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Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers
Lyman S, Fleisig GS, Andres JR, Osinski ED. Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers. The American Journal of Sports Medicine 30(4):463-468, 2002.

Methods

Researchers from ASMI and the American Baseball Foundation (ABF) followed 476 baseball pitchers ages 9-14 for one season in the spring of 1999. Data was collected from the pitchers using pre-season and postseason questionnaires, injury and performance interviews following each game, pitch count logs, and video analysis of pitching mechanics. The pre-season and postseason questionnaires were used to determine the types of pitches thrown (of particular interest were the fastball, change-up, curveball, and slider). Interviews were performed by phone, and included questions regarding stiffness and pain in the shoulder and elbow. Pitch counts were calculated as pitches per game and pitches per season.

Results

The 476 pitchers used in the study pitched 3789 games during the 1999 spring season. Almost 7% (254 of 3789) of those appearances resulted in elbow pain, and over 9% (353 of 3789) resulted in shoulder pain. Elbow pain was reported by 28% (134 of 476) of the subjects at least once during the season, while shoulder pain was reported by 35% (165 o 476) of the subjects. Half of the subjects in the study reported either elbow or shoulder pain at least once during the season.

The study evaluated the relationship between the types of pitches thrown (fastball, change-up, curveball, and slider) and shoulder or elbow pain. Pitchers in the 9-14 age bracket who threw sliders were 86% more likely to experience elbow pain during the season. Pitchers who threw curveballs were 56% more likely to experience shoulder pain during the season. On the other hand, pitchers who threw change-ups were 12% less likely to experience elbow pain and 29% less likely to experience shoulder pain, although these findings were not statistically significant.

The study also found that as pitch counts increased, the number of cases of shoulder and elbow pain also increased. At the 75-99 pitch count range, the risk of shoulder and elbow pain increased by 52% and 35% respectively.

The authors recommended that pitchers between the ages of 9 and 12 should limit themselves to throw only fastballs and change-ups, and not throw sliders or curveballs. Baseball organizations should also consider limiting the number of pitches throw to 75 pitches per game and 600 pitches per season. Limiting the amount of pitches thrown could also be accomplished by limiting the number of batters faced to 15 batters per game and 120 batters per season. The pitch counts refer to full effort, game pitches only and does not include practice, warm-up, or drill pitches, which are important in developing the mental and physical skills necessary for the development of young pitchers.

Copyright © 2000, American Sports Medicine Institute
October 05, 2004
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quote:
Originally posted by D. Terry,M.S.:
Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers


You missed the best part of the article. The part which tells pitchers and their coaches how to prevent problems. On page 465 of this article, the authors make the following statement...

"In fact, two mechanical flaws, backward lean in the balance position and early hand separation, correlated with a decreased risk of elbow pain. Two other flaws, a long arm swing and arm ahead of the body at the time of ball release, correlated with a decreased risk of shoulder pain."

The authors' use of the term "mechanical flaw" in the paragraph above is unfortunate (if not a bit misleading). I believe that the authors do not mean that doing these four things will hurt your velocity or control. Instead, I believe that they are just saying that these four things differ from what they believe are ideal mechanics.

How could they be flaws if they reduce the risk of injury but don't also harm velocity and control?
Most of these conclusions would merit a big, "Well, duh!"

The one about 120 batters faced per year is curious, though. At 15 batters/outing, that's only 8 outings/year. That may be OK for the typical April--June rec league schedule, but if they're saying you should stop at that point and not pitch all summer or fall, I'm going to have to disagree. Hopefully that's not what they meant.

There's a lot to be said for building stamina and conditioning through regular repetitions, esp. if none of the outings are excessive/abusive in themselves. My personal opinion is that the pitcher who throws in moderation but for a longer season will fare better in the long run than the kid who heats it up for two months, shuts it down for 10, and then tries to come out smokin' again come April when he's stone cold from a conditioning perspective.
Last edited by Midlo Dad
Midlo Dad,

Thanks for the duh. There are some out there that are not as pitching savy as yourself. This is for those who need the information such as Tiger Paw Mom.

If you look at the article again this was a study of 9-14 year olds. A pitcher at these ages is not going to go out and throw 75 pitches every time out. If a player is going to play for 4-6 months in continuous seasons he will need to have limits at these ages.

