Let's talk arm care for pitchers...
In this article, you'll learn how to take care of your arm before and after pitching during the season—and also what to do for a sore arm.
It's essential pitchers understand the importance of working the rotator cuff in-season and off-season...
...and also why too much of the wrong kind of upper body weight training can cause injury to the cuff as well as reduce flexibility.

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Consider this:
During a baseball pitch, the shoulder of the pitching arm abducts 90° or more, externally rotates up to 180°, experiences a peak force of over 600N, and then internally rotates over 7000° per sec...
...all in less than 2 seconds!
It's the fastest human motion in any athletic activity. And no one does it better or throws harder than Aroldis Chapman.
Aroldis Chapman of the Cincinnati Reds has thrown the fastest official pitch in Major League Baseball at 105.1 mph.
Here's something else to consider:
The rotator cuff becomes even more important the harder a pitcher throws.
In Little League, most injuries are to the elbow because most LL pitchers don't throw with enough force to cause stress at the shoulder, even though there are many growth plate injuries due to overuse throwing.
But once pitchers hit high school and begin to get bigger and stronger, and start to put more stress on their shoulders—they need to begin protecting their rotator cuff.
This is even more important at this level since pitch counts usually begin going up, too.

A closer look at a pitcher's shoulder and rotator cuff
The shoulder is the most flexible joint in the body. However, unlike the hip, it is a very shallow ball and socket joint—thus the flexibility.
One thing that stands out when you watch major league pitchers is just how much whip (for lack of a better word) you see in their throwing arms. And it makes a lot of sense that greater external rotation in your throwing shoulder would contribute to higher velocity.
Check out the flexibility of Aroldis Chapman and Billy Wagner during max external rotation (MER) or "forearm lay back" to see it:
If you don't have this range of motion in your shoulder to get your forearm near parallel with the ground at MER, you're not going to get the same catapult effect in the elbow extension/acceleration phase of your throw.
Now here is the amazing thing that many pitchers don't understand:
The ball part of the shoulder joint is the upper arm or the head of the humerus.
The only thing that holds the head of the humerus in the shallow socket of the shoulder are four tendons about the size of your first four fingers called the rotator cuff.
Here are the components of the rotator cuff:
These four tendons (teres minor, infraspinatus, supraspinatus and subscapularis) are what try to maintain the distance between the humerus and the shoulder socket. So when we maintain a balance between these four tendons, three that are in the front and one in the back, there is enough clearance and therefore no rubbing or impingement.
But when these tendons get out of balance, it's then that pitchers can suffer inflammation, impingement and even tearing.
And when pitchers have high arm angles, like over the top, the space between the head of the humerus and the socket are reduced. That's why over the top can be more stressful.
What causes muscle imbalances in the throwing arm?
We already know the act of throwing a baseball is the fastest movement in all of sports. It's also the most stressful.
Imagine the tremendous stress that pitchers who throw in the 90's put on their arms. The arm is going 90 mph and those four tendons are taking the majority of the stress.
Over time one of these tendons can fail and that can mean surgery and at least a year of rehabilitation.
Now here's what's important:
The front of the shoulder gets worked in all sorts of ways, throwing being one.
Throwing is mainly a forward motion.
So the back of the shoulder gets very little work, unless we strengthen it on a regular basis.
Here is what happens when you work the front of the chest or shoulder with heavy weights while not working the back of the shoulder:
The muscles in the front shorten and pull on the head of the humerus. So when the pitcher goes to throw, the humerus is pulled forward because the tendons in the back of the shoulder are not strong enough to hold them back.
This is called an imbalance.
So what the pitcher ends up with is impingement or tendonitis, both of which will show up as pain.
In order to maintain muscle balance, pitchers must work the back of the shoulder by strengthening while keeping the front stretched.
Having a quality arm care program should be the first priority of any pitcher.
