Little League Injury Prevention Program

12yo - ER tubing 1 Thanks to those in attendance at the MGH Sports Medicine 2010 program last weekend.  My last talk was on the prevention of youth throwing injuries.  We discussed many of the topics associated with little league throwing injuries, including the use of injury prevention and strength and conditioning programs.

In the past, I developed a basic 10-exercise core program for youth athletes to help prevent throwing injuries.  This has been on the MGH Sports Medicine website for a couple of years now but thought it would be a good time to share here as well.

The concept behind the program isn’t rocket science – keep it simple!  I selected my top 10 basic exercises to address weaknesses that could be harmful for Little League pitchers.  This is from my past experience working with athlete of all levels and some of my research articles on exercise selection (check out my latest article in JOSPT).  One thing I have learned over the years is that an adolescent athlete performing ANY injury prevention program is better than NO program at all!  However, as always there is a BETTER way as well.

Below is a copy of this program but be sure to also visit MGH Sports Medicine’s site for more information.

Youth Throwing Injury Prevention Program

Reinold Little League Program

6 replies
  1. Anonymous
    Anonymous says:

    Mike, I cannot open the site I shared via firefox or explorer. :( You may not like the posterior capsule stretching they advocated, but I swore I saw some research they were doing. Forgive me, but I read way too many things to remember everything. I thought what I read appeared pretty good – their research was supporting their safe throwing platform (which includes the stretch you don't like).


  2. Mike Reinold
    Mike Reinold says:

    Great comments everyone.

    @ Selena – My presentation actually reviewed the 4 areas of concern – Overuse, Mechanics, Pitch Type, and Conditioning. I talked about each in detail but this post only discusses the last aspect, conditioning, as I wanted to post the program that I referenced. Perhaps I'll do a webinar of some sort in the future to present the entire talk. The website your reference looks good, but there are also some disadvantageous items there (look at the posterior capsule stretching program – ouch…). Appreciate the heads up that they are copying some of the programs I helped develop (throwers 10 etc) without proper attribution!

    @ Chad – I wouldn't ignore the subscapularis (and realistically the other IR muscles such as the lat) as these are very important in throwing. Notice that if you just performed the exercises above there is a 2:1 ratio of ER:IR. I would tweak this even more by performing 3×10 of ER and 2×10 of IR in certain people and increase the ratio to 3:1. Good thoughts.

    @ Greg, agree that overuse is the #1 factor, that was in my talk. Jump rope sounds like a good exercise but I would think that you need to include it in a program that focuses more specifically on certain muscle groups. I like it in combination of this program but maybe not in isolation. I know these are boring but wouldn't say they are "awful!" If kids want to emulate their MLB idols and wear Under Armour clothes, eat sunflower seeds, and wear eye black, then they should also realize that being good at baseball requires work just like their idols. It takes education on our part.

  3. continuingedofanatc
    continuingedofanatc says:

    Mike/Greg –

    Jumping rope seems like it may fit pretty nicely with the rhythmic stabilization strategy to help turn on the cuff prior to activity.


  4. Greg Arnold, DC, CSCS
    Greg Arnold, DC, CSCS says:

    I am still stunned that NO ONE talks about jumping rope as the best way to keep the shoulder and elbow healthy. The functional isometric contractions that occur with jumping rope is unparalleled and it's my #1 exercise for all my athletes. The kids love doing it and I've had football, rugby and volleyball players, and surfers all get significantly better so much faster when jumping rope consistenly. Plus, it costs $12!

    Very surprised/disappointed ASMI hasn't done more on jumping rope for shoulder and elbow injury prevention.

    If the player is healthy, why make them do the awful band exercises? The kids hate them, they never use proper form, and never do them at home. Only if the kids have been injured do I recommend bands.

    The #1 risk factor for little league injuries is, without a doubt, year-round baseball. I constantly preach ASMI's 3-month rule of "active rest". 90% of the kids I've seen in my office with elbow pain this year played Fall Ball.


  5. Chad Ballard, PT
    Chad Ballard, PT says:

    Mike- It's interesting to see IR strengthening part of this program as well as the "Throwers 10" exercises when we know that the ER:IR strength ratio should be at least 65% for normal shoulder function with overhead athletes (optimally 66-75%). I've pretty much cut out isolated IR work in my athletes and cuff repairs that present with good IR strength in order to try to "catch up" their ER strength. Any thoughts?

  6. Anonymous
    Anonymous says:

    Hey Mike,

    I can't get a certain site to open for some reason, but I saw what appeared to be an excellent program for reducing injury –

    I wasn't at your session and didn't hear your presentation, but it always seems "strength and conditioning" are generally always targeted for injury prevention. I haven't seen a ton of literature on any specific strength and conditioning program that reduces shoulder injury in throwers, so I have mixed feelings. I personally don't believe strengthening as a key component in injury prevention will solve the problem.

    The above site, if it ever gets working again, had awesome information that included throwing mechanics, frequency of throwing, risk factors for injury…

    With this particular post, it seems you are strongly advocating for strengthening and conditioning, which is good, but there are probably other factors to consider that would substantially reduce risk of injury.


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