As a father of a 9 year old who pitches. He will only pitch every 3rd to 4th day based on if it is a regular game or tournament.

As a 9 year old he is in no way able to pitch for that many months or seasons as you stated.

There futures as players are in your hands as a parent and coach.

D.Terry
Last edited by D. Terry,M.S.
Having an almost 21 year old pitcher in good health, I don't really need the information as much as those players and parents who need to know the implications of throwing curves and sliders too young. With so many injuries occuring among young players, any info is better than none. I am in strong favor of youth organizations limiting innings and pitches thrown per game and bannning the CB and slider until a certain age. I am not so much in favor of total batters faced in a season as per game. Any pitcher who has to face too many batters per game should have been pulled off the mound anyway.

Midlo Dad,
It may be a duh for you and me, but I think there are many out there who need to read about the duh! Big Grin
Last edited by TPM
I would say that while 75/outing is certainly too high for a 9-year-old, it is also certainly not too high for a 14-year old, so it is not correct to treat them both the same.

And I don't know where you've been, but there are scores of 9's playing 6-9 months per year. I would still contend that throwing for all of those months, but in moderation, is better for their current health and their long-term health than throwing for just two months every year. I'm talking about just throwing straight pitches at age 9, keeping them under 40 early on, capping them at 50 pitches throughout.

Also, a player who does build this conditioning and stamina will be better able to handle a 75-pitch outing at age 14 than the kid who threw only 2 months/year for those same 5 years. (Still avoiding breaking pitches through that year.)
Nice article - ASMI has done some really good work on pitch counts and youth pitchers. I only wish that coaches and leagues would follow the guidelines more closely!!!!

I think Little League is headed the right way with their pitch count limits and hope that the trend continues right up into the older levels (e.g. all pre high school ball). I would especially like to see these types of limits in travel ball tournments - where an incredible amount of abuse occurs...
Midlo Dad,

My opinion as a former player,coach and current medical professional a 9 year should not be playing 9 months out of the year. You talk about increasing the risk of injury. That is pushing the limits. As far as the 14 year old player goes, you are talking like these kids are well trained athletes. I see this all the time with parents and coaches of players of this age who throw them way too much. They fatigue as the season goes on and on. The injury risk gets greater every time out.
They are not capable at that age as a pitcher to last that long of a season. As far as the ones who make it through the season without injury, great job.
Last edited by D. Terry,M.S.
Dr. I do agree with a lot of things you said but, Over doing it is NOT BAD. If you dont throw a lot at a young age (between 12-16) then your arm wont develop like it really can. Only kids who throw hard and throw typically fastballs (70% to 80%) of the time will have the arm strenght to throw 90+ miles per hour when they get older. Velocity has decreased in baseball because young pitchers dont throw enough fastballs per workout or per game. With so many different types of off-speed pitches young pitchers are trying to trick hitters rather than throw it by hitters. The end result is, pitchers with below-average to average arm strenght. High school pitchers and college pitchers today throw around 50% or more breaking ball pitches In a game. Some people say power pichers are born not developed. Which is NOT true but coaches need stop resting kids for a long amount of time. Don't get me wrong rest is allways good for the arm but let younger kids throw the ball around more. By young pitchers discarding the fastball they cant develop durabilty in there arms. The key to not over working a young arm is a good work load but not to much. And most importantly PROPER training and machinics. Which will take a lot of unnessasary stress off your arm.
Just thought I'd throw in my Two-cents.
Hello to all,

While this study definitely makes one wonder whether letting a child throw for extended periods of time is justified, there are some other factors that need to be investigated as well. Some of which include:

A)Nutrition
B)Proper Physical Development
C)Postures
D)Core Function
E)Intensity to Volume Ratios of Throwing in games, practices and warmups
F)Post-game therapies
G)Type and Lengths of Warmups
H)Stretching Programs
I)Faults in Using Surveys in Studies on Children

I could keep going, the only statement I'm attempting to make is that studies only show a tiny bit of the truth. As Charles Poliquin has stated many times, "it's like looking at the world through a straw."

These studies are important in the whole scheme of things, but should not be relied on exclusively to answer all of the questions we have regarding the health of child athletes.

