By David Hill
David Hill is an Assistant Editor at Coaching Management.
Coaching Management, 9.7, October 2001, http://www.momentummedia.com/articles/cm/cm0907/pitch.htm
Many say that to be a pitcher takes a certain mentality. Hurling pitch after pitch at a batter just 43 feet away requires fearlessness, focus, and attitude.
But, in many high school and college softball programs, pitchers are also asked to possess one more quality: the stamina of a workhorse. If a pitcher is good--much better than the number two and three choices--she may be asked to pitch game after game, with little more than an ice pack thrown in for good luck.
Some pitchers can do this and even revel in it. Some grit their teeth and bear it. Others find themselves in the doctor's office diagnosed with an overuse injury.
Why can some pitchers handle lots of innings and others can't? Much of it has to do with their preparation: their preseason training, their mechanics. And a lot has to do with their coaches' understanding of overuse injuries, including the warning signs.
The conventional wisdom appears to be true: The underhand pitching motion of fast-pitch softball, though whip-like and vigorous, is far more natural than the overhand baseball pitch and puts less strain on the elbow and shoulder. But there is also much less research on the softball pitching motion and its related injuries.
In this article, doctors and coaches share their advice on how to get the most out of pitchers without making them susceptible to arm and shoulder injuries.
A Pain in the Arm
While softball pitchers are not as injury-prone as baseball pitchers, they can still suffer overuse injuries if the proper precautions are not taken. Since softball pitchers are often able to pitch complete game after complete game, even two on the same day, it can be easy to overlook the wear and tear they face as the innings pile up.
"Pitchers are not like plow horses," says Dr. Alvin Loosli, a sports-medicine orthopedist based in San Francisco and lead author of one of the few studies on fast-pitch softball pitcher injuries. "They're far more like racehorses, and if you overuse them, they'll break down."
In 1989, Loosli and colleagues at the Saint Francis Memorial Hospital Center for Sports Medicine in San Francisco surveyed athletic trainers from eight NCAA Division I playoff teams. The 24 pitchers on those teams averaged 139 innings that season, with a maximum of 240 innings. Twenty of those 24 pitchers reported 26 injuries or complaints, 17 involving their arms. Twenty-one of the injuries had a gradual onset (rather than a one-time occurrence like a bruise) such as tendinitis, biceps strain, finger and thumb sprain, strain of the shoulder muscles, and ulna nerve damage in the elbow.
Though 12 years old, the study remains one of the few to scientifically inventory softball pitcher injuries. Today, Loosli says he is seeing an increase in overuse-related complaints of pain in the wrists, elbows, and shoulders of high-school-age softball pitchers.
Loosli believes there can be many factors that contribute to pitchers' overuse injuries. One is their development and conditioning, which means a reasonable amount of work for one player may be extreme for another. Second is mechanics--a coach who is not qualified to judge whether a pitcher is using proper mechanics may not see the beginning stages of overuse. Third is a lack of knowledge about how the body is interconnected--a pitcher who suffers a non-pitching injury (hurting her leg, sliding or straining her back, for example) may compensate for that injury and end up damaging her pitching arm.
Loosli is also concerned that pitchers may consistently rely on ibuprofen and other painkillers to get through a game. In the late '80s, he learned that all of the pitchers on the University of California's softball team were taking Advil three times a day just to be able to pitch. If a horse trainer masked a sore hoof like that, he says, the hoof would get torn up from use.
Therefore, coaches must thoroughly understand that overuse can hurt pitchers. Ice packs and massage can only go so far in lessening the damage caused by an overworked shoulder, and coaches need to be in tune with how to prevent and recognize overuse injuries.
Connections
Understanding pitching injuries starts with understanding the pitching motion. Although it looks like the arm and shoulder muscles do most of the work, almost every muscle in the body is used during the pitching motion. The key areas are the core, leg, and shoulder muscles.
Core muscles include the hip, stomach, and back muscles, and they need to be strengthened before anything else, according to Strength and Conditioning Specialist Vern Gambetta, President of Gambetta Sports Training Systems, in Sarasota, Fla. "The most important link in the functional chain is the core," he explains. "It is where all movement begins. A well-developed core allows for improved force output, increased neuromuscular efficiency, and decreased incidents of overuse injuries."
