Patient Information Resources

Alpine Physical Therapy
Three Locations
In North, South, and Downtown Missoula
Missoula, MT 59804
Ph: 406-251-2323
Fax: 406-251-2999

Child Orthopedics
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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I'm a college-level assistant baseball coach with two pitchers on the bench with elbow injuries. I've been assigned the task of helping these guys get back on the field. What's the current thinking about rehab and recovery using flat-ground throwing? I've heard some say work on speed while others go for distance. Should we do both? Should we work on one first before the other?

Throwing programs are needed to help players gain greater arm strength, flexibility, and pitch speed. The goal is to help athletes prevent injuries, boost performance, and when injured, recovery quickly and completely. The use of proper throwing mechanics is essential in training programs for baseball pitchers. This is especially true for the recovering player who is in rehabilitation for a shoulder or elbow injury. The results of a recent study from the American Sports Medicine Institute in Birmingham, Alabama support the use of flat-ground (long toss) throwing as a safe and effective rehabilitation exercise. Here's what they found: 1) pitchers leaned farther forward when trying to pitch to a maximum distance, 2) maximum-distance throws also required greater elbow flexion and shoulder external rotation, 3) elbow extension velocity (speed of elbow moving from flexion to extension) was greater for maximum-distance throwing, and 4) long distance throwing changed foot mechanics. Using the flat ground long toss as a warm-up exercise is okay. But caution is advised when throwing as far as possible during the early phases of rehab and recovery after injury. Throwing for distance requires the pitcher to lean forward much farther. This position increases the amount of force placed on the arm and may not be tolerated by injured tissue that is still on the mend.


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