19 arm care exercises for pitchers
An MLB pitcher performs tubing exercises in Spring Training as part of his arm care program. ( Tom Hagerty)
By working on specific shoulder, rotator cuff and arm conditioning and strengthening techniques, you may be able to avoid injury and improve the efficiency of your throwing motion.
Here are two arm care routines you can do to strengthen your rotator cuff and shoulder:
Pitchers tubing exercises
This flexible tubing routine can be performed twice a week on days when the pitcher is not on the mound.
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Flexible Tubing Exercises | Sets | Reps |
---|---|---|
Flexion | 2 | 10 |
45° Flexion | 2 | 10 |
Abduction | 2 | 10 |
Internal Rotation | 2 | 10 |
External Rotation | 2 | 10 |
External Rotation @ 90° —or— External Rotation 90°/90° |
2 | 10 |
Reverse Fly @ 90° | 2 | 10 |
Straight Arm Pulldown | 2 | 10 |
Reverse Throw | 1 | 15 |
Optional: Cuff Dribble | 1 | 30 sec. |
Flexion: Stand with tubing securely in active
hand and opposite end under same
foot of the involved side to control
tension. Tube should be taut. Lift
active hand straight forward from
side to shoulder height. Repeat.
45° Flexion: Stand with tubing securely in active
hand and opposite end under same
foot of the involved side to control
tension. The tube should be taut. Lift
active hand straight up from side at
45° to shoulder height and repeat.
Abduction: Stand with tubing securely in active
hand and opposite end under same
foot of the involved side to control
tension. Tube should be taut. Lift
active hand straight to the side to
shoulder height at 90°. Repeat.
Internal Rotation: Stand with tubing securely in active
hand and opposite end attached to a
doorknob or fence. Tube should be
taut. Starting with active arm away
from body, rotate active arm inward
to body. Keep elbow at side. Repeat.
External Rotation: Stand with tubing securely in active
hand and opposite end attached to a
doorknob or fence. Tube should be
taut. Starting with active arm in at
body, rotate active arm outward
away from body. Keep elbow at side.
Repeat.
External Rotation @ 90°: Stand with shoulder abducted at 90°,
externally rotated 90°, and elbow
flexed at 90° (elbow at shoulder
height). Keeping shoulder abducted,
rotate shoulder backward keeping elbow
at 90°. Return tubing and hand to
start position. Repeat. Keep back
straight and elbow still.
Reverse Rotation 90°/90°
Reverse Fly @ 90°
Straight Arm Pulldown
Reverse Throw: Start in follow-through pitching position, feet spread apart. With tubing taut, bring
tube back to chest by lifting with elbow (see "pic b"). Continue to diagonally extend
hand away from body into high-cock throwing position and repeat.
Pitchers lightweight dumbbell exercises
This lightweight dumbbell routine is based on the popular Throwers 10 rotator cuff circuit and Dr. Frank Jobe pitching exercises and can be performed twice a week on days when the pitcher is not on the mound.
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Lightweight Dumbbell Exercises | Sets | Reps | Weight |
---|---|---|---|
Post delt | 2 | 10 | 2-5 lbs |
Lateral raise | 2 | 10 | 2-5 lbs |
Full can | 2 | 10 | 2-5 lbs |
Anterior raise | 2 | 10 | 2-5 lbs |
External Rotation | 2 | 10 | 2-5 lbs |
Internal Rotation | 2 | 10 | 2-5 lbs |
Separation Drill | 1 | 15 | 2-5 lbs |
Full ROM Drill | 1 | 15 | 2-5 lbs |
Post Delt: Bend at waist. Arms hang freely.
Squeeze shoulder blades together.
Bring dumbbells straight out and up
to shoulder height. Return to start
position in a slow, controlled manner.
Lateral Raise: Stand straight. Squeeze shoulder
blades together and raise dumbbells
straight outward and upward from
side to shoulder height. Return to
start position in a slow, controlled
manner.
Full Can: Stand straight. Squeeze shoulder
blades together and raise dumbbells,
thumbs up, to shoulder height
at a 45° angle. Return to start position
in a slow, controlled manner.