Leg and shoulder muscles are also critical. Strong legs provide power and endurance to a pitcher while strong shoulders provide control.
And shoulder muscles are also critical to slowing the arm after the ball is released. "The pitcher winds up, lets the ball go and then within a yard, the ball and the hand are going 60 miles per hour," says Loosli. "The hand has to decelerate from 60 to zero in about three feet. That deceleration comes from the back rotator cuff muscles, the back muscles in the shoulder beneath the shoulder blade. If it weren't for those muscles the arm would go to home plate with the ball.
Preseason Work
At Florida State University, which had the lowest NCAA Division I earned run average this past year (a three-woman staff allowed only 48 earned runs in 70 games for an ERA of 0.71 without any pitching-related injuries), injury prevention begins well before the first pitcher takes the mound. "Preseason is really where you start the whole process," says Florida State Pitching Coach Heather Compton, a first-team All-American at UCLA in 1991 and a pitcher in the Women's Professional Softball League. "Our pitchers have different programs from the rest of the team. They work harder in the fall and less in the season as far as training."
Working with Florida State Assistant Strength and Conditioning Coach Janna Walkup, Compton has developed a preseason program for pitchers that stresses cardiovascular endurance and leg strength more than the program followed by position players. "The pitchers might do the same workouts as the rest of the team, but then they might go for a two-mile run above and beyond that with me," Compton says. Besides running, preseason endurance training for the pitchers involves Stairmaster workouts, bicycling, swimming, and aqua running.
Compton and Walkup want to teach players how to pitch while tired. "The point is learning to use your legs instead of your arm, because when you use your arm alone you hurt yourself," Compton says. "If you're not used to using your legs and don't have strong legs, when your body gets tired you go to bad mechanics and overuse your arm. That's really how you hurt yourself."
Florida State pitchers also strength train their core three days a week with exercises for the abdominals, hips, and back. "That's where all the movement comes from," Walkup says. "If we couldn't do anything else, we would do that.
"As far as shoulder work, the upper-body lifts primarily are unilateral so they don't do both arms at the same time," says Walkup. "We don't want one side getting stronger than the other. That's another cause of injury."
Flexibility work is also included, with the focus on pitching-specific stretches. Surgical cords and bands are ubiquitous--each pitcher has her own and clips it to the fence for across-the-arm and above-the-head stretching before and after each practice. It's a routine that continues through the season and before and after games, Walkup says. The hip flexors also receive special attention.
Seminole pitchers also take to the pool to work on their upper-body strength. Compton briefed Walkup on the windmill pitching technique so that the pitchers could get the most from their water workouts.
"They want the pinkie to come right beside them when they're throwing the ball," Walkup says, "so when they do the backstroke, we want their pinkie to come in first. We ask them to really think about their pitching technique when they are doing the backstroke."
While pool work might not be feasible at all levels of competition, coaches elsewhere describe otherwise similar preseason programs. "Our program is simple and basic," says Damian Williams, Head Coach at Williamette University, the NCAA Division III ERA leader in 2001 at 0.76. "In the off-season, our pitchers throw about twice a week for an hour and they do a lot of exercises with lifting and long toss to strengthen their throwing arm and body. If they're pitching correctly, they're using a lot of body and not much arm at all."
At North Eugene (Ore.) High School, which has sent several pitchers to top collegiate programs, "we'll start in October and not let them touch the ball," says Head Coach Mike Jodoin. "We try to do a couple months of weight lifting and aerobic training before we start doing anything with the softball."
While the importance of a strength and conditioning program is not disputed, coaches do point out that choosing the correct exercises takes special care. University of Washington Head Coach Teresa Wilson stresses shoulder work that focuses on strength and flexibility, not bulking-up. In addition, weight workouts are done in conjunction with throwing to keep shoulders and arms loose.