Dave
i wonder if they had these problems 40 years ago.someone said a 9 yr old shouldn't play 9 months a year.back in the day we played baseball until sept.everyday. then football everyday then basketball.i don't remember anybody hurting their arm,but we had no mlb players either.
kids don't play ball everyday.i don't mean parent ball with umpires and things i mean pick up ball.we threw all the time.i think that makes the arm stronger ,i don't know this to be a fact but just makes sense to me.

maybe we just know to much today?
In the article set out above, there is nothing in the data presented that supports the conclusion that a kid should shut it down after a two-month season. This appears to be a conclusion thrown in after the fact by someone who feels that "better safe than sorry" governs. But if there are data to support your conclusion, go ahead and put them out there for us to consider.

While I agree with "better safe than sorry" as a general philosophy, I think you are misapplying it here. What you say about young kids not being conditioned athletes is true in some instances, not so in others. Also, you are arguing for an approach that guarantees that their arms never get conditioned, so you have a Catch 22 you're setting up there. You can't throw because you're not conditioned, but you aren't conditioned because you don't throw enough.

In my view, "better safe than sorry" means get the kids in good baseball condition and then use some common sense about pitch limits, no curves, and rest intervals.

Doc, what you say about kids being worn out after months of play is contrary to my own lifetime of experience. When I was a kid we played out in the street ever darned day for hours on end and nobody kept track of how much we threw. These days everything is done in uniform on a field and street ball has gone the way of the dodo bird, but those who do suit up for 8-9 months a year do so with smiles on their faces. My own son used to get sad only when winter came and we had to quit because there was snow on the field!

I'll keep an open mind and listen to any hard data you have to back up the 2-month season idea. But if you go back and re-read the article set out above, there are no data there to sustain this conclusion. It appears to be nothing but an unsupported opinion.
quote:
Of course, if you never even pick up a baseball, you'll never get hurt playing baseball, I guess.


No one stated not to play the game at all but be responsible with the players that do play.
As far as the statements about no one ever had arm injuries 40 years ago and you played 9 months out of the year in the yard.
40 years ago kids were not trying to throw sliders or split fingers either. They played in the neighborhoods and not organized games 4-5 times a week for 9 months either. They played other sports as well and not solely one sport year round like kids today.

When these kids are on the mound they are trusting the coach and parents when it comes to making the decisions for there futures. If all that comes out of a study like this is to make a coach or parent more aware of arm safety, then I think it has helped.

It is a good thing that this research is done.
No one has all the right answers on pitching or KNOWS IT All, TRHIT.

D.Terry
TR, while I have stated my disagreements with the good Doc, I would also caution against the idea that everyone is different, if by that you would suggest that some kids can pitch forever without getting hurt.

I suppose there are some humans who are built more sturdily than others, but even if that is true, (1) that's more apt to be true when they are adults, less so when they are young and still growing, and (2) you have no way of knowing which are which until after you find out who gets hurt and who doesn't, and by then it's too late.

I definitely agree with keeping pitch counts and observing limits. I also agree with limits on breaking pitches, though I am less sold on concerns about use of a splitter (jury still out on that one).

Granted, if you're overusing a kid every outing, a longer season would spike the odds that this would create an injury. But if you observe reasonable limits per outing, an athlete at any age can become conditioned without injury. In other words, I don't view a long season as a threat in itself.
quote:
Originally posted by Midlo Dad:
The one about 120 batters faced per year is curious, though. At 15 batters/outing, that's only 8 outings/year. That may be OK for the typical April--June rec league schedule, but if they're saying you should stop at that point and not pitch all summer or fall, I'm going to have to disagree. Hopefully that's not what they meant. There's a lot to be said for building stamina and conditioning through regular repetitions, esp. if none of the outings are excessive/abusive in themselves. My personal opinion is that the pitcher who throws in moderation but for a longer season will fare better in the long run than the kid who heats it up for two months, shuts it down for 10, and then tries to come out smokin' again come April when he's stone cold from a conditioning perspective.


This is exactly what they are saying; that year-round ball is problematic.

A number of studies (done in California and Taiwan at least) have come out that suggest that year-round ball is a real problem because it doesn't give players' bodies the time they need to recover from the damage the incur during the season.

I would also add that year-round ball also increases the risk of burn-out.
Burnout and overall damage are issues for sure, yet another big issue is usually forgotten: the decline in overall physical ability.

If we are to look at the biomotor abilities necessary to becoming a good ball player and look at how many remain untrained, it's fairly shocking how little baseball actually trains a human to be a "well-rounded" athlete.

