The Importance of an In-Season Training Programs

Lewis Lupowitz, PT, DPT, SCS, CSCS

It's finally here! Baseball season has begun. Athletes have spent all off-season preparing their bodies, arms, and minds for the big day. Yet once the season starts this all seems to be forgotten, but why?
To lift or not to lift. This is something I am asked constantly by my athletes during the season. Many think that performing an in-season training program will stiffen up their arm, decrease their velocity, and limit their endurance as the season progresses. I am here to debunk all these myths and explain the importance of an appropriate in-season arm care program as per evidence-based research. Additionally, I will provide a link to an exercise program that’s proven to mitigate injury risk and increase performance.

In 2021, Uhl et al. performed a clinical review of the literature from 2010–202 and found that those who participated in group-based arm care programs focusing on posterior shoulder stretching, full-body strength, dynamic mobility, and balance were at 50% reduced risk of elbow injury. Most prominently, in 2017 Sakata et al. studied 307 youth athletes between the ages of 8 & 11, having them perform 9 stretches and 9 strengthening exercises for approximately 20 minutes at a minimum of 1x per week over the course of the year and found in doing so a 49.5% reduced risk of injury. After realizing that their program may be excessive, they reduced it to just 9 activities (5 stretches, 2 dynamic mobility, and 2 balance activities) performed again just 1x per week for a year amongst 237 youth athletes and found 48.5% reduced risk for injury.

These studies by Sakata demonstrate an increase in total shoulder rotational ROM, non-dominant hip internal rotation ROM, and decreased thoracic kyphosis angle (decreased rounded shoulders/improved posture); all of which we indicated in our last blog post on 1/30/2022 were risks for injury. Myth 1: Busted! Range of Motion will NOT decrease from exercise programs.

Myth 2: If I am doing strength exercises during the season, I’ll get tired and lose the velocity I worked so hard to get all offseason. Andrews, Fleisig, and Escamilla looked at 34 youth athletes between the ages of 11 & 15. Half of them (the training group) performed a 4-week baseball conditioning program 3x per week composed of a sports-specific warm-up, resistance training with elastic tubing, a throwing program, and stretching which took about 75 minutes. What they found was that those who trained increased their velocity from 56 to 58 mph. Escamilla further went on to perform a study 2 years later analyzing high-school athletes and found that those who performed The Thrower’s Ten exercise program (based on electromyographic data that implicate specific exercises to best achieve meaningful muscle activation and strengthening of the shoulder girdle and elbow musculature) over the course of 6 weeks demonstrated a 1.7% increase in velocity. Myth 2: Velocity will continue to increase with appropriate strength and conditioning!

Myth 3: I’ll be more tired and not be able to throw as many innings/pitches if I am training during the season. Throwing with arm fatigue is the #1 risk factor for injury in baseball/softball athletes. Olsen, Fleisig et al. noted a 36x increased likelihood (3600% increase chance) for injury in doing so. The posterior shoulder endurance test is a valid way to determine the fatigue factor in overhead athletes. Kibler et al. found that those who performed supervised exercise 3x per week for 5 months improved their scores by 58 repetitions (36 reps in the first 4 weeks) compared to those who did not exercise. Third and final myth: BUSTED!

Overall, we can confirm that arm care programs are essential and should be performed year-round to maintain range of motion, increase strength, endurance, performance, and reduce the risk of injury. This past year Wilk, Arrigo, and Lupowitz analyzed all the arm care programs mentioned in this post and blended them together to develop the Youth Throwers Ten Exercise Program. This program can be found in the references below and is available with a PDF handout at all Orlin & Cohen Orthopedic offices and Prospect Sports Performance.

1. Posterior Shoulder Stretching: Modified Cross-Body Stretch
   Set up by lying completely on your throwing shoulder. Perform a quarter-turn towards your back so that you are lying on your throwing shoulder blade. Take your non-throwing arm and grab your throwing arm elbow, pull across your body until you feel a stretch in the back of your shoulder.
   
   
2. Strengthening Exercise: Modified Robbery & Side-Lying External Rotation
   Modified Robbery: Start by holding bands with your hands at your sides and palms facing upward. Rotate your arms back, pointing your thumbs backward, squeezing your shoulder blades together.
   Side-Lying External Rotation: Start lying on your non-working shoulder. Place a towel roll or baseball glove under your working shoulder and hold a dumbbell or weighted ball in hand. Start with your hand at your stomach and rotate upward until you have the weight positioned in line with your body. (As seen in image above, do not over rotate)
   
   
3. Posterior Shoulder Endurance Test/Training
   Prone Shoulder Abduction: Lie over a table or stability ball with knees fully extended and arms rested towards the floor. Aim to raise your arms into a T position.