"Muscle mass in the shoulder area will equate to tension, and that decreases arm speed," says Wilson. "Rather than doing your typical bench presses and behind-the-neck presses that would make the shoulder area bulkier, we go for strengthening. Each pitcher has a full Theraband workout that she does."
Once the season starts, workouts focus on maintenance. Compton strives for twice-weekly weight workouts at Florida State but often settles for once a week.
She also insists that her pitchers take one day off each week, but not the day before pitching a game. Compton says she found she had control problems herself the day after a complete day off. Workouts the day after pitching are mandatory, but moderate, with an emphasis on stretching.
Mechanical Fine Points
Another key to injury prevention is proper mechanics. Jodoin, for one, won't let a pitcher get much playing time until she perfects her technique.
"I had a younger pitcher this year who was throwing more sidearm and bringing her arm away from her body," says Jodoin. "It was putting too much stress on her shoulder. Sometimes you have to work on technique and cut down the amount of time that they're throwing until they start doing it properly."
So what does it mean to have good mechanics? What should coaches look for?
Each player has her own style and each coach his or her own approach. The windmill has nearly completely replaced the half-circle slingshot technique, but each player has an individual style and each coach a guiding philosophy.
On the release point, for instance, Florida State's Compton extols releasing right at the hip, where the arm hangs naturally. Some pitchers may release fastballs, breaking pitches, and change-ups at slightly different spots.
Washington's Wilson says she teaches that the ideal release is a little forward, somewhere between right at the hip and the knee of the landing leg, so long as the legs are flexed properly and the head is up to avoid pitching high.
Some coaches and pitchers stress a stiff landing knee and ending up in a Figure 4 or "pro bowler's stance," with the trailing leg up in the air behind the front leg, but Wilson says that's a sign of imbalance. Instead, she believes, the knees, hips, and shoulders should be in alignment, facing the catcher, in a ready-to-field stance.
There appears to be, however, consensus on certain key points:
€ The arm makes a full, perfect circle, hence the name of the windmill technique, and remains in the plane toward home plate. There should be no short-arming, which looks like curling the biceps.
€ As the pitcher strides toward home and the arm begins its descent, the hips should face third base for right-handers and first for left-handers, then close to face the plate upon release.
€ The knee of the landing leg should be firm but flexed. "People talk a lot about pitching off of a firm front side," Wilson says. "So pitchers mistakenly define that as 'When I land, I want my stride to be locked up'. That creates a pole vault effect. The body then gets shaken to a drastic halt."
€ Wherever the release point, it comes with a vigorous snap of the wrist.
The dominant thing to look for is efficiency, says Wilson, who adds that in 15 years, she's never had a player hurt from pitching. And a tip-off to efficiency is whether all the motions are on the same line of force--like a car with wheels properly aligned.
"If a right-handed pitcher draws a straight line from where her right leg is on the rubber to the catcher, that's the line of force," Wilson says. "If her stride leg does not land on that line of force, then she's not going to get her hips and legs in a good position to execute a pitch.
"If she stays on that line of force, and in a flexed position," she continues, "then she exacts longer levers at the point of release and gets more out of the pitch with less stress on the arm and with more utilization of the legs and the hips."
Norm Findt, Head Coach at North Ridgeville (Ohio) High School and president of the Ohio High School Fastpitch Softball Coaches Association, says pitchers can test their technique by seeing how far they can throw. Michelle Smith of the U.S. Olympic team, he says, can pitch a ball from the center field fence to home plate--possible because she has impeccable technique with little wasted effort.
Communication & Trust
Once the season gets going, coaches say injury prevention depends on balancing the maintenance of the preseason conditioning and muscle memory while avoiding fatigue. Coaches need to communicate with their pitchers and any athletic training and conditioning staff at their disposal. Most important, coaches need to heed signs of overuse.
Most pitchers will never admit to being tired, so the coach has to be judge and jury. In practical terms, that means looking for warning signs during play:
€ Is the pitcher effective?
€ Is she controlling her pitches, placing them, popping the catcher's mitt, and making breaking balls and off-speed pitches work?
€ Are otherwise sound mechanics failing?
