Eight Essentials of Post-Pitching Recovery
By: Jim Ronai MS, PT, ATC, CSCS
Member, USA Baseball Medical/Safety Advisory Committee

The institution of the pitch count in youth baseball represents a positive step towards ensuring that the game of baseball is safer both in the present and future careers of young pitchers.

As an adjunct to this new pitch count regulation and in an attempt to protect the health and safety of youth baseball pitchers, the following post-performance suggestions are offered. Since most youth baseball pitchers are typically removed from the mound, but not necessarily from the game, these suggestions are intended for post-game or for a time when the pitcher is considered done for the day.

1. Children learn most effectively with a consistent routine. All athletes need to have a routine that they perform both pre- and post-game. The routine should be monitored and consistent. Athletes need to know that the routine needs to be completed correctly before they will be permitted to participate in subsequent game or practice play.

2. Perform a "cool down activity." Have pitchers jog for four to six minutes, to the point when they start to sweat. This increases general blood flow throughout the body and prepares the body for a post-performance flexibility routine. Increasing blood flow allows the body to circulate oxygenated blood to fatigued muscles. Oxygenated blood helps soft tissues recover and heal following activity.

3. Spend five minutes on a post-game, "static flexibility program." Incorporate movements for the forearms, shoulders as well as the torso and lower body. Holding each stretch for a period of 18 to 20 seconds and repeating each stretching pattern 3 times allows for maximal gains in flexibility. As an example, have athletes perform passive wrist flexion and extension stretching with their elbow in a fully extended position for a 20-second count. Repeat each direction 3 times. Traditional sidelying quadriceps (thigh) stretching performed by pulling one's heel toward the buttocks while laying on the opposite or traditional hamstring stretching represent only a portion of a post-outing routine that help the athlete stretch their entire body. Along with increasing the flow of oxygenated blood to muscles and tendons, stretching following an athletic performance helps to relax soft tissues while mediating the by-products of exercise that make the body stiff and sore.

4. Designate one staff member to review the pitcher's performance. Keep things simple and to the point. Review the negative aspects of the pitcher's performance, but be sure to finish the conversation by emphasizing the positive. Leave the athlete feeling good about his/her outing.

5. Since most young athletes answer questions about how they feel with a shrug or a one-word answer, develop a visual analog scale for the pitchers to use to quantify how they feel before, during, and after the game. The scale can be something as simple as a one-to-10 scale with a picture of a frown at No. 1, a neutral face at No. 5, and a happy face at No. 10. Ask the pitcher how he/she feels before the game, at the end of each inning, and at the end of the performance. The visual scale allows younger players to easily point to the number or picture that most describes how the arm is feeling. Coaches can use the scale to inquire about the condition of a pitcher's arm before the game as well as any symptoms that he/she develops during or at the conclusion of the game. Monitoring a young pitcher's perception of his/her physical wellness helps coaches make note of trends related to performance or potential injury related to volume, lack of endurance, or other variables.

6. Having a cooler of ice available in the dugout is an important part of optimizing a pitcher's recovery. Keep a few bags of ice available for pitchers to apply to their shoulders and elbows following a pitching outing. Never apply ice directly to the skin or for more than 12-15 minutes. Also be aware of the Ulnar nerve found in the area of the "funny bone," and be sure not to apply ice directly over it.

7. Do not allow pitchers to go home and re-create their game by throwing with "coach Mom or Dad." Once they are done on the field, they are done for the day. Encourage families to follow this approach for the sake of the child's health.

8. In an attempt to establish consistent pitching performance, athletes need to gain and maintain strength as well as control of their bodies. An age-appropriate strength, balance and coordination routine for your pitchers should be taught at the beginning of the season and should be performed by pitchers the day after each outing. These activities help to ensure that the athlete is taking care of his/her "pitching muscles" on a consistent basis in preparation for the next outing. Simple programs should address balance, as well as strengthening for the rotator cuff, back, core and leg muscles. Remember that the season is long, and that without training, muscles fatigue and lose strength over time. Keep them strong for the long haul.

Jim Ronai MS, PT, ATC, CSCS is a Physical Therapist, Certified Athletic Trainer through the National Athletic Trainers Association (NATA) and a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association (NSCA). He is the Director of Physical Therapy and Sports Medicine at Rehabilitation Associates, Inc. in Connecticut and Director of Jim Ronai's Competitive Edge LLC, an athletic performance-training program. Jim has served on the medical staff for two U.S. Olympic teams and is a member of the USA Baseball Medical and Safety Advisory Committee.