36X More Likely to Blow Your Elbow. Whaaaat?

What is Fatigue? And why is it 36X’s more likely to cause elbow injury? Read on my friend. It’s time to nerd-out over arm care and injury prevention. Some eye-popping statistics to get in front of here.


I often quote Eric Cressey. His stuff surrounding performance training for athletes… baseball players… and pitchers specifically is legendary and I’m completely on board his bandwagon.  A recent podcast of his featured Ben Hanson, a VP at Motus Global. Motus is the company that makes an arm sleeve loaded with sensors to track data etc. The result of all that data? Crazy awesome info and recommendations on how best to manage and protect arms. I had to pull over several times to take notes, and highly recommend a listen. It’s a bit technical, but absolutely loaded with good info. Next time you are driving and need to feel productive, take a listen HERE.

Here are some highlights I pulled from the podcast:

  • Mechanics may not be as important to injury as we may have thought. While they are crucial to producing and maximizing power, the data Motus is compiling continues to defy some widely accepted mechanical no-no’s (listen for description of the “Strasburg Inverted W”, and the “Tommy John Turn”). Now, don’t take that too literally! Of course mechanics are vitally important, and especially so for younger pitchers that lack any sort of foundation. That said, Eric and Ben gave me a bit of an exhale in describing the lack of correlation between specific mechanical flaws and significant increases in injury risk.
  • Manage your athletes volume – You NEED to responsibly track how much your athlete is throwing. Here’s why:
  • A 10-year ASMI study showed the following about rates of injury:
    • If you throw more than 100 innings per year, chances of injury increases by 3.5X’s.
    • If you throw more than 8 months per year, 5 X’s more likely to get injured.
    • If you throw when “fatigued”, 36X’s more likely to experience injury

Whaaaaat? 36X’s more likely to have an injury if you pitch when fatigued?!?!? Well then, what is the laymen’s explanation for pitching when fatigued. Well, let’s start by emphasizing the first two bullet points: If you have pitched more than 100 innings in the last calendar year, you’re moving towards fatigued Likewise, if you haven’t had an extended break in the last year then you are playing with fatigue-fire. Here are some other (really common) examples off the top of my head:

  • If you’re pitching in the fifth game of a single weekend, you’re likely approaching the fatigue zone.
  • If you threw 30 pitches yesterday, and you’re toeing the rubber today… say hello to my little fatigue-friend.
  • If you closed on the mound in the first game, sat down and ate a sandwich, and then started the next game on the bump… fatigue is riding on your shoulders.
  • If you warmed up Friday (and didn’t pitch), warmed up on Saturday (and didn’t pitch), and are now 75 pitches in to an outing on Sunday… this could be the fatigue zone. Especially if you’ve this for each of the last four weekend series.

Here was the best line I stopped to write down:

“Fatigue and overuse are two tried and true predictors of injury. If you do too much and do it in a state of fatigue, you are at risk. The other factor that really affects risk is previous injury. Those athletes need to be very, very conscious of fatigue and overuse.”

So I’ll quote myself again now:

“Manage your athletes volume. You NEED to responsibly track how much your athlete is throwing.”

And some other great takeaways I intend to think longer about:

  • PreGame Bullpens – Shorten these. With a conscious respect to each individual’s routine, I am going to think about encouraging my guys to cut down the number of pregame pitches thrown.
  • When to break – Cressey and Ben discuss the high school and college and pro calendars in an effort to determine when to break. It’s an interesting discussion and brings into light summer ball, fall showcases, and especially the winter break.
  • Winter Break – To expand a little further, the data may suggest than taking a short break might actually NOT be the best thing for long term arm care. While an extended break is good, a shorter break followed by an aggressive ramp up may not do the benefit that we thought.

Shoot, that brings up another tangent to discuss…


If you haven’t yet stopped playing baseball, it’s time to take a look at the calendar.  How and when are you going to get 8-12 weeks of no overhead throwing? Pro guys take that much time off, why wouldn’t a high schooler? Let’s let Cressey speak on the topic, he’s the duuuuude: Cressey on Rest.  And if you tell me that your kid just loves to play so much, I’ll drop the response: “Okay, well your kid loves pizza. You gonna eat let him it all-day-every-day?” Keep that love, that fire, that want to play by forcing a break.

And what about that discussion on short breaks!?  I, for one, have been big on trying to sneak in a break in and around the winter holiday. This may not be the best for our pitchers! I need to listen again to more fully understand what the data showed, but my takeaway notes say that I need to review the concept of a break between fall ball and spring season. I would recommend doing the same… but only if you are a pitcher, that throws pitches, at a high rate of effort, and does that a lot.

  1. Manage your athlete’s volume – You NEED to responsibly track how much your athlete is throwing. The first step is simply knowing how much your stud is pitching. Then, you can move closer to #2 below.
  2. Set Rules – With respect for all, set some bright lines for your pitcher. In addition to following pitch count regulations, work with a respected and knowledgeable coach to set and communicate rules for your pitcher. Example: No throwing in back-to-back days. “Hey Mister Coach, you can use me… but you got one shot. Once I’m hot, let me go!”
  3. Pitch Counts are great, but we’re not there yet – While pitch counts have been great to push arm-protection forward, they are not the solution. Example: It is likely much better for a physically prepared pitcher to throw 75 pitches in a single day, than to throw a combined 75 pitches over two back-to-back days in an effort to stay under competitive pitch count laws. In this era of tournament play, and the need for a club coach to win… this is extremely relevant and supports #2 above.
  4. Take an extended break – Ahem. That break time is right around now. If you haven’t taken a break from spring ball to now, then you need to look at the calendar and mark off the dark / non-throwing weeks.

Play hard, have fun, and get some rest.


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