The Importance of a Return to Throwing Program for Baseball Players Recovering from Injuries

For a baseball player, a return-to-throwing program is often overlooked. Many times players are given a sheet of paper by their doctor or physical therapist with a generic throwing program to follow and they are told “good luck.”

This is not how baseball players should rehab and recover. 

Introduction to the Significance of an Effective Return to Throwing Program

The return to throwing program is one of, if not the most important aspects of the entire rehab program, and therefore should be overseen by a physical therapist and/or qualified rehab throwing coach.

Continue reading to discover how a structured return to throwing program can help baseball players safely regain their arm strength and prevent future injuries.

The Benefits of a Return to Throwing Program

I like to use the weight room as an analogy for the return to throwing program. 

If you stopped working out because of a back injury, you wouldn’t go back to the gym on the first day and test a 1-rep max for your back squat or dead lift. You would slowly start working back into the movements, starting with lower weight and higher repetitions, gradually increasing sets and then ultimately adding more intensity with higher weight. 

While you were working at the lower weights and higher repetitions, you would also be working on improving your exercise technique, using proper form and enhancing your movement efficiency.

We do the same thing with throwing. When we consider what we want in a return to throwing program, we want to:

• Gradually progress and control the loading of the throwing arm

Our philosophy is to start with low intensity throwing (short distances and low effort drills) and accumulate a high volume of throwing gradually over time. Then, we gradually start adding intensity with greater distance and higher effort throwing. 

This might look like light catch play at 30-45 feet for the first week, progressing out to 60 feet, 75 feet, 90 feet, gradually over time. 

• Improve mechanics 

The biggest difference we notice between high school baseball players and professional baseball players in the return to throwing phase is the amount of focus the pros put into each and every throw in their throwing program. 

There are no wasted throws. They are looking for feels, performing dry drills, and trying to improve or restore their mechanics each time they touch a ball. 

What are “good” mechanics?

There is no one “right” way to throw a baseball, but there are several key elements that we look for in an athlete’s throwing mechanics. Overall, we want to see arm efficiency, which is the highest possible arm speed with the lowest possible arm stress.  

This is going to involve the proper use of the lower half, good hip-shoulder separation, and appropriate timing of the arm to the lower half.

Designing a Personalized Return to Throwing Program

You won’t find a cookie cutter “downloadable” throwing program at the end of this blog (there are many of those available online). That is because we find it important to individualize each return to throwing program to the individual athlete. 

What Leads to Differences in Return to Throwing Programs?

• The player’s injury and their recovery status

A player that is out for 10 days with a sore shoulder will need a different throwing program than a player that is recovering from Tommy John and hasn’t thrown in 4-6 months. 

Typically, the more significant the injury and the longer the time out of throwing, the slower and more gradual the return to throwing program will be.

• Goals and timelines for return-to-play

The throwing program should be modified based on the players ability level, position and the timeframe. 

A position player will only need to do long toss prior to returning to practice and competition. A pitcher will not only need to do long toss, but will also need to go through a bullpen progression and live at bats before returning to pitching in a game. 

Even within pitchers there are different demands for a return to throwing program. A pitcher that only throws 70 mph may be able to get away with a shorter build up period than a pitcher that throws 95 mph. The stress and demands are much different and need to be accounted for. 

Finally, the time frame makes a difference. If we had two players that throw the same velocity and play the same position, we might use a different approach based on time of year. 

If player A got injured at the end of the baseball season going into the off-season, we might use a slower, more gradual throwing approach because there is no reason to rush back to full health in the middle of the off-season. If Player B got injured in the first practice of the season and is trying to make it back to compete this year, we may use a more aggressive approach and a shorter throwing program.

• Selecting an implement and return-to-throwing philosophy

One of the most common questions we get is “What should I throw?”

Many players see rehabbing baseball players throwing plyoballs, while other rehabbing baseball players throw baseballs, footballs, clubs, or other implements. Plyoballs are simple rubber-coated weighted balls filled with a sand-like material that come in varying weights, some lighter than a baseball’s weight and some heavier.

