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Are Weighted Baseball Velocity Programs Safe and Effective?

Weighted baseball velocity training programs continue to rise in popularity in baseball pitchers of all levels despite us not knowing why they may improve velocity, the long term effects on the body, or the most appropriate program to perform.

Unfortunately, it seems like the trend is towards more aggressive programs every day.

The following is a summary of the 2-year research project that we have just finished conducting at Champion PT and Performance.  Myself and Lenny Macrina teamed up with Dr. James Andrews and Dr. Glenn Fleisig of ASMI to design and conduct the first study to document the effects of a 6-week weighted baseball training program on pitching velocity, arm characteristics, and injury rates.

This may be the most important research project I have conducted to date.  Weighted baseball programs continue to rise in popularity while injury rates continue to soar in baseball.  This is completely unbiased scientific research that has been conducted with sound methodology.  I actually make a living rehabbing baseball injuries, so you can assure I am sincere when I say I want to decrease the amount of baseball injuries.

I simply want to advance the game of baseball.

The injuries we are seeing at the youth, high school, and collegiate level are heartbreaking.  Collegiate and minor league baseball pitchers are having their second Tommy John surgery, which have a low success rate.  When I first started working with baseball players, Tommy John surgeries were occurring in older baseball veterans, not youth.  The severity of injuries we are seeing are significant.  Never before in my 20 year career have I seen such an enormous amount of significant injuries in baseball players.

We have presented the findings of this study at numerous conferences so far, and the manuscript is currently submitted for publication in a scientific journal.  It is currently in the running for the 2018 Excellence in Research Award by the Sports Section of the APTA.

I’ve decided to publish an initial summary because I know many people are looking to start weighted baseball velocity programs this offseason.  The journal submission and publication process can takes months or even years to finally get the information published, and I did not want to delay any further.

 

We Still Don’t Know the Science Behind Weighted Baseball Velocity Programs

There has been a recent increased emphasis on pitch velocity within the amateur and professional levels of baseball.  According to Pitch/FX data, the average fastball velocity in MLB has gone up each year since tracking began in 2008, from 90.9 MPH to 93.2 MPH in 2017.  Previous studies have shown both a correlation between increased pitch velocity and increased elbow stress and elbow injury rates.   Thus, it is not surprising that injury rates continue to increase in a nearly linear fashion with increased average pitch velocity.

This emphasis on pitch velocity has resulted in the development of several velocity enhancement programs often marketed on the internet to baseball pitchers.  These have become increasingly popular with amateur baseball players looking to enhance their playing potential in the future.  One of the most popular forms of velocity enhancement programs utilize underweight and overweight weighted baseballs.

These programs have been theorized to enhance throwing mechanics, arm speed, and arm strength, resulting in enhanced pitch velocity, despite this not being validated scientifically.

Several studies have shown that weighted baseball training programs are effective at enhancing velocity, however, we still do not understand why or the long term effect of these programs.

Thus, the purpose of this study was to determine the effectiveness of a 6-week weighted baseball training program on enhancing pitch velocity while also quantifying the effects on biomechanical and physical characteristics of the shoulder and elbow.

 

How the Study Was Conducted

Youth baseball pitchers between the ages of 13 and 18 years old were recruited for the study.  To be clear, there was one 13 year old who turned 14 shortly after, who was in the control group and did not throw weighted balls.  The majority of subjects were ~16 years old.  We just reported how old they were in year, not the months, many were almost 16 years old.  If we were to have used the month, the mean would have been about 16 years old.  We choose to use high school aged pitchers because we wanted the study to look specifically at this population, as these are the baseball pitchers that are often looking to perform a weighted baseball program due to the aggressive amount of marketing online.

38 youth baseball pitchers with the mean age of 15 years old met these criteria and agreed to participate.  Subjects were randomly divided into a weighted baseball training group and a control group.

Upon enrollment in the study, baseline measurements of shoulder passive range of motion (PROM), elbow PROM, and shoulder strength were measured for each subject.  They then underwent baseline pitching performance testing while we recorded pitch velocity, elbow varus torque, and shoulder internal rotation velocity using the Motus M Sleeve.

After the baseline testing, both groups were allowed to participate in a supervised baseball offseason strength and conditioning program.  All subjects participated in a throwing program, but were not allowed to practice pitching off a mound.

The weighted baseball group performed a 6-week weighted ball throwing program in January and February of the baseball offseason.  Throwing was performed 3 times per week.   The 6-week program was developed to be similar, if not more conservative, than commonly marketed weighted baseball velocity programs available programs for baseball pitchers.  The volume, frequency, and weight of the balls used was less than many popular programs.