In my opinion, this could be a major reason behind so many kids' careers ending after little league and high school. Their bodies simply didn't develop like the kids who were invovled in multiple sports and activities. Although the emotional and physcological burnout play important roles in this as well. There is so much great logic behind having a kid be a...well, kid and letting him play and be involved in many different sports.
I disagree with some implications. In previous threads it has been said that pitch count, appearances and pitch selection depend on the individual player.

How can a coach really know? Because the kid is tough and wants the mound? I foolishly let coaches over-pitch my kid because he said he could do it. Last year in high school he went 4-1 in 8 days.

Last November he had elbow surgery. At an early age he had growth plate separations. Neither I nor any coach has x-ray vision, we cannot see into the arm or shoulder. How do you really know that a kid is getting hurt? Mark Prior and his perfect mechanics is not going to be hurt is he? You cannot look at mechanics, attitude of the player or what he throws to know if he is being damaged.

It is TIME for pitch counts or other limitations in youth sports and high school.
quote:
Originally posted by baseballpapa:
I disagree with some implications. In previous threads it has been said that pitch count, appearances and pitch selection depend on the individual player. How can a coach really know? Because the kid is tough and wants the mound? I foolishly let coaches over-pitch my kid because he said he could do it. Last year in high school he went 4-1 in 8 days. Last November he had elbow surgery. At an early age he had growth plate separations. Neither I nor any coach has x-ray vision, we cannot see into the arm or shoulder. How do you really know that a kid is getting hurt? Mark Prior and his perfect mechanics is not going to be hurt is he? You cannot look at mechanics, attitude of the player or what he throws to know if he is being damaged.


This is paradoxical, but in many cases a stronger a kid is MORE vulnerable, not LESS vulnerable, to serious injuries.

The problem is that their stronger muscles make it easier for them to pull their bones apart at their growth plates. A weaker kid can't throw as hard, but they also can't generate enough force to pull their bones apart at the growth plates.
baseballpapa,

It's funny you mention Pryor! I use him as an example when I'm describing how small of a role mechanics actually play in overall health of pitchers. He was touted as having "perfect" mechanics and yet is injured on a regular basis!

Sort of on the topic; you also see alot of degenerative-type injuries in kids that have been exposed to improper weight training at a young age. I've literally had to tell an entire team to stop lifting...period, until they did it right! In the years previous, they had more over-use, r.s.i.-type injuries than many of the "poorer, po-****" teams from small towns that lacked a "quality" facility. This changed as soon as they started using weight training to actually train their bodies and not drain them.

In my experiences and subsequent research, a basic, systematic approach to discoving the underlying cause of their injury is to:

A)Check nutrition and lifestyle factors (sleep, stresses, etc.) and if their symptoms don't subside...
B)Check their posture and core function to see if there are any significant dysfunctions. If there are still symptoms...
c)If they have a weight training and cardio program, eliminate it and see if the symptoms subside. If they don't...
D)Look at their throwing and running programs. Many times, you'll find that if they're still having symptoms of over-use, their throwing and running programs are over-the-top (I.e. coach that only sees game to game, season to season). IF they still don't respond and their symptoms don't improve...
E)Stop all throwing, running and lifting and let their bodies truly recover for a considerable period. This does NOT mean to have them sit on the couch and play xbox all day! This simply means that all of the structured work (games, practices, structured play, etc.) should be temporarily eliminated and they should focus on recovery.

THIS IS NOT SET IN STONE, THIS NOT THE TRUTH, THIS IS JUST MY OWN EDUCATED RECOMMENDATION. IF YOUR CHILD IS SUFFERING FROM ANY R.S.I.-TYPE INJURIES, DON'T LISTEN TO SOMEONE LIKE ME WHO HAS NEVER MET HIM...GO TO SOMEONE LOCAL YOU TRUST! Smile
quote:
Originally posted by exercisecoach:
It's funny you mention Pryor! I use him as an example when I'm describing how small of a role mechanics actually play in overall health of pitchers. He was touted as having "perfect" mechanics and yet is injured on a regular basis!


I wouldn't trust the assessment of Prior's mechanics as being perfect.

I think Prior's shoulder problems (at least) are related to a mechanical problem with how he breaks his hands. He ends up taking his elbows both above and behind his shoulders. This leads him to put a tremendous amount of stress on his Subscapularis.



