Lots of pitching drills can make the thrower faster and more accurate. Now researchers  have shown that the right sort of exercises can also reduce arm injuries.

For years, official baseball authorities have had one piece of advice for people concerned about injuring their arms through pitching: Don’t pitch so much. The USA Baseball Medical Safety Advisory Committee has set up pitch-count limits for kids.

For adults, it’s hard to find any advice at all. (Major League teams try to limit the amount their pitchers spend on the mound, but one study found that pitch counts for pros were useless and another found them only marginally useful.)

This spring, researchers from the South Carolina Center for Reconstruction and Rehabilitation Sciences reported on a different approach: back in 2009, they taught 103 high school pitchers a set of exercises to improve their arm strength and range of motion, and asked them to do the exercises along with regular pitching drills three times a week for eight weeks.

Here are two of the 12 they prescribed:
High External Rotation by LincolnUniSports

Low External Rotation by Upperperkpt

The researchers then counted the number of pitchers who hurt their arms. They also followed a control group of 93 high school pitchers of the same age, who didn’t learn the exercises, to find out if those pitchers got hurt.

Part way through the experiment, they realized they had a problem. They had expected the control group to stick to regular pitching drills. But the coaches of high schools in the control group got wind of the study, and gave their pitchers exercises to do as well.

Risk Factors for Pitching Injuries

By 2012 there wasn’t much difference between the two groups. Among the pitchers who learned the special exercises, 15 got injuries. Among the pitchers in the control group, 12 got injured. The difference is not statistically significant.

But the exercises did seem to help — both the ones prescribed by the researchers and the ones the baseball coaches found on their own. The researchers documented a big difference between 2009, when the pitchers sustained 29.3 arm and hand injuries per 1,000 games or practices, and 2012 when they had only  3.4 per 1,000.

Interestingly, those pitchers who had already had an arm or hand injury, but didn’t get the training, were more likely to have another injury.

The researchers concluded that baseball pitchers should do some kind of exercise program. “Our recommendation is that doing something is better than doing nothing,” said researcher Chuck Thigpen, when we met at the American Orthopaedic Society for Sports Medicine annual meeting in Seattle in July.

To get a real-world perspective, I asked Will Workman, a team physician for the Oakland A’s, about the program. “It looks pretty good,” he said.  “It is a lot of work.  Maybe could be tailored so that there aren’t as many exercises.”

Exercises Enhance Pitching Drills

How can we winnow down this set of 12 exercises? If you have to choose I’d focus on the strengthening rather than the flexibility exercises.

The reason is that there is some evidence static stretching can cause temporary weakness, and not much that it prevents injury. In fact, one study found that weakness in a key shoulder muscle was a risk factor for pitching injury, but reduced range of motion was not.

So the key exercises in the program may be the ones in which the athletes use cables on weight machines, or elastic bands, to rotate their shoulders. That’s why I chose videos of these types of exercise to illustrate this story.

These are the only options, though. Workman recommends the “Throwers Ten” group of exercises, which strengthen the shoulders in a similar way. I couldn’t find any studies to show this particular collection prevents injury. But I did find one study that showed this program (and a couple of others) increased the velocity of pitches a little bit.

That’s more than you can say for most pitching drills.

It’s reasonable to imagine that both Thigpen’s program and the Thrower’s Ten will achieve both injury reduction and performance enhancement. What more could you want?