In 2001, it was reported that there were roughly 2.5 million baseball players in the United States with approximately 99% of those participating in youth (pre-high school) or high school baseball (8). The other 1% of players came from college or professional (minor league to major league baseball) baseball (8). Most recently, it was reported that approximately 15 million children and adults play organized baseball with some 5.7 million children eighth grade or lower playing baseball (23). Because most baseball players are youth and high school athletes, it makes sense that programs designed to potentially offset injury and enhance performance should take into consideration the chronological age, maturation status, and playing experience of the players because these athletes are not “miniature adults” (11).
For baseball-related injuries, a research study by Olsen et al. (21) established a link between throwing volume and shoulder/elbow injuries among youth baseball pitchers. The findings of this study stated that the injured group of pitchers self-reported pitching more months per year, innings per game, and pitches per game. It was additionally reported that pitchers who threw more than 8 months per year increased the odds of surgery by 5-fold. The most concerning finding was that pitchers who regularly pitched while their arm was fatigued were 36 times more likely to be in the surgery group.
To add more fuel to this incidence of injury fire, it was recently reported that today's youth baseball players can play on multiple teams, local and travel teams, playing 70 games or more per year over 8 consecutive months (21). Fleisig and Andrews (13) stated that the huge rise in elbow injuries in youth pitchers is related to the extended competitive baseball playing time. These data from previous studies prompted the USA Baseball Medical and Safety Advisory Committee to make 6 recommendations, of which 4 that relate to this article are listed. They are that (a) pitchers take 3 months off during the year, (b) pitchers learn good pitching mechanics, (c) pitchers should get involved in a year-round physical conditioning program, and (d) limit participation to 1 team per season (26). Based on these recommendations, it is suggested that youth athletes get involved in other sports throughout the year that could increase their athleticism, allow the young athlete to experience other activities, and offset any potential burnout from playing 1 sport continuously for 12 months (13).
Furthermore, it has been suggested that proper sports training should begin in childhood with long-term athletic development (LTAD) in mind (4,7,17). The LTAD model suggests that there are vital “windows of opportunity” during youth developmental years (17). However, this is difficult to accomplish if you only work with a young athlete periodically throughout each year and are not involved in their continued training as they grow and mature. Hopefully, youth athletes are playing multiple sports throughout the year because physical fitness components, such as strength, speed, and power, will be enhanced. Therefore, a program designed for youth athletes should be significantly different from that of the adults from an intensity, volume, and total daily training time standpoint. Furthermore, it should consider anatomical and biological age, length of training, and be flexible (7,17).
Anatomical age refers to a number of stages of anatomical growth that can be recognized by identifying various developmental characteristics (7). In this article, the stage of prepuberty for boys, indicative of a slow and balanced development when the functions of some internal organs become more efficient, is defined as the chronological ages of 7–12 years and will be broken into 2 age categories from 7–9 and 10–12 years for resistance training. For the long toss throwing programs described in this article, this age range for the youth baseball players is divided into 3 age categories, 7–8, 9–10, and 11–12 years. The stage of puberty for boys generally occurs from 12 to 14 years, but in this article, the chronological ages of 13–14 years will be used for the resistance training and long toss throwing program described later in this article. This stage is indicative of fast growth and development in height, weight, and the efficiency of some organs, as well as sexual maturation with change in interests and behaviors (7).
Biological age means “the physiological development of the internal organs and systems in the body that help determine the physiological potential, both in training and competition, to reach a high-performance level” (7). If a coach believes in a firm chronological age classification system or does not take age into consideration, this could result in misjudgments, bad evaluations, and poor coaching and training decisions for a particular athlete. Two youth athletes with the same anatomical age, who appear similar in height, weight, and muscular development, could be of different biological age and have different abilities to perform various training tasks (7).
