How to Prevent Common Baseball Injuries and Improve Performance

By Dr. Edwin Porras, PT, DPT, OCS and Dr. Nathan Denning PT, DPT, SCS, CSCS

Are you looking to prevent common baseball injuries?

Are you wondering how to improve performance as a baseball player? 

Well, what if you only needed to do three things to reach the highest level? 

What if that also meant you never sustained a common baseball injury?

This week’s blog is co-written by Dr. Edwin Porras from PRO Athlete Physical Therapy in Denver, CO. Edwin works to prevent injuries and improve performance with pro athletes in multiple sports. He also works with youth athletes looking to improve their game and prevent baseball injuries. If you’re interested in working with him, Book a FREE consult with Dr. Edwin Porras

Aroldis Chapman? You’ll throw harder than him. 

Aaron Judge? Your exit velo will top his. 

Elly De La Cruz? You’ll beat him from home to second!

Package those three things up, do them every day and you are 40-man bound! Forget about long hours spent in the gym, in the cages and on the field honing your skills. 

Forget about your arm care to prevent an arm injury as a baseball player.

You just need these three things and boom - you’re set! 

Record scratch.

Now that you’re awake from that dream, you already know that unfortunately it is not that simple. In fact, finding three things that every baseball player should be doing every day is almost impossible. Each player is built differently (literally), responds to exercise differently and (believe it or not) goes about the rest of their personal life differently.

So what can be done?

Where to Start: Three Tests

Even though there isn’t a silver bullet to prevent common baseball injuries or improve performance, there are three “tests" that most baseball players should do to check-in with their body.

Think of these tests as gauges in a car. These tests reflect an athlete’s performance readiness “level”. Dipping below a certain point on any of these tests makes producing power to throw 95 mph or rake anything other than grandma’s lawn.

Every split second counts. 

Anything less than ideal decreases reaction time to that sweeper making it nearly impossible to adjust and go yard.

Anything less than ideal limits the ability to brace in the lay back position, multiplies stress on the body and increases the chance of an elbow injury.

Every inch counts. 

What are the Tests?

The three tests athletes should utilize to improve performance and prevent common baseball injuries are the following: 

1. Single Leg Stance (Anterior Reach)
2. Grip Strength
3. Mid Back or Thorax Rotation

Single Leg Stance

Single leg stance, also known as the anterior reach of the y-balance test, shows an athlete’s ability to control the end ranges of balance/mobility. This test reflects how well an athlete’s brain and muscles are in sync that day. 

There’s something else super cool and useful about this test. Guess what it is.

Amazingly, single leg stance tells us how at-risk an athlete is for baseball injuries! Research has shown that limitations in the ability to stand on one leg are related to elbow injuries in pitchers (“Tommy John” ligament specifically). 

Wondering how on earth that’s the case. Let’s get into that.

Think of how much force is needed from the back leg to propel forward toward the plate. 

And the force needed to put into the ground with the lead leg in order to stop the body.

And then the body has to transmit that force upward through the torso and out through the arm to pump out velo.

A decreased ability to stabilize on one leg at a low intensity simply cannot translate to the high intensity skill of pitching. Without this stability, efficiency is lost and can lead to more stress at other body parts that are not supposed to handle that stress. 

Grip Strength (at 3 ways)

A lot of time grip strength is measured only at the side with the elbow straight. This is a great start. But measuring in these three positions is ideal to improve performance and prevent common baseball injuries:

1. Arm at side with elbow straight
2. Arm at side with elbow elbow bent
3. Overhead with elbow straight 

These three positions can tell us a great deal about how well an athlete’s body is responding to training. 

Why is Grip important?

Grip strength shows how well an athlete can protect themselves. Think of the number one baseball injury - a UCL tear or “Tommy John” injury. The most force on this ligament happens in the layback position when the arm is accelerating forward. 

This ligament does not have enough strength to resist the forces without the muscles of the forearm. That’s why elbow injuries happen when the muscles of the forearm are weak and/or compromised during the throwing motion. 

Enter grip strength testing.

Grip strength gauges the elbow’s ability to resist the intense forces of throwing. Grip strength is also a full body/core strength indicator as it shows how well athlete can produce tension through the whole body. 

Proving this doesn’t require an entire science department - test it yourself. 

Measure your grip strength above your head. Record that number.

Measure it again but this time, clench the opposite fist, squeeze the glutes together, lock out the knees, and grip as hard as possible.

There’s a 99.99% chance the number went up.

Improving overall body strength and core control/strength leads to increased force production to throw faster, hit harder and decrease the risk of baseball injuries. 

Mid Back or Thorax Rotation

What is Good Rotation?

Adequate rotation should see the shoulders rotating while the hips are completely still. 

Why is this important?

One of the most crucial skills for a baseball player is the ability to rotate like this in an organized yet violent manner to produce power. 

How do the best players in baseball do this?

By creating separation from the hips and shoulders. The mid back and/or thorax rotational test assesses the ability to do this. 

From a baseball performance perspective, players are trying to add up forces created from the ground and feet then transfer them upward to the upper body. The more mobility available to do this, the greater the opportunity to create and transfer those forces. Think of extra mobility like 4-wheel drive in a car. It doesn’t always need to be on, but boy is it helpful in a pinch.

Now, where does the human body transfer those forces? In the middle of the body - more specifically at the mid back and core. Mobility limitations there will limit the ability to transfer the forces to the upper body and to the ball or bat. 

If extra mobility is like 4-wheel drive, think of the entire core and trunk as the transmission. 

Rotation Test: Prevent Injury

How does good rotational mobility help prevent arm injuries? Let’s try something again. 

Round your back, slouch down as much as possible. Now try to reach an arm overhead.

Do it again but this time allow your upper back to extend backwards. You reached further above your head, right? That’s why upper back mobility is needed for shoulder mobility!

There’s something else incredible about testing mid back mobility and shoulder mobility as well. You can probably guess what it is at this point.

Yup! 

Research has shown that a small limitation in shoulder flexion (ability to reach overhead) by just 5 degrees increases the risk of elbow injuries by 2.83 times! That is crazy! What’s worse? 

Each additional degree of limitations increased injury by 9%!!!

Rotation Test Takeaway:

Mid back mobility = good for rotation.

Mid back mobility = good for shoulder mobility.

Mid back mobility and good shoulder mobility = good to prevent common baseball injuries and improve baseball performance. 

Bottom Line

None of these 3 tests and gauges will guarantee that you will be the next Shohei Ohtani. These tests by themselves also won’t prevent the most common baseball injuries. In fact, none of these tests correlate to being a good baseball player at any level. 

But you know what will?

Preparing the body to train intelligently and specifically.

These tests do show where an athlete is at a physical disadvantage, though. Which can lead to twice as much work and effort to catch their peers. This can then lead to overtraining and fatigue which carries over to sleep, diet and so many other factors. All of the factors mentioned in our previous blog posts here that discuss staying healthy as a baseball player.

To get the most out of training in the weight room and on the field, make sure to work with someone that is constantly looking at these gauges. This is a surefire way to improve baseball performance and reduce common baseball injuries!

Are you a baseball player in the Indianapolis area interested in working with Dr. Nathan Denning at Integrated Performance? Book a FREE consult with him today!

Are you a baseball player in the Denver area interested in an individualized arm care program to prevent baseball injuries? Book a FREE consult with Dr. Edwin Porras a PRO Athlete Physical Therapy today!