"If I feel my pitcher is losing some velocity and she's not able to do the things she was doing earlier in the game, I would pull her and use my other pitcher," Findt says. "I think it's between you and your pitcher. As a coach you have to know what she's capable of doing."
Perhaps most important is communication. At the University of Utah, an unexpected departure of another pitcher meant junior Kristin Arbogast would have to handle most of the load in 2001. Despite extra preseason strength and flexibility work and good mechanics, she eventually developed shoulder inflammation.
"She tried to keep it from me," says Utah Head Coach Mona Stevens. "So, you've got to have a good enough relationship with your pitchers so that you can say to them, 'Look, if you're injured, you've got to be honest with me. I want to get you back as quickly as we can. If you hide an injury, you're going to end up getting more hurt and it's going to take longer to recover.'"
Wilson concurs. As a player, she says, she never took herself out of a game. But as a coach, she stresses the big picture to her pitchers: Take care of it now, or you won't finish the season--and your career might end. It takes some maturity on the part of the player, Wilson says, but part of the coach's job is to put things in perspective.
For Compton, trust comes from showing players that you will take care of them and letting them know what's going to happen if they do get tired, sore, or hurt. She also says that keeping pitchers healthy involves regular communication among the coaching, athletic training, and conditioning staffs.
"On the first mention of any pain," says Compton, "I tell them to go see the athletic trainer. I talk with the athletic trainer to make sure they did. I also talk to the strength coach and say, 'Hey, she's hurting, so we might not want to do any exercise on that muscle this week.' It's done that instant. Within two hours of them telling me, everybody knows what's going on and we're taking care of it.
"A big part of being a coach is getting to know your players, seeing it on their faces, seeing how they're moving, seeing how they warm up," Compton continues. "Some days their pitches are popping, and other days they're really tired. So you have to know when to push them through that workout and when to lay off."
sidebar:
Three Is Key
One way to avoid overuse of pitchers is to develop some depth at the position. Two starters and a reliable reliever will work for most programs, says Teresa Wilson, Head Coach at the University of Washington.
While there are some coaches who've left a pitcher in simply because they had no one else who could get the ball over the plate, most coaches warn against that practice.
"I wouldn't like to go into a season with just one quality pitcher and have her do all the games," said Jeanne Tostenson, Head Coach at NCAA Division II 2001 national champion University of Nebraska-Omaha. "At some time, she's going to experience some wear and tear a little through the four years. At this level we have three pitchers, and two of them are quality ones who we've been constantly switching."
"The third person is important," says Damian Williams, Head Coach at Willamette University. "A couple of years ago, when we led the country in saves, we would bring in a third pitcher when the game was out of hand and we'd let her get in a couple innings and pick up the save. If we're playing an important game on the weekend, we'll let our third pitcher pitch during the week. That way, we know our number one and number two are well rested."
sidebar:
Counting Pitches
Although popular in baseball, limits on the number of pitches thrown in a game or competitive innings pitched in a week have little support from softball coaches. What's more important, they say, is adequately preparing pitchers and knowing them well enough to see when they need a break.
"It's a tool, but it's not one I would put a lot of weight on," says University of Washington Head Coach Teresa Wilson. "I still go by the way a pitcher feels and is performing. As pitchers get tired, fundamentals start to break down. You just call it quits then."
If there's a time to count, however, it's during early preseason workouts and during rehabilitation from an injury. "During preseason I will put a pitch count on my pitchers because they may not have been pitching a lot leading up to the actual preseason," says Norm Findt, Head Softball Coach at North Ridgeville (Ohio) High School. "Most of the time those kids are also playing another position and I'm trying not to wear them out going into the start of the season."
Heather Compton, Pitching Coach at Florida State University, counts pitches in preseason and in-season practices. A full in-season workout, say two days before a start, might consist of 160 pitches, a medium one is 80 to 100, and a day-before could mean 20-30 pitches, as if they were warming-up to enter a game. A key point, Compton adds, is to match the level to the player's current needs and condition, which can include non-softball factors.
"During finals week, I'm a lot easier on them because they're already fatigued from being up late and studying."