For length of training, previous research by Escamilla et al. (9) demonstrated that youth baseball players, aged 11–15 years, increased throwing velocity after completing a 4-week combined rotator cuff and long toss throwing program. Most recently, Escamilla et al. (10) indicated that high school baseball players, aged 14–17 years, increased throwing velocity after completing 1 of 3 different 6-week resistance training programs that used either the Thrower's 10 program, Keiser pneumatic resistance machine exercise program, or plyometric program alone (10). This study demonstrated that no single resistance training program was more effective than the other in increasing throwing velocity. However, the authors stated that the Thrower's 10 and plyometric programs were the easiest to implement because both programs used minimum and inexpensive resistance devices (tubing, dumbbells, and medicine balls). On another note, it was mentioned in both articles that the short duration of the studies was advantageous because over the course of a year, oftentimes young athletes are playing multiple sports, are involved with other extracurricular activities, and they do not have the opportunity to complete long-term resistance training programs.
Training to improve throwing velocity is only 1 aspect of overall baseball performance. There are also the aspects of having fun, bat velocity, running, agility, injury prevention, and overall health and fitness. Therefore, those that train youth baseball players should use information from research and strength and conditioning to develop age-appropriate resistance training programs for youth baseball players.
The goal of this article is to provide readers with examples of 6-week preseason resistance training programs for youth baseball players that are research based, relate to the movements of the game, and do not take a significant amount of equipment or time to complete. Additionally, this article presents medicine ball and resistance training exercises as well as rotator cuff exercises accompanied with a long toss throwing program for youth baseball players aged 7–14 years. The aspects of flexibility, speed, agility, and conditioning are not presented in this article.
The weekly program design in this article for the youth baseball player incorporates plyometric medicine ball and full-body resistance training exercises on Monday, Wednesday, and an option for Friday in addition to rotator cuff exercises and a long toss throwing program on Tuesday and Thursday before baseball practice. The programs designed in this article are intended to develop explosive rotational power that mimic various parts of baseball movements, tendon, muscle, trunk, and arm strength, as well as joint flexibility. Table 1 displays the weekly schedule.
The plyometric resistance program designed in this article consists of medicine ball exercises performed explosively. For this program, all the medicine ball exercises are to be performed using the stretch-shortening cycle, which requires a rapid eccentric muscle action (prestretch) followed immediately by a countermovement that involves a rapid concentric muscle action to generate peak force as quickly as possible (10,16). All the medicine ball exercises involve the entire body, sequencing from the lower body to the torso to the upper body. These movements mainly take place in the transverse and diagonal planes, which were chosen because of their specificity to throwing, hitting, and similar baseball movements. Because of the ballistic and explosive nature of the medicine ball training, slightly fewer repetitions are used during this training compared with the Thrower's 10 exercises and the resistance training programs (10). Players between the ages of 7 and 9 years will use medicine balls that weigh between 2 and 6 lbs, whereas players between the ages of 10 and 14 years will use medicine balls that weigh between 4 and 8 lbs. However, if modifications need to be made because of different maturation status or overall strength, adjust the weight of the medicine ball accordingly. Each exercise should be performed as explosively as possible. The players, depending on age, will perform 2 sets of 6–10 repetitions (reps) 2–3 times per week with 60–90 seconds of rest between sets. Weeks 1 and 4 will be for 10 reps (2 lb = 7- to 9-year-olds and 4 lb = 10- to 14-year-olds), weeks 2 and 5 will be for 8 reps (4 lb = 7- to 9-year-olds and 6 lb = 10- to 14-year-olds), and weeks 3 and 6 will be for 6 reps (6 lb = 7- to 9-year-olds and 8 lb = 10- to 14-year-olds) while performing the exercise properly. For example, see Tables 2–4 for exercise programs.
The 9 medicine ball exercises used in this article are based primarily on the research by Escamilla et al. (10) and Szymanski et al. (25) and are as follows: (a) chest pass—performed first with right foot forward and then performed with left foot forward while standing 3 ft away from the wall (Figure 1A and 1B), (b) perpendicular throw—performed first with the right foot forward and then performed with the left foot forward and performed on both sides of the body while standing 3 ft away from the wall (Figure 2A and 2B), (c) ear throw—performed with ball first held on right side of the body and then with ball held on left side of the body while standing 3 ft away from the wall (Figure 3A and 3B), (d) rotary straight-arm toss—performed on both sides of the body while standing 3 ft away from the wall (Figure 4A and 4B), (e) Hitter's push—performed on both sides of the body while standing with back foot 10 ft away from the wall (Figure 5A and 5B), (f) squat to thrust (Figure 6A and 6B), (g) overhead slam (Figure 7A and 7B), (h) Lunge figure 8 throw–performed while standing with back foot 10 ft away from the wall (Figure 8A–D), and (i) standing diagonal wood chop throw—performed on both sides of the body (Figure 9A and 9B).