How do you decide what to throw? This is completely individualized and there is no “right answer”.  

At Kinetic, we are definitely fans of long toss as a component of the return to throwing program (more on that below). Long toss can help with restoring rhythm for a thrower, improving or restoring shoulder range of motion and arm strength.

And even simpler, baseball players throw a baseball in a game, not a plyoball. We feel that incorporating a baseball as part of the return to throwing program is important for that reason alone. However, we also have players throw plyoballs frequently as a part of their throwing program since they have benefits of their own that a baseball alone cannot provide.

Some of the Benefits of Plyoballs:

• Heavier balls lead to slower arm speeds. This results in less stress each throw, potentially beneficial as a warm up, to accumulate more volume early in a throwing program.
• Heavier balls result in more feedback for the brain on where the arm is in space. This can help facilitate mechanical changes.
• Lighter balls can help restore arm speed.
• Plyoballs can be thrown against a wall, and therefore with no partner, which is helpful living in Wisconsin or other cold weather areas where finding space to throw can be an issue depending on the weather!

Additionally, some players are used to throwing plyoballs as a major component of their weekly throwing routine and they don’t play as much catch. If that is the case, we try to help the player return to their normal program and don’t “force” them into something they aren’t used to, like playing long toss. 

So there is no one “right” implement to throw, but there are many tools that you can utilize as a component of your program based on your goals, time frame and available equipment.

The Role of Long Toss in the Rehabilitation of Baseball Players

Uncover the advantages of incorporating a long toss program into the recovery process and how it can enhance performance on the field.

The Benefits of Long Toss

Catch play and long toss are a time-tested method for a few things: one, baseball players to build arm strength and endurance in preparation for a season, two, to warm up before practice and games or three, to help return to throwing after injuries. 

The most commonly used long toss program is the Jaeger routine, where a player will work out using “extension” long toss to warm up (throw a ball on an arc) out to some maximal distance, followed by “compression” long toss, working back in where the player starts throwing the ball more and more on a line. 

In baseball shorthand, this is commonly referred to as “taking your arm for a walk.”

But Why Long Toss?

Long toss is a (somewhat) objective way to build arm strength and endurance. If you count the number of throws you do at a specific distance and gradually increase it, you will know you are building up your arm tolerance and workload. In other words, if I threw 30 balls at 90 feet, and now I can throw 60 balls at 90 feet, my workload improved. If I threw a ball 60 feet last week and I throw it 120 feet in 3 weeks, I know the intensity or arm strength improved. 

An underrated benefit of using extension based long toss is to help improve shoulder range of motion and layback. Typically, through a period of shut down from throwing, a player's shoulder range of motion will decrease. Putting the ball on an arc in long toss is a great way to help restore the extreme range of motion that throwing demands.

Finally, baseball players are used to playing catch! It can help with the mental side of injury recovery to return to a familiar routine like catch play. It can help a player take their mind off the injured areas and allow them to focus on accuracy (hitting their partner's glove), how the ball is moving, etc. This can help the player relax and work into their normal smooth throwing motion. 

Implementing Long Toss in the Rehab Program

Incorporating long toss into a rehab program is simple, but not easy. 

Warming Up

First, warming up is key. If you have a warm up routine that you have used previously and works for you, start there. But many times, players do not have a consistent warm up routine, or they aren’t sure what they should do to warm up before they throw. 

A basic framework that we like to use is the acronym R.A.M.P.

R.A.M.P.

Raise: Raise your body temperature with movements like jogging, skipping, arm swings, leg swings, etc.

Activate: Use exercise to target muscles that are key for throwing, specifically lower body stabilizers around the hips, core musculature, rotator cuff and scapular stabilizers. We need these groups fired and ready to go! 

Mobilize: Target specific areas that tend to get tight, like shoulder flexion, the posterior shoulder muscles, hips and t-spine.