Over the course of the 6-week program, throws were performed from the knee, rocker, and run and gun positions.

weight baseball velocity program

Athletes were instructed to throw at 75%, 90%, and 100% of their full intensity depending on the week of the training program.  The intensity gradually ramped up over the course of the program.  Throws were performed from each position on each training session with a 2 ounce, 4 ounce, 6 ounce, 16 ounce, and 32 ounce ball.  One set with each weighted baseball was performed with the outlined repetitions below:

baseball weighted ball velocity program

 

Many of commented about throwing 2lb balls at full intensity run-and-gun.  Two things to realize about this:

  1. We choose to include this because this is being performed in our athletes
  2. Over the course of 6-weeks, there were 540 total throws, 18 of these were with 2lb balls at full intensity with run-and-guns.  This only represents 3% of the program.  We should not lose focus on the other 97%.

The control group performed an independent throwing program using standard regulation 5 oz baseballs and were not allowed to throw with any underload or overload balls.

All measurements were repeated after 6-weeks for both groups.  The subjects went on to pitch as normal through spring and summer baseball season.

Below is a summary of the major findings of the study.  The results were eye opening for me, personally.  I feel like we have discovered why weighted baseball training programs may work, and you could argue this isn’t for a good reason.

 

Pitch Velocity Increased, But Not in Everyone

After 6-weeks, the weighted baseball group showed a 3% increase of 2.2 MPH, from 67 MPH to 69 MPH.  The control group as a whole did not show a statistically significant increase in velocity.  However, we did note that:

  • 80% of the weighted baseball group improved velocity, and 12% showed a decrease in velocity
  • 67% of the control group also improved velocity, and 14% showed a decrease in velocity

Weighted baseball training on average does help increase velocity, however, not in everyone and some people actually go down.  Many people that did NOT perform the weighted ball program also increased velocity.

 

Shoulder External Rotation Increased, Likely in a Bad Way

There was a significant increase in almost 5 degrees of shoulder external rotation range of motion in the weighted ball group.

This rapid gain in external rotation occurred over a 6-week training program and did not occur in the control group.  I have previously published my results and reported that shoulder external rotation increased from pitching, however, reported only a 5 degree increase in external rotation in MLB pitchers over the course of an entire 8-month baseball season.

While we are not able to determine the exact cause of the increased pitch velocity, based on past studies it may be from the increased amount of shoulder external rotation observed following the weighted ball training program.  Previous biomechanical studies have shown that shoulder external rotation mobility correlates to both pitch velocity, as well as increased shoulder and elbow forces.

It is not known if such a rapid gain in external rotation following a 6-week weighted baseball training program is disadvantageous or challenges the static stabilizing structures of the shoulder.  However, previous research has shown that 78% of pitching injuries occur in athletes with greater amounts of shoulder rotational motion.

 

Weighted Baseballs Do Not Increase Shoulder Strength, They May Actually Inhibit Strength Gains

One of the more interesting findings to me was that external rotation rotator cuff strength actually went up in the control group and not the weighted baseball group.

During the 6-week period, subjects in both groups were allowed to perform a baseball-specific offseason strength and conditioning program.  Strengthening of the rotator cuff, particularly the external rotators, was a specific focus of this program and has been shown to increase pitching performance.  The control group showed a 13% increase in dominant shoulder ER strength, which we were thrilled about, while the training group showed no change.

It appears that not only do weighted ball training programs not help develop rotator cuff strength, as previously theorized, they may in fact inhibit strength gains and should be further investigated.

 

Weighted Baseballs Do Not Increase Arm Speed or Strength

There were no statistically significant differences in valgus stress or angular velocity of the arm in either group.

Arm strength, arm angular velocity, and arm stress were not statistically different following the training program.  This refutes the commonly reported theories that the effectiveness of weighted ball training programs can be attributed to the development of greater arm strength or arm speed.

 

24% of Pitchers Were Injured in the Weighted Ball Group

Potentially most important to the study was the finding that 24% of those in the training group either sustained an injury during the training program or in the following season, including two olecranon stress fractures, one partial ulnar collateral ligament injury, and one ulnar collateral ligament injury that surgical reconstruction was recommended.   This is the first study to document the injury rates associated with a 6-week weighted baseball training program.

No injuries were noted in the same time span within the control group.