Before beginning a resistance training program, make sure that youth athletes know how to perform all exercises properly. This can be accomplished by having a certified strength and conditioning coach who demonstrates and explains how to correctly perform all the exercises before the players perform them. Additionally, it is important that the coach correct improper lifting technique, answer any of the athlete's questions, and provide positive encouragement during the training sessions. The National Strength and Conditioning Association (NSCA) has written youth resistance training guidelines and recommends 1–3 sets of 6–15 reps with age-appropriate weight loads (11). Additionally, the NSCA recommends that resistance is increased gradually (5–10%) as strength and exercise technique improve and athletes become skilled in the various exercise procedures (11). According to Faigenbaum and Westcott (12), 7- to 9-year-olds respond well to brief exercise sessions that use moderate weight loads and higher reps. Bompa (6) states that the attention span for youths 7–9 years is very short, they cannot sit and listen for long periods of time, and they want to be actively moving around. Therefore, it is recommended in Table 2, which has been modified from Szymanski (24), that 7- to 9-year-olds only perform 1 set of a 9 station full-body exercise program for 10–15 reps of the resistance training exercises 2 times per week (12). There should be 60–90 seconds of rest between sets.
The NSCA, in its youth resistance training guidelines, recommends that athletes aged 10–12 years perform 1–3 sets of 6–15 reps with age-appropriate weight loads 2–3 times per week (11). Additionally, the NSCA recommends that resistance is increased gradually (5–10%) as strength and exercise technique improve and athletes become skilled in the various exercise procedures (11). Because these players attain similar results from resistance training as 7- to 9-year-olds, it is recommended in Table 3, which has been modified from Szymanski (24), that 10 to 12-year-olds perform 1–2 sets of a 10 station full-body exercise program for 10–15 reps for resistance training exercises 2–3 times per week (12). There should be 60–90 seconds of rest between sets.
For young athletes aged 13–14 years, the NSCA recommends 1–3 sets of 6–15 reps (11). Additionally, the NSCA recommends that resistance is increased gradually (5–10%) as strength and exercise technique improve and athletes become skilled in the various exercise procedures (11). In Table 4, it is recommended that beginners, those with less than or equal to 2–3 months lifting experience, perform 1–2 sets of an 11 station full-body exercise program for 10–15 reps for resistance training exercises 2–3 times per week. For more advanced athletes, those with at least 12 months of resistance training experience, it is recommended in Table 4, which has been modified from Szymanski (24), to perform 2–3 sets of an 11 station full-body exercise program for 8–12 reps for resistance training exercises 2–3 times per week (12). There should be 60–90 seconds of rest between sets.
ROTATOR CUFF PROGRAM
The rotator cuff is comprised of 4 muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) which are important in shoulder movements and in maintaining glenohumeral (shoulder) joint stability (20). These muscles arise from the scapula and connect to the head of the humerus, forming a cuff at the shoulder joint. They hold the head of the humerus in the small and shallow glenoid fossa of the scapula. The glenohumeral joint has been analogously described as a golf ball (head of the humerus) sitting on a golf tee (glenoid fossa).
The Thrower's 10 program focuses on muscles in the throwing arm, such as the rotator cuff, biceps, triceps, and forearm muscles (28). Those who train youth baseball players who would like to incorporate variety into their program are encouraged to include the 17 upper extremity resistance exercises (UERE) described by Escamilla et al. (9) in an alternating fashion on days when the rotator cuff exercises are being completed at the baseball field. For example, if 10- to 14-year-old players are being trained, the Thrower's 10 program could be performed on Tuesday, whereas the 17 UERE could be performed on Thursday for the 6-week preseason program. Additionally, it is relatively easy to incorporate these exercises into the beginning of each baseball practice at the end of an active dynamic warm-up. Once players know how to perform the exercises properly, it only takes 10 minutes or less to complete.