Potentiate: Throwing is a fast movement! You need to get your body moving quickly! Incorporating skipping, jumping, medicine ball throws, or gradually increasing intensity of plyoball throws can get your nervous system firing. 

Here is an example of one potential warm up routine.

Know Where You’re Heading

The next key is to start with the end in mind. I recommend picking where you want to finish, determining what your max distance for the rehab portion of your throwing is (typically 120-180 feet), and deciding on your timeline. Then, work backwards and break it up into gradual intervals.

Typically, a bare minimum is 1 week of an interval throwing program for every week you were shut down. Then, add in longer timeframes for longer or more significant injuries and for higher velocities.

On average, the long toss phase will range from 4-16 weeks. 

Start with low distance, low intensity and a small number of throws. Gradually build workload by increasing the number of throws and then build intensity by throwing greater distances or with greater velocity.

Here is an example of a 6 week build up program for a healthy pitcher. While this is not a perfect option for coming back from an injury, it still gives great context for how to gradually progress and prepare your arm.

Monitor Progress and Adjust When Needed

The final step is monitoring. We believe all throwing programs should be written in pencil, not pen. You need to be willing to adjust based on how your arm is feeling and progressing. 

In order to adjust, you need to properly monitor the throwing volume, intensity and how your arm is handling it.

The most simple ways to monitor throwing are distance and number of throws. 

But, we all know you can throw a ball at 60 feet and lollipop it to your partner, or you can rip a max effort pull down from 60 feet. Those two throws are not the same stress or intensity.  

That is why we recommend supplementing distance with velocity for feedback on intent. You can use simple radar guns like this Pocket Radar if you don’t have access to one through your training facility. Another option is using a monitoring device like a Motus Pulse to help track arm speeds and workload. These tools are great options to provide more objective feedback on your daily throwing workload.

We also recommend consistent monitoring with a physical therapist throughout your throwing program. Physical therapists are specifically trained to monitor subjective markers like arm pain or fatigue, but more importantly on gathering objective data on shoulder strength, grip strength and range of motion to watch for changes and signs of how your arm is tolerating the throwing program.

Common Mistakes to Avoid in a Return to Throwing Program

In a perfect world, every return to throw rehab program would go smoothly with no soreness, no setbacks and no delays. Unfortunately, this isn’t a perfect world and it is common to have a few bumps in the road during your return to throw program.

Here are some of the most common pitfalls that players encounter during their recovery journey and some tips on how to prevent setbacks.

Rushing the Return

You are feeling good, the ball is coming out great, and your arm feels alive. You try to push it just a little faster, a little more intent, just to “test” it out.

But then, you feel pain, or the next day your arm is sore.

It is important to be patient, stick to the process and build up slowly. There is no need to rush it, to “test” it out. Focus on executing the plan with the correct distance, intent or velocity range. Use the feedback from a radar gun or a Pulse sensor to keep your effort level in check and trust those metrics.

But what if your arm isn’t feeling good?

The ball isn’t coming out well, every throw feels hard, your arm is really fatigued or sore. Even your warm up feels hard and you are really stiff.

Don’t just blindly follow the program and progress each day. 

Take the feedback from your body that it is not handling the stress well, adjust to an easy throwing day or taking a day off. It is better to miss one day of throwing and try again later in the week than to need to take 2-3 weeks off because you flared up the injury.

Neglecting Proper Mechanics

The early stages of a return to throwing program are a great time to work on restoring or improving your mechanics. You have a high volume (repetitions) of low intensity throws. It is easy to incorporate specific drill work and “feels” into your routine.

But, be cautious to use proper intent on these throws. Many times we see younger, developing players “tune out” on 30 and 45 foot catch play while they just go through the motions.This is not only wasting an opportunity to improve your mechanics, but can negatively affect mechanics if poor habits are picked up during these earlier throwing phases.

But what should you work on?

It is crucial to have a physical therapist and/or pitching coach that is familiar with working with injured athletes. There are specific inefficiencies in arm actions that can increase stress on the shoulder and elbow. There are also specific drills to work on arm patterning, body rotation and kinematic sequencing. Getting a player into the right drills for them is key to getting the most out of early phases of a throwing program. 