It should also be noted again that the weighted ball program utilized in the current study is far less aggressive in regard to the weight of the balls used as well as the volume and frequency of throwing, in comparison to many commonly performed programs.

Of note, two players of the players that were injured both exhibited the greatest amount of increase in shoulder ER PROM of 10 and 11 degrees, making this appear to be related.

It is unclear how quickly athletes gain external rotation and whether it occurs at a safe rate, and future research should attempt to answer this question. While pitch velocity may be enhanced, injury risk may also be elevated when performing a weighted baseball training program.  Future studies should continue to assess the effects of different weighted ball training program on different age groups.  We still need to find the right dosage to maximize the effectiveness while reducing the injury risk.

 

Should You Perform a Weighted Baseball Velocity Program?

Based on the results of this study, it appears that weighted baseball training programs are effective at enhancing pitch velocity, but the question is, at what cost?

It is still unknown why velocity goes up.

Since arm strength and speed were not changed after the training program, and Dr. Glenn Fleisig of ASMI has shown no change in mechanics, the increased pitch velocity observed may be related to this gain in shoulder external rotation motion.

This is alarming to me, as I feel this may also at least partially explain the increase in injury rates.  This is not natural.

 

Who May Want to Perform a Weighted Baseball Program

Realistically throwing any baseball, even a standard 5 oz baseball, has an inherent amount of risk.  I, in fact, actually including weighted balls at times in both our rehabilitation programs and our Elite Pitching Performance Program at Champion.

However, we do them in a very controlled fashion with less volume, intensity, and weight.  We perform 4-7 oz throws with many of our athletes, however we have strict criteria to do so, that includes:

  • Full skeletal maturity
  • Efficient throwing mechanics
  • Baseline of strength and conditioning (usually a year or more of training)
  • Baseline of arm strength and dynamic stability (usually a year or more of training)

Essentially you need to be mature and developed enough to withstand the stress of these programs as well as justify the need to push the limits.  Weighted baseball programs should not be where you begin when developing pitching performance.  If you skip any of the above steps and jump straight to weighted baseballs, you are focusing on the frosting before you even baked the cake.

For you to use lighter balls, heavier balls, or aggressive run-and-gun drills, you need to be even more advanced.   Few will meet this criteria.

There are many people that are willing to accept the increased injury risk, especially older baseball pitchers that are trying to make it to the next level.  Weighted ball programs may be an effective option for you in this case, especially if you have maximized your throwing mechanics, strength and power development, and arm strength and dynamic stability.

Unfortunately, most baseball pitchers I meet have not done so.

 

Who Probably Should Not Perform Weighted Baseball Training

While some older baseball pitchers may be willing to accept this risk in an attempt to extend their career or take their game to the next level, it’s difficult to recommend most others perform an aggressive weighted baseball training program.

I’m not talking about warming up with a few light throws with a 6 oz ball, I’m talking about an aggressive several week- to month-long program with aggressive intensity using underload and overload balls.  These are the videos that are being sensationalized on Instagram so much.

Because it appears weighted baseball training programs are likely effective by pushing your physiological limits, they should be reserved for those that have maximized their potential and have again achieved our criteria of:

  • Full skeletal maturity
  • Efficient throwing mechanics
  • Baseline of strength and conditioning (usually a year or more of training)
  • Baseline of arm strength and dynamic stability (usually a year or more of training)

Basically, if you are still growing, have inefficient mechanics, haven’t been training in a weight room for a significant amount of time, and have never performed an arm care program, you’re not prepared to perform a weighted ball program.

Plus, I can show you several scientific studies that show different training programs and arm care programs can be just as effective, if not more, at gaining pitching velocity without the inherent risk.

We can’t just be jumping to the quick fix.

The problem I am seeing is that we are using weighted ball programs with everyone, regardless of age, mechanics, training level, and injury history.  This and the fact that we continue to try to push the limits and get more aggressive.  If a 16 oz ball works, than a 32 oz ball may be twice as effective.  This is simply unrealistic and unsafe to think this way.

More is not better.

I’ve talked about this before in my article, “Are Baseball Velocity Programs to Blame for the Rise in Pitching Injuries?”  We are overdosing.

I think the most scary trend I am seeing in baseball right now is the blind use of generic weighted baseball programs.  This includes people buying a random program on the internet, or worse, a baseball coach starting one generic program with all players on the team.

We’ve seen college teams with 4+ Tommy John surgeries with their players in one season, this was unheard of just a few short years ago.

We need to make the adjustment.