Anterior Raise: Standing straight, squeeze shoulder
blades together and raise dumbbells
straight forward from side to shoulder
height. Return to start position in
a slow, controlled manner.
External Rotation: Lying on side, active elbow pressed
into side of body, squeeze shoulder
blades together. Slowly raise dumbbell
away from body until arm is
pointed directly upward. Lower to
start position in a slow, controlled
manner.
Internal Rotation: Lying on side, active elbow pressed
into side of body, squeeze shoulder
blades together and slowly bring
dumbbell into mid-section of body.
Return to start position in a slow,
controlled manner.
Separation Drill: Perform slowly! Slowly mimic the arm action of your pitching motion. Separate hands down and back by
squeezing shoulder blades together and thrusting chest outward. Bring dumbbells into "high
cock" pitching position. Slowly return to start position. Repeat.
Full Range Of Motion (ROM) Drill: Perform slowly! Slowly mimic the arm action of
pitching motion. Separate hands
down and back by squeezing
shoulder blades together and
thrusting chest outward. Continue
the throwing motion right
through your follow through position.
Then go in reverse. Be
slow and deliberate. Use good
form. Repeat.
90° Cuff Dribble: A basketball or small medicine ball is
needed. Stand facing wall and bring
active elbow to shoulder height with
hand at 90°. Dribble ball against wall
as fast as possible. Tap the ball; release.
Do not catch the ball. 30 dribbles
counts as one set.
7 secrets to improving rotator cuff strength for pitching
Here are some important points to remember about the rotator cuff:
- Keep it strong in the back and stretched in the front.
- Don't over-work or use too heavy weights or over-train it.
- Do the exercises always after upper body work or throwing.
- Do it 3 times a week off-season and 2 times a week during the season.
- Make sure the rotator cuff gets recovery time.
- Do arm care exercises for the shoulder, biceps, triceps, elbow, forearm, wrist and hand three times a week. Use light weight dumbbells, or flexible tubing. Also do push-ups 2-3 times a week.
- Dumbbells, flexible tubing and medicine balls are much more functional than using machines in the weight room.
Remember the ideal weight used should be 2-3 pounds, and not more than 5 lbs. And don't overdo it. Just like any weight training, the rotator cuff needs time to recover.
So for high school, college and pro pitchers, you must think about doing your rotator cuff exercises as "arm insurance."
Differences between pitching arm pain, soreness and stiffness
It is imperative that parents and coaches stay closely tuned in to your pitcher's arm so this doesn't happen:
Former closer Jason Grilli comes out of a game with arm problems.
In the image above, Jason Grilli left a game with right forearm discomfort.
It's worth noting that forearm problems usually point to an elbow injury (but not always), and Grilli has a history of elbow problems that includes a fracture (2000) and Tommy John surgery (2002).
Consistently ask your pitchers how their arm is feeling, before and after games, before and after practice.
It is perfectly normal for pitchers, after a heavy workload, to be a little sore/tight/stiff in their shoulders, core and legs.
But knowing where the soreness or stiffness is can help us work to improve or condition muscles or isolate and fix a mechanical issue that may be present.
- If the arm soreness lasts for more than 2 days, it should begin to raise a red flag.
- If your pitcher feels pain/soreness on their inner elbow, it should also begin to raise the red flag.
- If your pitcher feels pain on top of or deep within their shoulder, it should begin to raise a red flag.
- If ANY pain happens on a regular basis, such as during or after each outing, it should begin to raise a red flag.
Here is a very brief description of some pain, soreness and a brief description of what they may mean:
Problem | Possible cause |
---|---|
Front shoulder soreness | The muscles on the front of the shoulder are responsible for acceleration. If these muscles are sore, maybe the player is not warming up enough. Maybe the player is trying to over throw or throw too hard with their arm and not properly utilizing their body. Maybe the pitcher threw on an already fatigued arm (such as after pitching the day before). |
Top shoulder soreness | This could possibly be a direct rotator cuff injury and should be evaluated. |
Back of shoulder soreness | The muscles on the back of the shoulder are responsible for deceleration (slowing the arm down after the ball is released). Soreness in this location can mean the pitcher is not following through (mechanical issue) or it could just mean that these decelerator muscles need a little more conditioning (elastic bands and reverse throws) |
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Should pitchers ice their arm after they pitch?