Anthony Reyes of the Cardinals does something similar, and I wouldn't be surprised if he ends up with similar problems.



For the record, very few pitchers take their elbows above and behind their shoulders. Most do take their elbows behind, but below, their shoulders.
Last edited by thepainguy
While I don't disagree with your last statement, I tend to wonder how we can say difinitively what good and bad mechanics are.

Can you imagine being Tom Seaver's high school baseball coach now, with how much bend he had in his drive leg? Or better yet, let's go back further to the old school windups...how efficient were any of those? How about being Kevin Appier's coach in college? Do you think many of them thought he'd last longer than a couple years?

It's similar to teaching individuals to squat, bend, push, pull, etc. while there are guidelines...each squat will have it's unique fingerprint...which is pretty much what baseballpapa is talking about.

Personally I think we're all pretty much on the same page.
quote:
Originally posted by exercisecoach:
While I don't disagree with your last statement, I tend to wonder how we can say difinitively what good and bad mechanics are.


The way to do this is to look at pitchers who do similar things and see if they tend to have similar problems.

For example, all of these pitchers take their elbows above and behind their shoulders and coincidentally (or not) have had shoulder problems...

- Mark Prior
- Paul Byrd
- Billy Wagner
- Bobby Madritsch
- Don Drysdale

Pitchers who keep their elbows below their shoulders tend to be free of shoulder problems.

Similarly, pitchers who start rotating their shoulders before their forearms are vertical and in the high cocked position tend to have shoulder problems. This includes...

- Billy Wagner
- Chris Carpenter
- Mario Soto

Pitchers who keep don't start rotating their shoulders until their forearms are vertical and in the high cocked position tend to be free of shoulder problems.

It's not 100% definitive, but I think it's interesting.
Last edited by thepainguy
I've never heard it put exactly that way but that's an interesting point to consider.

I will say that I have always wondered who it was who kept pushing the notion that Pryor's mechanics were ideal. What I've always thought is that he is very tight with his pitching elbow; he pulls up his arm with the ball closer to his head than his elbow is. Personally I think the "down, back & up" motion is looser and involves less stress. Your observation of the elbow position relative to the shoulders may be just another way of saying the same thing, or they may be related flaw. But I do think they are flaws.

Francisco Liriano is another one who has a very tight elbow motion and as good as he is, already you are seeing signs that he might not be very durable, either.
quote:
Originally posted by Midlo Dad:
I will say that I have always wondered who it was who kept pushing the notion that Pryor's mechanics were ideal.


It was Tom House who said that Prior had perfect mechanics.

The thing that really bothers me about this situation is that House evidently hasn't retracted this statement. Instead, he is blaming Prior's lack of conditioning for Prior's problems.


quote:
Originally posted by Midlo Dad:
What I've always thought is that he is very tight with his pitching elbow; he pulls up his arm with the ball closer to his head than his elbow is. Personally I think the "down, back & up" motion is looser and involves less stress. Your observation of the elbow position relative to the shoulders may be just another way of saying the same thing, or they may be related flaw. But I do think they are flaws.


I agree with you that down, out, and up is better. However, photos of Greg Maddux shows that he also brings the ball relatively close to his head (e.g. bends his elbow more than 90 degrees).

I wonder if the difference is that...

1. Maddux keeps his elbows below his shoulders.

2. Maddux breaks his hands, and gets to this point, very differently than does Prior.






quote:
Originally posted by Midlo Dad:
Francisco Liriano is another one who has a very tight elbow motion and as good as he is, already you are seeing signs that he might not be very durable, either.


I haven't spent much time looking at Liriano, and I don't know if he's having any problems and if so what kind, but I found the photo below on the web which resembles the photos of Prior and Reyes (e.g. his PAS elbow is both above and behind his shoulder). I believe that suggests that Liriano may have a problem with his shoulder (specifically the Subscapularis) at some point in the next few years.



This photo below of Liriano shows what I think you are talking about; bending the elbow more than 90 degrees so that the hand passes closer to the head. I can see that, but am not sure if that is necessarily bad on its own (again, because Greg Maddux does it). However, it could be the combination of the two things -- bring the elbows above and behind the shoulders and bringing the elbow close to the head -- could cause problems ala Mark Prior.



The photo below also shows how high his elbows get.