The Thrower's 10 program consists of the following exercises: (a) diagonal 2 (D2) pattern flexion and extension, (b) lateral raise and 30° V-up, (c) bent-over lateral raise, (d) bent-over straight-arm extension, (e) internal and external rotation at 90° abduction, (f) biceps curls, (g) overhead triceps extension, seated wrist flexion and extension, seated pronation and supination, (h) push-ups (from wall, bench, or floor), (i) press-ups, and (j) bent-over rows with scapula retraction. Photos and detailed descriptions of all these exercises can be found in the study by Escamilla et al. (10), online in PDF format at www.asmi.org/SportsMed/throwing/thrower10, and online in videos at www.asmi.org/SportsMed/media/thrower10. The players, depending on age, will perform 1–2 sets of 8–12 reps 2–3 times per week with 60–90 seconds of rest between sets. Weeks 1 and 4 will be for 12 reps, weeks 2 and 5 will be for 10 reps, and weeks 3 and 6 will be for 8 reps with the greatest resistance possible, between 1 and 5 lb, while performing the exercise properly. If players are using resistance bands to perform the exercises, then those who train them must have different color bands that represent different resistance. It is recommended to have bands that are between 1 and 5 lb of resistance. For 7- to 8-year-old beginners, start with 1 lb of resistance and advance to the 2 and then 3 lb resistance bands over the 6-week preseason program. For 9- to 10-year-old beginners, start with 2 lb of resistance and advance to the 3 and then 4 lb resistance bands over the 6-week preseason program. For 11–14 year-old beginners, start with 3 lb of resistance and advance to the 4 and 5 lb resistance bands over the 6-week preseason program. If, for some reason, coaches or players only have 1 set of bands, then the players executing the exercises can change the resistance by how much tension is placed on the bands. For more tension, stand further away from the point of band attachment (i.e., the fence or wall). The players can also use dumbbells of the same weight (1–5 lb) if they do not have resistance bands. For those that do not have bands or dumbbells, use the player's baseball glove as resistance. To increase intensity, add 1, 2, or 3 5-oz baseballs inside the glove wrapped with a rubber band to hold the baseballs inside the glove. Ultimately, those that train baseball players are only limited by their imagination for resistance devices to perform rotator cuff exercises. As long as the resistance is within the 1–5 lb resistance range, the athlete should be fine to perform the exercises. Each exercise should be performed in a 3-second repetition (1 second for the concentric phase and 2 seconds for the eccentric phase).
Photos of the 17 UERE using MVP elastic bands (A Change of Pace, Inc, Davis, CA) can be found in the article by Escamilla et al. (9) and include the following: (a) elbow extension, (b) arm extension, (c) chest fly, (d) reverse chest fly (performed the opposite of chest fly), (e) rowing, (f) internal rotation with shoulder flexed 90°, (g) external rotation with shoulder flexed 90°, (h) internal rotation with shoulder abducted 0°, (i) external rotation with shoulder abducted 0° (performed the opposite of internal rotation with shoulder abducted 0°), (j) internal rotation with shoulder abducted 90°, (k) external rotation with shoulder abducted 90° (performed the opposite of internal rotation with shoulder abducted 90°), (l) shoulder abduction to 90°, (m) shoulder abduction to 180°, (n) D2 diagonal pattern flexion, (o) reverse throw, (p) D2 diagonal pattern extension (reverse of D2 diagonal pattern flexion, starting with shoulder flexed and externally rotated and elbow bent and ending with shoulder extended and internally rotated and elbow straight with hand at opposite hip), and (q) standard forward throw. Each of the 17 UERE should be performed in a 3-second repetition (1 second for the concentric phase and 2 seconds for the eccentric phase). Make sure that each player is instructed on how to perform each exercise with proper form and technique and use enough resistance for each exercise that allows them to perform 1 set of 20–25 reps but no more. Instruct players to adjust the tension in the MVP elastic bands to accommodate their improvements in muscular strength throughout the training program.