Weighted ball programs must be individualized, monitored, and implemented progressively.  If you can’t do this, you shouldn’t be using them.

Not everyone is appropriate for weighted baseball programs.  Many players that are currently performing a program probably shouldn’t be doing so, especially if they haven’t established a proper foundation of strength training, arm care, and physical maturity.  In fact, at Champion, we have found that stopping weighted ball programs in those that are not ready for this stress has resulted in an even bigger gain in velocity after we have focused on foundational strength training and arm care programs.

 

Call to Action to Everyone in Baseball

I need your help.

We need to get this information out there so we stop seeing so many injuries in baseball pitchers.  Baseball players, parents, coaches, and even rehabilitation and fitness specialists that work with baseball players need to understand the science behind weighted baseball training programs.

Yes, velocity goes up, but at what cost?

Based on this study, weighted baseball training does not change mechanics, increase arm speed, or increase arm strength.  In fact, they may inhibit strength gains.  They do stretch out your shoulder in a potentially disadvantageous way and lead to a 24% chance of injury.  1 in 4 players sustained an injury.  Are you willing to accept that risk?

Once you understand the science, you can make a more educated decision if using weighted baseballs is appropriate for you.  And if you do, how to safely and effectively choose to use these programs on the right players at the right times.

Please share this article with anyone that you feel shares our goal of advancing the game of baseball.  I feel that many baseball players, parents, and coaches simply are not aware of the science.   The more we can share the science, the better we can become.

We need to get better.  We need to accept the science.

 

 

The New Alternative to Tommy John Surgery – UCL Repair with Internal Brace

The baseball world has been buzzing regarding a potential new surgery to repair the Tommy John ligament, rather than the traditional reconstruction, that has the potential to reduce the time to return from surgery.

The new procedure involves repairing the damaged ligament and reinforcing it with a collagen-coated fiber tape in contrast with the traditional UCL reconstruction that involves drilling tunnels in the bone and using a graft from a tendon in your arm or leg.

UCL Repair with Augmentation and Internal Brace

 

The new UCL repair with internal brace is less invasive and offers hope that the new procedure can reduce the time it takes to return from surgery while providing similar effectiveness of the traditional procedure.

 

UCL Repair and Augmentation with Internal Brace

The following presentation by Dr. Jeff Dugas from ASMI in Birmingham, AL, discusses the procedure, early results, and what we currently know about the procedure.  Dr. Dugas is one of the pioneers of the new procedure.

The following video is just one of the many amazing presentations from the 2017 ASMI Injuries in Baseball Course, which is now available online through Elite Baseball Performance:

 

Is The New Procedure a Miracle?

The mainstream media has been calling the new UCL repair with internal brace procedure “the next miracle,” but like everything else, we need to take what we read in the media as entertainment, not fact.  The media loves to sensationalize a topic, and this is no different than what is occurring with the new procedure.

The truth is that this procedure is still new, although promising.  Results are coming in and have been satisfactory to date, but realize that very strict patient criteria has been used so far to date.  We do not have a very large sample size of higher level baseball players just yet, though they are coming.

Furthermore, we do not have long term data.  Short term data appears promising, but we have a saying in scientific research, “if you want to report good results, just look at short term data.”  We don’t know the longevity of these repairs and if they prove to be as reliable and durable as UCL reconstruction.

So until we have a larger sample of data and a longer follow up time to analyze the effectiveness, the procedure should still be considered experimental at this time.  The traditional Tommy John procedure, which is more invasive and reconstructs the UCL ligament, is still the current gold standard with decades of research supporting it’s effectiveness.

 

Who’s a Candidate for The New Alternative to Tommy John Surgery?

While the traditional Tommy John reconstruction will likely remain the gold standard for some time, there are some people that may be great candidates for the new alternative UCL repair with internal brace procedure.

Younger baseball players with open growth plates can not perform the traditional procedure as it involves drilling of the bones in the arm and may impact the growth plate.  Baseball players with strict timelines, such as a college or high school baseball player going into their senior year, may also be good candidates.  Other athletes, such as gymnasts, football players, and those that have had a traumatic injury to the UCL may also be good candidates.

 

Who’s NOT a Candidate?

I recently spoke with Dr. Dugas about this exact topic.  As he has gained more experience with the procedure, we’re getting better at determining who is NOT a good candidate.

It really comes down to tissue quality.  If you have been wearing your ligament down for some time with past episodes of elbow pain or even ligament sprains, the tissue quality is probably not good enough to support the repair.  In addition, if you have boney changes in your ligament, such as ossicle formation from chronic stress and past injuries, the tissue quality is likely not adequate enough to support the procedure.

