By: Dr. Jesse Zeger (DPT, NSCA-CSCS, C-PS)

Spring sports season is upon us, and that means arm health is top-of-mind for athletes competing in sports such as baseball, softball, volleyball, and other activities that involve a lot of overhead throwing/hitting motions.

Did you know that during a baseball pitch, if a pitcher were to maintain their maximum arm speed for a full second, their arm would complete nearly 20 rotations in that time? The motion of pitching a baseball is one of the fastest human motions, which is why – without proper attention to detail – it can easily lead to injury.

Shoulder and elbow overuse injuries are particularly heightened in baseball, with acute traumatic injuries like UCL tears also rising. In professional baseball, these injuries have increased dramatically over the past decades. Even in just one year between 2022 and 2023, the rate of arm injuries increased by 44%. Unfortunately, this trend is also carrying over to the youth level.

However, many of these injuries occur from a lack of care or understanding. With proper education, guidance, and training, you can greatly decrease your risk of suffering a serious injury.

This article aims to introduce strategies derived from current scientific research to lower the likelihood of arm injuries and enhance performance in overhead-throwing athletes. While the focus is on baseball players, the information provided can benefit other overhead athletes such as those in softball, javelin, volleyball, and similar sports.

Strategies to Reduce the Risk of Injury

1. Load Management/Limiting Volume

It’s important to manage how much you throw. Aim to gradually increase by about 10% each week leading up to the season after taking a yearly break from throwing (more on this later). Avoid pitching on back-to-back days because it significantly raises the risk of arm pain or injury. Ideally, give yourself five days between pitching sessions to allow for better recovery and less fatigue.

Limit competitive throwing to a maximum of 8 months per year, followed by a 4-month break. Pitching regularly for longer than that increases your risk of arm injury. Importantly, pitching when fatigued increases the risk of injury by more than 3,000%.
Fastballs put the most stress on the arm, so it’s wise to closely monitor your fastball usage at maximum effort. Stick to pitch count guidelines based on your age. Athletes often struggle to judge how hard they’re throwing, so it’s helpful to track your throwing volume to understand the strain on your arm.

2. Strength & Mobility Training

When you try to do something strenuous, your body adjusts. But if your hips, trunk, or shoulders aren’t strong or flexible enough, it can put too much strain on your throwing arm. Limited movement in these areas has been linked to more injuries in overhead throwers. So, it’s important to work on building strength and flexibility during the off-season.

It’s also vital to train your overall power. This helps you handle fast, sudden movements better. You should focus on improving your overall body strength, flexibility, and control, especially in muscles like the rotator cuff and shoulders. Research shows that working on your legs and core can also boost your throwing speed.

3. Arm Care

Arm care programs are effective in lowering the risk of arm injuries from throwing. They help warm up and condition the arm for the stresses of throwing. One such program is the Throwers 10 or Yokahama 9, which only requires your glove, making it convenient to do on the field.

4. Mechanics

New research suggests that while arm angles are important for performance, they might not be as crucial for predicting injuries as previously believed. Pitch speed seems to be more significant in this regard. Therefore, it’s recommended to limit the number of fastballs thrown to less than 48% of total pitches (in both practice and games) to decrease the risk of arm injuries. Around half of your throwing velocity comes from the step and rotation before the actual throw. This highlights the importance of using the lower body and core to enhance performance and minimize injury risk.

Interestingly, studies indicate that high school pitchers often rotate their shoulders faster than college pitchers, yet they achieve lower ball velocities. This could be because they don’t utilize their lower body and core as effectively.

5. Recovery

After throwing, engaging in active recovery is the most effective way to speed up the return to normal strength and mobility. This can include cardio, arm care exercises, or circuit training. Using ice on your arm after throwing is not currently advised because it can slow down the body’s natural healing process, but this is currently a hot topic of debate and ongoing research in the medical field.

When Should I See a Professional?

If you have pain lasting more than a few days or notice a drop in your performance, it’s best to see a sports physical therapist or sports medicine doctor for guidance.

Sports Physical Therapy in Maryland

If you’re suffering from an injury or are experiencing persistent pain that is keeping you from doing what you love, sign up for a consultation with the doctors of physical therapy at Herlong Sports Physical Therapy. We specialize in treating physically active people, operating out of four distinct locations throughout the state of Maryland. No doctor’s referral is required to get started and we are in-network with all major insurance plans!



10312 Governor Lane Boulevard #5007
Williamsport, MD 21795

Located inside of TrueAP




1438 Liberty Rd, STE 10A
Eldersburg, MD 21784

Located inside of MadLab Performance




2470 Longstone Ln, STE A
Marriottsville, MD 21104

Located inside of Campanaro Strength & Conditioning




12447 Clarksville Pike
Clarksville, MD 21029

Located inside of Campanaro Strength & Conditioning