LONG TOSS PROGRAM
The topic of long toss throwing for baseball pitchers is a long-standing debate among baseball pitching coaches as well as for those that train baseball pitchers. Some advocate it, whereas some do not. Interested readers only need to enter the topic on their computer to find the many opinions expressed regarding this form of training. However, the long toss throwing programs described in this article are for all injury-free players, no matter what the position, based on age and are not for maximum distances. According to Axe et al. (3), “the only way to mimic the forces of a baseball throw is to actually throw a ball.” The long toss throwing programs in this article are progressive sport-specific regimens for noninjured baseball players that gradually expose them to the demands they will experience as they play the game. Because this article assumes that each youth baseball player is healthy, only 6 weeks of throwing is required. However, if readers are interested in a more individualized throwing program for those players returning from injury, see the articles by Axe et al. (1,3). The goals of the long toss throwing programs in this article are to prepare the baseball player for the workload experienced during games and to minimize the chances of injury. One of the major features of these long toss throwing programs is that they are research based. In support of this, Axe et al. (1) stated, “In this era of evidence-based medicine, it is important that treatment interventions be based on objective data, whenever possible.”
Research completed about how many throws are made during actual collegiate baseball games by all the various positions in baseball has been reported previously by Barrett and Burton (5). The results indicated that most throws during a college game are made by pitchers (51%), whereas catchers make 29% of the total throws per game. The rest of the throws made during a college game, which are made by all the other position players, range between 3 and 5%. Additionally, the distance thrown by position and number of throws per game was reported as well. Most throws were made between the distance of 46 and 60 ft, and these throws were made mostly by the pitchers and catchers. The longest throws (180 ft and longer) during games were made by outfielders.
Recently, Fleisig et al. (15) compared the biomechanics of baseball pitching and long toss throwing. They had college baseball pitchers throw fastballs from a pitching mound, which is 60 ft, 6 in from home plate and then throws with a baseball from 121.4, 180.4 ft, and maximum distance from flat ground. Pitchers were instructed to throw “hard, on a horizontal line” for the throws from 121.4 and 180.4 ft. There were no constraints on the trajectory of the throws for maximum distance. The conclusion from this study was that hard, horizontal flat-ground throws are biomechanically similar to pitching from a mound “and are, therefore, reasonable exercises for pitchers.” These authors did, however, state that maximum distance throws produced increased shoulder internal rotation torque, elbow varus torque, and changes in throwing motions. Because of these results, the authors did state that caution is advised when performing long toss throws for maximum distance for rehabilitation and training.
With the information provided by the studies of Barrett and Burton (5) and Fleisig et al. (15), it is recommended that long toss throwing programs for high school and more mature baseball players are no longer than 180 ft. However, because this article deals specifically with youth baseball players, specific recommendations will be provided for them. The long toss throwing programs in Table 5 for youth baseball players aged 7–10 years old were modified by the author of this article from the distances and times for the older youth players in Table 6 recommended by the research of Escamilla et al. (9) and are not for maximum distance. Furthermore, it must be stated that youth baseball players do not generally have sound throwing mechanics, so those that train them should teach youth baseball players how to throw properly. However, it is beyond the scope of this article to address how to teach proper baseball throwing mechanics. Interested readers are therefore directed to the articles by Fleisig et al. (14), Marsh (18), and Whiteley (27). The distances and times in Table 5 have been used to train Dixie Youth baseball players in North Louisiana by the author. These programs should be performed at the baseball field with the other players on the team after completing an active dynamic warm-up and the rotator cuff program. The only equipment needed for these programs are baseballs, a glove, and a tape measure. The total duration of the programs for 7- to 10-year-olds is 25 minutes, which addresses the short attention span of young players. Before beginning the long toss throwing program, it is strongly recommended that those training the baseball players put cones on the outfield area that mark the specific throwing distances, measured with the tape measure, to ensure compliance. After a 5-minute warm-up throwing at a 20-ft distance, have players aged 7–8 years perform pivot throws with an arc (no step allowed) for 9 minutes (30-ft throws for 3 minutes, 40-ft throws for 3 minutes, and 50-ft throws for 3 minutes). Then, have each player perform long toss throws with an arc (1 step allowed) for 6 minutes (50-ft throws for 3 minutes and 60-ft throws for 3 minutes). For these players, have them end their throwing by performing 5 hard throws (2 steps allowed) at 50 ft, 5 hard throws at 40 ft, and 5 hard throws at 30 ft while using proper throwing mechanics.
