Dr. Michael Ciccotti
Friday March 13th, 2015

This is the second in a series of sports medicine articles from the Rothman Institute. Series editors are Rothman doctors Richard H. Rothman, MD, and John A. Anderson, MD.

As the winter chill starts to thaw and spring approaches, players of all ages are getting ready for baseball. No matter what level, it’s essential that all players pace themselves and condition their bodies with a structured preseason program. This requires much more than just picking up a ball and letting it fly or taking several swings with the bat. Baseball is an extremely complex activity that requires the entire body be in ideal shape.

Studies show that the act of throwing a ball and swinging a bat involve an elaborate chain of events with energy being created at the ground level, transmitted through the legs, hips and core muscles and then finally through the upper extremity to the ball or bat. These research studies indicate that a focused, balanced, whole body preseason program can enhance performance and may even help an athlete avoid baseball injuries.

This program consists of several basic components that include flexibility, strengthening, aerobics and sport-specific training. Let’s take a look at each one individually.

  1. Flexibility training: This includes gentle stretching of the upper and lower extremities and trunk, with particular focus on the throwing arm. These stretches should be performed in a slow, sustained, and non-ballistic manner. Special attention should be placed on shoulder internal rotation. Some research has suggested that deficits in shoulder internal rotation may predispose to throwing injuries. This flexibility training should be performed a minimum of three times per week.
  2. Strength training: Muscle strengthening with low weights and higher repetitions will aid strength without resulting in the decreased flexibility seen with too much muscle mass. This balance between appropriate strength and flexibility is essential to the throwing athlete. Biomechanical studies of baseball indicate that this strengthening program should include the entire body with a focus on the upper and lower extremities and core. Upper extremity strengthening should include rotator cuff exercises as well as scapular stabilizers such as shrugs and push-up plus maneuvers. Strong lower extremities create the foundation needed to throw and bat effectively and safely. Appropriate leg exercises include leg press, quadriceps extensions, hamstrings curls, lunges and squats. Strengthening of the core musculature including abdominal and back muscles is key in the throwing athlete. Such exercises as crunches, sit-ups and ball exercises are beneficial. Recent studies have indicated the importance of core stabilization for the healthy baseball player. This strengthening program should be performed three times per week in coordination with flexibility training.

    Dr. Ciccotti works with players from the Philadelphia Phillies.
    Dr. Ciccotti works with players from the Philadelphia Phillies.
    Courtesy of Rick Cushman/Rothman Institute

    ​3. Aerobic training: Cycling, running and elliptical machines are all excellent aerobic exercises. Not only do these aerobic activities improve cardiovascular and respiratory endurance, but they also enhance the musculoskeletal endurance that is essential for elite baseball players. This aerobic activity should be gradually increased over several weeks aiming for 30-45 minutes at a time. It can be performed on the same or alternate days as flexibility and strength training.

  3. Sports-specific training: Every ballplayer should prepare by reviewing all the proper techniques of the game. This may be best reviewed with a knowledgeable coach or trainer. This training can be performed on non-strengthening days. The baseball specific training protocols include:
    1. Tossing Program (Short Toss/Long Toss) – All ballplayers will benefit by a progressive tossing program. This includes playing catch with a teammate and progressively increasing the distance of throwing from 30 feet to 200 feet.
    2. Pitching Program – Once completing the tossing program, pitchers then proceed to a pitching program where they throw fastballs first with increasing effort, then followed by off-speed pitches. This can be done on flat ground followed by throwing from the pitcher’s mound.
    3. Base Running – All players benefit by re-acclimating to running the base paths. This is truly different than straight ahead sprinting or interval training.
    4. Situational Training – All players will profit by reviewing some of the split-second decision-making that occurs with various baseball situations (i.e. – bunting, base-stealing, tagging up, double-plays, etc.).

[daily_cut.MLB]Time-tested principals and research shows that a preseason conditioning program is essential to the health and success of any baseball player. Success does, however, require focused effort on the part of the ballplayer, regardless of age or level of play. Youth ballplayers will especially benefit by this type of structured program. If a player is recovering from an injury or surgery, then a sports medicine specialist should be consulted before safely progressing in this type of program. By applying these principles, players will be optimally prepared for all that comes with spring … and the start of baseball.

Dr. Michael Ciccotti is director of the sports Medicine team at the Rothman Institute and internationally recognized for his work in sports medicine. He is a Professor of Orthopaedic Surgery, Chief of Sports Medicine, and Director of the Sports Medicine Fellowship and Research at Thomas Jefferson University. He serves as head team Physician for the Philadelphia Phillies and Saint Joseph’s University as well as senior medical consultant for the Philadelphia 76ers.

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