I am sure almost all of you have iced your arms after pitching at one point in your career. You may have been told to do this by a coach, trainer, teammate, etc.
It is a common belief that icing a pitcher's arm after an outing will help prevent injuries and speed up the recovery time.
However, this is not entirely true. Icing may in fact inhibit the recovery process.
Icing the pitching arm
When ice is applied to a tired shoulder or elbow, the blood flow is slowed, and the delivery of nutrients to the shoulder area is hindered. After a pitcher throws, the shoulder is in need of repair.
Like any muscle in the body, the shoulder muscles break down when used and must be rebuilt before they can be used at full potential again.
The body uses blood to transport nutrients to the worn out muscles so they can be rebuilt. If ice is applied to the shoulder, these nutrients take longer to reach the shoulder and stall the healing process.
You may be asking yourself why you see the professional pitchers icing their shoulders after a game.
One reason is that ice is good when there is shoulder pain. Pain is different than fatigue. If there is pain, there is a good chance there is inflammation, and the ice will reduce this swelling. It is smart to ice the shoulder only when there is pain after throwing.
A good example to put this into perspective is to treat the shoulder as any other muscle in the body. After you do biceps curls, do you normally ice your biceps? Of course not! Are your biceps sore after a workout?
Most likely, yes they are. But there is a difference between soreness and pain. The key is being able to know what you are feeling.
So what are good alternatives to icing?
6 ways to improve a pitcher's recovery process
I get this kind of question a lot:
"What should my son be doing after pitching in games to keep his arm healthy?"
Here are six post-pitching activities to add to your arm care program:
Activity | What to do |
---|---|
Run | Waste products build up around your muscles during training sessions, which can cause damage if they remain in your system. A light jog helps flush out waste products and replace them with fresh oxygenated blood, so your muscles receive the nutrients they need to repair themselves. |
Use a foam roller | Foam roll areas prone to tightening up, including the lats, rear shoulder, groin, low back and glutes |
Get an arm massage | Perform a light soft tissue massage with either a tennis ball or a lacrosse ball to directly target smaller areas, including the forearms, triceps, rear delts and hip flexors. |
Stretch | Active-isolated stretching is most effective after a workout when the muscles are warm. Perform 3-4 light arm stretching. |
Shower | Start cold for 3-5 minutes and then finish hot to decrease post-workout inflammation. Alternating between cold and hot stimulates blood flow and muscle recovery. |
Refuel and rehydrate | To refuel your body after a workout, consume a mixture of carbohydrates and protein immediately afterward, preferably within 30 minutes of training. At this point, your cells are wide open and screaming for nutrients, and by drinking a shake or another balanced carb/protein small meal, you expedite the recovery process and maximize lean muscle growth. |
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So the next time you finish pitching, don't grab the ice bag (unless you have arm pain). Icing your arm will inhibit the body's natural healing process, and will slow down your recovery time. Do the activities mentioned above the day of and the following day to take care of your throwing arm.
What is dead arm syndrome?
In 2012, Chris Sale transitioned from reliever to starter—a move that has gone exceptionally well.
But the left-hander admitted that he was “going through a little dead-arm period” immediately after making the switch, so the White Sox give him some rest.
Chris Sale experienced a well-documented case of "dead arm syndrome" in 2012 when making the transition from a relief pitcher to a starting pitcher.
By most accounts, dead arm is an overall feeling of general, non-specific fatigue. It's expected to appear at some point before or during the season, and it has very recognizable symptoms.
Former big league starter Aaron Sele once described it as "a change of pace without throwing a change up."