After a 5-minute warm-up throwing at a 25-ft distance, have players aged 9–10 years perform pivot throws with an arc (no step allowed) for 9 minutes (35-ft throws for 3 minutes, 55-ft throws for 3 minutes, and 75-ft throws for 3 minutes). Then, have each player perform long toss throws with an arc (1 step allowed) for 6 minutes (75-ft throws for 3 minutes and 90-ft throws for 3 minutes). For these players, have them end their throwing by performing 5 hard throws (2 steps allowed) at 75 ft, 5 hard throws at 55 ft, and 5 hard throws at 35 ft while using proper throwing mechanics.
The long toss programs listed in Table 6 have been shown to be effective in enhancing throwing performance in youth baseball players (2,9). These programs were implemented by Escamilla et al. (9) for youth baseball pitchers aged 11–15 years and demonstrated statistically significant improvements in throwing velocity compared with a control group that did not engage in the 4-week baseball-specific conditioning program. Just like the 7- to 10-year-old players listed above, instruct the 11- to 14-year-olds to begin their long toss program after completing an active dynamic warm-up and the rotator cuff program at the baseball field. The total duration of the programs for 11- to 14-year-olds is 35 minutes, which addresses the short attention span of young players. After a 5-minute warm-up throwing at a 50-ft distance, have players aged 11–14 years perform pivot throws with an arc (no step allowed) for 15 minutes (60-ft throws for 5 minutes, 75-ft throws for 5 minutes, and 100-ft throws for 5 minutes). Then, have each player perform long toss throws with an arc (1 step allowed) for 10 minutes (100-ft throws for 5 minutes and 125-ft throws and beyond for 5 minutes). For players aged 11–12 years, have them end their throwing by performing 5 hard throws (2 steps allowed) at 100 ft, 5 hard throws at 75 ft, and 5 hard throws at 50 ft while using proper throwing mechanics. Have players aged 13–14 years end their throwing by performing 5 hard throws (2 steps allowed) at 150 ft, 5 hard throws at 125 ft, and 5 hard throws at 100 ft while using proper throwing mechanics.
The final 3 minutes of all long toss throwing programs for youth baseball players (7–14 years) should include shoulder internal rotation stretches, which consist of the sleeper stretch at 90° of shoulder flexion (Figure 10), sleeper stretch at 45° of shoulder flexion (Figure 11), and horizontal cross-arm (Figure 12). Each stretch should be performed for 1 set of 30 seconds with 30 seconds of rest period in between stretches (22). This should take no more than 3 minutes to complete. Research completed by Oyama et al. (22) demonstrated that collegiate baseball pitchers significantly improved acute internal rotation and horizontal adduction range of motion after performing a single session of posterior shoulder stretches using 1 of 3 different posterior stretches for 3 sets of 30 seconds with 30 seconds of rest between each trial. None of the 3 stretches was statistically different than the other. Therefore, all 3 stretches are used in this article for variety. However, it should be mentioned that McClure et al. (19) found that after 4 weeks of stretching once daily for 5 reps of 30 second holds, the horizontal cross-arm stretch resulted in significantly greater internal rotation range of motion than the sleeper stretch or not stretching in the control subjects of noninjured recreational athletes. So, if either of the sleeper stretches is uncomfortable, a youth baseball player could simply use the horizontal cross-arm stretch and be confident that it would have a positive effect on internal rotation range of motion.
If a player cannot make throws with proper mechanics at the farther distance(s), modify the program and shorten the distance by 10–20 ft for players aged 7–10 years and 25–50 ft for players aged 11–14 years accordingly. In the event that players cannot make throws from a respective distance that they usually can complete because of shoulder soreness, give the player 1–2 days of rest and have them perform 4 simple shoulder impingement tests: (a) touchdown test (Figure 13), (b) hand on opposite shoulder test (Figure 14A and 14B), (c) over and under test (Figure 15), and (d) hand behind low back test (Figure 16). If pain results from any 1 or more of these tests, shoulder impingement is possible, and it is recommended that the player have a sports medicine physician evaluate the area of pain (13). For the elbow, if there is tenderness or pain to the touch at the growth plate (apophysis) of the inside of the upper arm bone at the elbow (medial epicondyle) or on the outside aspect of the elbow, it is also recommended that the player see a sports medicine physician to assess the area of pain.
