Managing Workload to Protect Young Arms


To celebrate the start of the 2016 MLB season, we are featuring a blog series this week with articles written by HSS surgeons who work with professional baseball players. Our second installment is written by Dr. Joshua Dines, sports medicine surgeon.  Read our first installment on slides with Dr. Anil Ranawat here.

Home runs and 100+ mph fastballs: two things baseball fans can’t get enough of!  There seems to be more young MLB pitchers throwing heat today than ever before.  That said, regardless of the actual radar gun reading, the act of pitching puts a significant amount of strain on arms; as it requires an unnatural overhand motion.  With this in mind, it is important to manage the workload of young pitchers to prevent injuries and ensure a long successful career.

Because pitchers come in all shapes, sizes and ages, it is impossible to make a sweeping generalization about how many innings one should pitch in a given year. In youth leagues, for example, there are guidelines for how many pitches a pitcher should throw in a week based on recommendations made by USA Baseball. At the college and professional level though, there’s no official guidelines used to impose inning limits.  Instead, it is up to the discretion of each coaching staff with the help of the medical staff to evaluate each individual pitcher to manage his workload effectively.  Determining the best plan for a pitcher depends on a couple of things:

  1. Convention – It is generally accepted that 100 pitches for a starter in a game could be a good limit and is the right time to go to the bullpen for relief.
  2. How the pitcher is feeling – Are the mechanics starting to break down? Is the pitcher losing heat and missing his spots? Are his pitches becoming more predictable and are the opposing batters getting better swings? All of these subtle clues may indicate the pitcher is starting to fatigue and needs rest.

Back in the day, Spring Training was where players would come to get back into shape for the upcoming season. These days, players are constantly conditioning even during the off-season. Even if a pitcher hasn’t been throwing in the winter, they have been training and working out.  They use Spring Training to build up their arm strength and perfect their mechanics. Additionally, players who may be on the cusp of making the roster will arrive at training camp as ready as possible to make a quick, good impression on the coaches.

During Spring Training, starting pitchers will start very slowly. First, they will work on arm strength in bullpen sessions.  They will most likely only pitch one inning in their first Spring Training start, adding an inning or so each start. This slow build-up and gradual increase in workload will get pitchers ready to go for the regular season.

Relievers will also start slow – however they are training for a marathon, not a sprint. Relievers have to be ready to pitch every day so they will throw more regularly than starters in Spring Training but with fewer pitches per workout.

During the regular season, there are certain warning signs that medical staff and coaches look out for when monitoring a pitcher to see if he is in need of rest, including:

  • Is he getting hit hard each time he’s on the mound?
  • Is his velocity down?
  • Is he taking longer than usual to warm up? Is he having difficulties loosening up?
  • Is he having control problems?

Without a doubt, there will be normal fatigue and wear-and-tear during the course of a 162-game season so those observations will all have to be taken into context with how the pitcher is performing and feeling. If a pitcher is showing these signs, it is best to give him an extra day of rest and possibly go to a 6-man rotation to accommodate.

The postseason gets a little trickier. You never want to place a player’s long-term health in jeopardy – but most players are hyped up and want to go out there and win.

There is no exact science behind the exact number of pitches and innings any given pitcher should throw in a season. It’s best for medical staff and coaches to work together to figure out a personalized plan for each individual pitcher to maximize their potential while keeping them safe and healthy.

Dr. Joshua Dines

Dr. Joshua Dines is an orthopedic surgeon and a member of the Sports Medicine and Shoulder Service at Hospital for Special Surgery. He currently serves as an assistant team physician for the New York Mets and a sports medicine orthopedic consultant for the New York Rangers.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

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