According to the National Pitching Association, dead arm is a deficit situation caused by the body's inability to recover from daily use. Recovering from dead arm relies on rest and good nutrition. The NPA says you should cut back your work load to about 70% until your arm recovers.
2 ways to get rid of dead arm
In an article titled, "Coming Back from Dead Arm", by Ryan Sienko of the NPA, says:
"Since dead arm is a deficit issue, it is counter productive to work harder to cure it. Many pitchers overwork into a 'black hole' that is difficult from which to return. Ultimately they and their coaches are convinced that dead arm is due to not enough work, when in fact it is just the opposite. The body has been put in a deficit from over use. Dead arm is a result of this deficit which is the body's way of not letting us overextend it. The body is basically trying to protect itself from injury."
Here are two treatments for dead arm:
- Continue to do your routine arm care, but do not overdo it.
Do not be mistaken into thinking that doing more arm care will help you recover quicker. You need to get some blood flow going in your arm, but you do not want to fatigue your arm any more than it already is.
- Learn to pitch without your best stuff.
If you can be a successful pitcher when you are going through dead arm and don’t have your best stuff, I tip my hat to you.
Most pitchers get frustrated when they don’t have their best command, velocity, or movement, but the best competitors will find a way to win and be successful in any circumstance.
Pitching during a dead arm phase is one of the best ways to work on developing this intangible quality of being successful without your best stuff.
What is Little League Elbow?
LL elbow happens to growing kids, is on the inner side of the elbow, and is mostly related to a certain stage of development. At that particular stage the pitcher is throwing too frequently and there can be pain. Parents and coaches have to decide what is more important, losing a year of development vs. losing a career.
If the player is complaining of pain you have to listen to them. Its either pain for anatomical reasons or pain for whatever reason he doesn't want to play. Once the pain is evaluated and someone tells you that you can't find any cause then you have to sit back and have a heart to heart talk.
On the other hand if there are anatomical things, and it is not looked into, and people continue to force the kid to go out there, then you might be into something much worse that will threaten a career.
Pitchers elbow exercises
In the Chicago Cubs organization, we used rice bucket exercises to increase stability and strength from the fingers to the elbows. Twice a week, pitchers can perform this rice bucket series of exercises using just a standard five-gallon bucket filled with long grain rice.
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Rice Bucket Exercises | Sets | Reps |
---|---|---|
Circles Left | 1 | 30 sec |
Circles Right | 1 | 30 sec |
Back and Forth | 1 | 30 sec |
Side to Side | 1 | 30 sec |
Figure Eights | 1 | 30 sec |
Here's a video of some additional rice bucket exercises for pitchers:
Pitchers forearm and wrist stretches
Here are the four best stretches for the forearm and wrist taken from the Pittsburgh Pirates Shoulder & Arm Care Manual:
Four great forearm stretches for pitchers are, clockwise from top left, wrist extension, wrist flexion, wrist supination and wrist pronation.
3 steps to proper arm care and injury prevention
There are three things I always refer to regarding proper arm care and injury prevention:
- First, be sure that the shoulder always works properly and there is good muscle balance and flexibility around the shoulder. This can be done via conditioning and rotator cuff programs.
- Second, an enormous part of good arm care comes learning good mechanics. If you just let pitchers throw without proper instruction, they develop bad habits and it reinforces poor mechanics.
- Third, adhere to these pitch count limits guidelines. Good rotator cuff strength and proper pitching mechanics plus following age-appropriate guidelines on workload limits to limit the likelihood of pitching with fatigue will help parents, players and coaches avoid overuse injuries and foster long, healthy careers for youth pitchers.
You can do all the conditioning you want—if they have poor mechanics and overuse young pitchers, it’s for naught. It’s a combination of the three factors.
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What do you think?
Now it's time to hear from you:
Are there any youth pitching arm care routines that I missed?
Or maybe you have an idea of how I can make this list even better.
Either way, leave a comment and let me know.
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