Last edited by thepainguy
quote:
Originally posted by thepainguy:
I haven't spent much time looking at Liriano, and I don't know if he's having any problems and if so what kind, but I found the photo below on the web which resembles the photos of Prior and Reyes (e.g. his PAS elbow is both above and behind his shoulder). I believe that suggests that Liriano may have a problem with his shoulder (specifically the Subscapularis) at some point in the next few years.


I just stumbled across this article which states that Liriano is having shoulder problems.

http://www.startribune.com/509/story/632466.html

Here's another picture that shows how high his elbows get...

Last edited by thepainguy
i know your talking about mlb players here but no one is talking about velocity. you don't here about the kid's with bad mechanics and throwing 82 getting hurt. it's almost always someone that throws in the 90's we here about.is it the velocity or hard thrower that has more of a problem?it also appears the faster you throw the more movement you want on the ball,more sliders cutters etc.does this cause more damage to the 90's guy than the kid throwing 82?or is it the fact that kids never really developed the elbow or shoulder enough to support throwing 90?
velocity seems to be left out of most pitching related talks,when it seems to be at the core of the problem. in my opinion anyway.
quote:
Originally posted by 20dad:
i know your talking about mlb players here but no one is talking about velocity. you don't here about the kid's with bad mechanics and throwing 82 getting hurt. it's almost always someone that throws in the 90's we here about.


Kids are just as vulnerable, if not more so. There are plenty of stories out there of kids whose arms are destroyed by 12.


quote:
is it the velocity or hard thrower that has more of a problem?it also appears the faster you throw the more movement you want on the ball,more sliders cutters etc.does this cause more damage to the 90's guy than the kid throwing 82?


It hurts both adults and kids, but in different ways.

Because kids under the age of 16 or 17 have open growth plates, they are vulnerable to different types of injuries. Systems break down at their weakest links and, while in the case of adults that generally means tendons and ligaments, in the case of kids that generally means growth plates.


quote:
or is it the fact that kids never really developed the elbow or shoulder enough to support throwing 90?


Kids muscles aren't strong enough to enable them to throw that hard. However, that doesn't mean they aren't vulnerable.


quote:
velocity seems to be left out of most pitching related talks,when it seems to be at the core of the problem. in my opinion anyway.


I believe that the quest for unnecessary velocity is a big part of the problem. Consumer radar guns are a big contributor because they let people seek velocity for its own sake.

My son certainly isn't the hardest thrower on his team (by design on my part), but he's still effective because he knows how to pitch. He changes speeds and keeps the ball down.

He doesn't just try to blow guys away.
Back in the 1930’s baseball coaches used the law “every action has an equal but opposite reaction” in err. Coaches taught that the pitcher with the great velocity in the delivery came from pushing or driving hard with the rear leg off the rubber. Many pitchers lost velocity, came up lame and soon dropped out of baseball. Coaches then developed the theory to just let the pitcher throw any way he wanted to….get them in shape and let them throw their own way. With all the injuries and surgeries today, is it possible coaches are teaching the same old drive theory today? Baseball books selling on the market today are still printing the theory of pushing or driving hard off the rear leg. They are saying this is where you get the power and velocity from in throwing a ball.



All power in hitting and pitching velocity in baseball comes from the pulling action of the stride leg. “Every action has an equal but opposite reaction” when applied to baseball is true, but must be applied as a pulling action of the stride leg, not a pushing action. The actual beginning of the throw or pitch occurs before foot plant. The only push on the ball occurs after it passes by your ear and this is where the cuts and curve movements are put on the ball.

Another theory came along. The underhand pitching of a softball was a natural act for we walk with our hands at our sides and no soreness or injuries will occur while pitching. The act of throwing a baseball “overhand” was not natural, so injuries or soreness incurred while throwing a baseball was considered “normal” and this is the IRON CLAD BELIEF in major league baseball today. No one stops to search out the reason for all the injuries or pain incurred from performing one of the basic skills of the game…..”throwing a ball.” They do not explain the thousands of players that are never sore or injured.

After a reasonable time for conditioning, if the arm is tired during or after pitching a game, you are making a throwing error. All power and velocity comes from the legs, not the arm.

Both the upper body, the arms and shoulders and the lower body, the feet, hips and legs must be in the groove to take all stress off the arm, shoulder and elbow and must be working together with the correct timing throughout the entire throwing motion

D.Terry,M.S.

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