I am coaching a 9U travel team and one of our coaches was told that there is a new line of thinking for young pitchers. First, he was told that the young kids should not perform the customary shoulder and triceps stretches because young kids perform them incorrectly. i.e. wrenching their arms when stretching, etc. The coach was told that the kids should still warm up, but they should not perform the stretches mentioned.
Our coach was also told that kids should not ice after pitching. Instead, they should throw lightly to cool down, but should not ice.
Can you please provide me with your thoughts and recommendations on these two points? We want to make sure we are taking the correct steps to prevent injuries in these young players.
I've been researching cryotherapy/icing (although not for any specific age) and here is some research that I've come across. Would love to hear an opinion from someone with sports medicine type qualifications.
"These results, along with the previously reported evidence for some negative effects of ice application on athletic performance, and no clear effect on muscle damage or DOMS may suggest that the use of cold packs should probably be reserved for traumatic injuries or used in combination with active recovery or massage and not with complete rest."
Dr. Gabe Mirkin who coined the term RICE (Rest, Ice, Compression, Elevation) says on his site: Healing is delayed by cortisone-type drugs, nonsteroidal anti inflammatory drugs such as ibuprofen, applying cold packs or ice, and anything else that blocks the immune response to injury. Now the treatments for an acute injury include Rest (stop exercising), Compression and Elevation (to reduce swelling), but no ice.
"In conclusion, 20 min of cryotherapy was ineffective in attenuating the strength decrement and soreness seen after muscle-damaging exercise, but may have mitigated the rise in plasma CCL2 concentration. These results do not support the use of cryotherapy during recovery. "
Post by Glenn Fleisig, Ph.D. on Feb 5, 2015 8:51:06 GMT -6
Matt & Joe,
I few years ago I surveyed the 30 head trainers in MLB about icing. I never published the results but I can tell you what I found. It was unanimous for icing the elbow or shoulder of a pitcher with a history of serious injury to that joint.
The opinions on icing pitchers without history of injury were more of a mixed bag. After talking with these trainers and people like Dr. Andrews, we concluded that icing should be one of several modalities offered by the trainer to pitchers. The feeling was that the trainers should make icing available, as some players feel it helps and others feel it has no effect. There was no concern that icing was detrimental; worse case was that it was just a waste of time.
On average, the head trainers ice the elbow of a pro pitcher for 15 minutes and the shoulder for 20 minutes.
So what does this mean for your youth players? The top thing is moderation. Try to avoid too much pitching (see www.pitchsmart.org for guidelines and suggestions). There is no harm to offer icing to the kids. Some pitchers might find that it helps reduce delayed onset muscle soreness (DOMS) while many others would find it a waste of time. Let them choose.
Now what is proper stretching and warm-up is a whole other question. If you search this forum you will find discussions about that. In general, scientific studies now show that dynamic warm up (i.e. move around and getting sweaty) is more beneficial than the old style of static stretching. If you want to talk to an expert on this, I would suggest Jim Ronai (cespeed.com/) or Mike Ryan (firstname.lastname@example.org).
My routine for post pitching was to wear a jacket or a sleeve and hang off and on from a tree limb or bleacher support by that arm for about 5 minutes. If a kid needed ice, or wanted ice, he would have the affected joint looked at and pressed on before his next participation, practice of game. This was done for players below age 14. Once they were 14 another factor came into play. As one pitcher put it to me after a game, "The chicks think icing is cool." His arm was fine and he told me so and the reason for the ice. No harm no foul.
I know this is an old topic but I'd like to chime in. The main argument against icing, other than that Dr. Mirkin has now removed it from RICE, is that it slows the healing process. Inflammation is the body's signal to start the healing process. Icing has been shown to slow this down so I tend to agree. I'm not a doctor, but I've worked in a health related field for about 12 years dealing with foot biomechanics and injury - it is a sidelight job these days though. Anyone who has a familiarity with prolotherapy might also agree. Prolotherapy is typically used for chronic pain injuries. The theory is that the body is no longer recognizing injury - the state of inflammation has become "normal". Prolotherapy introduces an irritant (typically an injection of dextrose (irritant) and lidocaine (pain reduction)) in a series of injections to re-stimulate the body's own healing process. In a similar line of thought, icing has been shown to slow this healing response. We still need good studies though.
Interesting to see this thread now. As mentioned in another thread, my son is recovering from little league shoulder. Last night he reached the step of his return to throwing program that had him use pitching mechanics from flat ground. He did his pitching after a full team practice that included a full warmup and as well as infield and outfield throwing. At the end of his pitching, I asked how his arm/shoulder felt and he said fine, but that he thought he might ice it afterward. I asked him to clarify whether he felt any pain or discomfort at all and he said no. So I told him that there was no reason to ice his shoulder. So I think I gave him the appropriate advice.