In fact, Dr. Dugas told me he is going into these procedures telling the patients that they may wake up and have had the full Tommy John reconstruction.  When they get in the elbow, they may feel the tissue quality is too poor.  But with time and experience, they are finding they are doing well figuring this out based on the x-rays and MRI prior to surgery.

At this time, I am personally finding it hard to recommend this new procedure for most baseball players.  I’m never a fan of adopting newer or experimental procedures when a option with good results and reliability exists.  The traditional Tommy John procedure is still my first recommendation for players that wish to continue their career development.

I hope in the future my opinion changes, as the hope of returning pitchers to baseball sooner than a traditional Tommy John procedure is exciting.

I do believe this is just the beginning.  New procedures, techniques, and biological advancements will emerge and our management of baseball pitchers with Tommy John injuries should only continue to improve.

 

2017 ASMI Injuries in Baseball Course

ASMI Injuries in Baseball 2017EBP has just released an online version of the 2017 ASMI Injuries in Baseball Conference, featuring world renowned speakers such as Dr. James Andrews, Dr. Glenn Fleisig, Kevin Wilk, Mike Reinold, and several MLB team physicians, athletic trainers, and strength coaches.  This is the premier conference for baseball related injuries and performance enhancement, with topics detailing pitching biomechanics, baseball specific functional anatomy, clinical examination, surgical management, injury rehabilitation, and performance enhancement for baseball players.

The course contains the most cutting edge information from the leaders in baseball sports medicine, including the above presentation by Dr. Jeff Dugas.

The ASMI Injuries in Baseball Conference has been on sale this week for $100 off, but there are only a few days left to save!  The sale ends Sunday June 25th at midnight EST.  Click the button below to learn more.

 

 

10 Things You Need to Know About Tommy John Injuries

Tommy John InjuriesTommy John injuries continue to rise throughout baseball, from youth through the professional level. The best decade has seen a dramatic increase in Tommy John injuries, and also an increase of youth injuries seen.

When I first started as a physical therapist working with baseball players, we rarely saw youth athletes need Tommy John surgery, and the professional players that had the surgery were older in general.

We have learned so much over the years, but we still can’t stop the rise in injuries as players continue to push themselves past their limits.

It’s not rocket science to figure out why Tommy John injuries occur. Just like any other injury, Tommy John injuries are a result of tissue overload.

It’s really that simple.

But too much stress on a structure and it will become injured. It’s just an overuse issue. But overuse doesn’t just mean pitch count. Overuse is an equation of intensity, duration, frequency, and load:

  • Intensity – we are throwing with more velocity
  • Duration – we are throwing longer throughout the year, with less time off
  • Frequency – we are throwing more frequently with multiple leagues, teams, and showcases
  • Load – we are throwing with over- and under-load weighted balls

 

While any of these variables can lead to overuse, we tend to see athletes push each of these to their limit, which significant escalates overuse.

To fully understand how to prevent Tommy John injuries, I’ve written two detailed articles in the past that every player, parent, and coach need to read.

 

5 Myths of Tommy John Injuries

The first article is my article describing the 5 Myths of Tommy John Injuries.

Dr. Chris Ahmad, of the New York Yankees, recently released a paper asking players, coaches, and parents about their perceptions regarding Tommy John surgery.

The authors report that players, parents, and coaches all believed:

  • Performance would be enhanced by having Tommy John surgery.
  • Velocity increases after Tommy John surgery.
  • Return from surgery would occur in less than 9 months.
  • Tommy John surgery should be performed on players without elbow injury to enhance performance.

 

You read that last one right… Amazing.

If we are going to start improving Tommy John injury rates, we need to start dispelling these myths.

 

5 Reasons Why There Are So Many MLB Tommy John Injuries

While many have speculated about the reasons behind the rise in Tommy John injuries, I wanted to share my perspective as someone that has worked with 1000’s of healthy and injured players from Little League to Major League Baseball.

If what I wrote in this article is correct, we should see Tommy John surgeries increase even more over the next decade.

We need to be honest about the culture of baseball development now and admit to ourselves that we are overdoing it. And if we do so, we can start to reduce injury rates.

 

Help Reduce Tommy John Injuries

Please, I urge you to share this article and help.

Without a proper understanding of the situation, we’ll never reduce Tommy John injury rates in baseball. We must dispel common myths and we must take a hard look at the potential reasons for all these injuries.