Overcoming Fear and Psychological Challenges in the Return to Throwing Program

The mental aspect of rehabilitation is extremely important, and can be a significant factor in any issues that arise during the return to throwing program.

Players may be fearful of reinjury, and “guard” their arm resulting in a “pushy” arm action. 

Players may struggle to progress and throw at greater distances because of concern over their arm health. Some players may even deal with the “yips” as a result of changing their mechanics due to lack of confidence in their arm. 

While progressing gradually through the throwing program may help restore confidence gradually over time, working with a sports psychologist or certified mental performance consultant can speed this process up and give athletes tools to excel. 

Here is one athlete’s experience of working with a sports psychologist during his return to throwing program after Tommy John. Ryan Roehl talks through how much of a difference that made for him here in this episode of the Milwaukee Sports Performance Podcast.

These professionals can give athletes tools to build mental resilience, mindfulness, visualization and much more! 

Maintaining Long-Term Arm Health and Injury Prevention

Going through a rehab process and return-to-throwing is a great time to learn about building a consistent routine to maintain long term arm health. Let's explore the practices and habits that can help baseball players maintain a healthy and injury-free arm throughout their career.

Proper Warm-up and Cool-down Routines

Every player needs to have a unique and consistent routine for pre- and post-throwing. 

We mentioned earlier the importance of a warm up and laid out a framework for your warm up if you do not have a consistent routine. Revisit our warm up routine if you need ideas.

But what should you do after you throw?

This can be a little bit more variable based on individual player needs.  

A player that tends to get tight and lose range of motion might benefit from some extra mobility work as a recovery tool. This can be a nice place to incorporate foam rolling, self myofascial release and specific active mobility drills. Incorporating breathing routines can be great for core engagement, to restore range of motion and to jump start recovery. 

But what about a player that tends to lose strength or is still trying to recover full strength?

We find that incorporating strength work following the highest effort throwing days can be a nice way to continue to work on strength during the rehab process. 

The idea is to stack stress to gain more time for rest and recovery between throwing sessions. It can be a nice way to incorporate grip strength, eccentric work in the posterior shoulder or other muscles to improve or maintain shoulder and forearm strength. 

Cross-Training and Conditioning

Incorporating a well designed strength and conditioning program is one of the easiest ways to limit the risk of both overuse and acute injuries to the arm (and any part of the body)! It helps maintain strength, stability, range of motion and tissue tolerance. 

Even 1-2 sessions/week of strength and conditioning is enough to see benefits in decreasing injury risk and performance gains. 

How to structure strength & conditioning in your week to allow adequate rest & recovery

We want to try to get your hardest strength and conditioning workouts within 24 hours of your hardest throwing workouts, if possible. This allows more time for recovery for the entire body prior to the next high effort day.

What are your hardest workouts? 

Lower body, heavy strength and power work tend to be the most physically and neurologically fatiguing. By doing these workouts on the same days after your hardest throwing days, your body will have optimal time to heal and recover, which promotes muscle growth and will reduce your risk of injury.

One example for a workout schedule might look like:

Conclusion

The return-to-throwing program for any baseball player is one of, if not the most important portion of a rehabilitation program. It should not be overlooked or underprioritized. It is important to follow a structured, gradual long-toss program with some type of monitoring to ensure that you build and restore arm strength, mobility and proper mechanics prior to returning to competition.

Were you given a generic return to throwing program? Are you wondering if your return to throwing program is up to par? We at Kinetic Sports Medicine and Performance specialize in baseball injuries, with a heavy emphasis in throwing injuries. We offer free consultations for you to talk with a doctor of physical therapy who can give you the right guidance on your recovery. Book yours today to get on the right track for your return to throwing program!

Wondering how to keep your arm healthy all season long after you've worked through a return to throwing program? Check out our free course below to get you started on the right foot to maintaining a strong and healthy cannon all year!