactate response would occur from squatting for multiple reps at about 70% 1RM; this might produce a lactate level of about 8-10mM (Reynolds et al., 1997). Furthermore, jogging to flush the arm of lactic acid after a start is unnecessary and not supported by the literature, especially since we learned all the way back in 2004 that lactate was not the cause of muscular fatigue ; even the New York Times reported on this in 2007! A lot of coaches simply haven’t caught wind yet – in spite of the fact that exercise physiology textbooks have been rewritten to include this new information.

I still haven't figure out how the conclusion that a 500% increase isn't significant but a 800% increase is even when the 800% increase was with an activity using multiple times more muscle fibers. Every time I do the math I get pitching as a more significant increase in lactic acid than squats. I got a completely different conclusion on that study than the original author did. 

The second study stated lactic was was actually beneficial and that it may not cause muscle fatigue. But that if it did its benifit was greater than the fatigue. Unless I missed something when I read the research. No where did it even comment on muscle soreness from lactic acid or that said latic acid couldn't be removed from a quick jog. 

I have no idea if lactic acid can be removed from running and therefor good for a pitcher to run after throwing. I do know no one else KNOWS either. No study has proven it one way or another. 

My 2019 son has thrown 105 and 117 innings the last 2 March-October....we have never iced, but always run poles after he throws and then followed up with a 20-30 minute run the following day. On the odd occurrence of running pitch count above 90, the runs occurred before bed that same night. We shut down every November December and spend another 3 weeks flat ground in January and have been fortunate enough to not deal with sore arms to date!

My son has been at the ARMory / Florida Baseball Ranch (Randy Sullivan) for almost 2 years now. He stopped icing 2 years ago, uses the Marc Pro and follows Randy's 5 day pitching rotation protocol.  Runs sprints, no poles.