This article was written with the understanding that a youth player's annual schedule may be very busy because of playing multiple sports, being involved in extracurricular activities, and being involved with family events among other possible activities. With all these other occurrences going on, and based on the previous research with youth baseball players, the programs featured in this article were designed to only be 6 weeks in length and occur during the preseason, so that the youth player would hopefully not get burned out, lose interest, or get bored before the summer baseball season. Furthermore, with the reduction of physical education classes that youngsters may be experiencing today in grade school, it is a good idea to have 2 or more additional days of exercise that is planned and structured. Plyometric and resistance training exercises in addition to rotator cuff exercises and a long toss throwing program are included in this article. These programs were designed to incorporate exercises that address the entire body and movements of the game. Increasing the power and strength of a young athlete may enhance performance, possibly offset injury, increase their overall fitness level, and teach life-long activity skills. However, it must be stated that it is very important to understand the training programs outlined in this article can be modified according to the player's stage of maturation rather than the chronological age listed in the various tables. Youth players of the same chronological age may differ by a few years in their level of biological maturation. Therefore, it is important to adjust the various programs to the individual athlete and let them develop at their own pace.
1. Axe M, Hurd W, Synder-Mackler L. Data-based interval throwing programs for baseball players. Sports Health 1: 145–153, 2009.
2. Axe MJ, Snyder-Mackler L, Konin JG, Strube MJ. Development of a distance-based interval throwing program for Little League-aged athletes. Am J Sports Med 24: 594–602, 1996.
3. Axe MJ, Wickman R, Snyder-Mackler L. Data-based interval throwing programs for Little League, high school, college, and professional baseball pitchers. Sports Med Arthrosc 9: 24–34, 2001.
4. Balyi I, Hamilton A. Long-term Athlete Development: Trainability in Childhood and Adolescence—Windows of Opportunity—Optimal Trainability. Victoria, Canada: National Coaching Institute British Columbia & Advanced Training and Performance Ltd, 2004.
5. Barrett DD, Burton AW. Throwing patterns used by collegiate baseball players in actual games. Res Q Exerc Sport 73: 19–27, 2002.
6. Bompa TO. Stages of athletic development. In: Total Training for Young Champions. Champaign, IL: Human Kinetics, 2000. pp. 21–30.
7. Bompa TO. Training guidelines for young athletes. In: Total Training for Young Champions. Champaign, IL: Human Kinetics, 2000. pp. 1–20.
8. Conte S, Requa RK, Garrick JG. Disability days in major league baseball. Am J Sports Med 29: 431–436, 2001.
9. Escamilla RF, Fleisig GS, Yamshiro K, Mikla T, Dunning R, Paulos L, Andrews JA. Effects of a 4-week youth baseball conditioning program on throwing velocity. J Strength Cond Res 24: 3247–3254, 2010.
10. Escamilla RF, Ionno M, deMahy MS, Fleisig GS, Wilk KE, Yamashiro K, Mikla T, Paulos L, Andrews JR. Comparison of three baseball-specific 6-week training programs on throwing velocity in high school baseball players. J Strength Cond Res 26: 1767–1781, 2012.
11. Faigenbaum AD, Kraemer WJ, Blimkie CJ, Jeffreys I, Micheli LJ, Nirka M, Rowland TW. Youth resistance training: Updated position statement paper from the National Strength and Conditioning Association. J Strength Cond Res 23: 60–79, 2009.
12. Faigenbaum AD, Westcott WL. Strength & Power for Young Athletes. Champaign, IL: Human Kinetics, 2000. pp. 139–158.
13. Fleisig GS, Andrews JR. Prevention of elbow injuries in youth baseball pitchers. Sports Health 4: 419–424, 2012.
14. Fleisig GS, Barrentine SW, Escamilla RF, Andrews JR. Biomechanics of overhand throwing with implications for injuries. Sports Med 21: 421–437, 1996.
15. Fleisig GS, Bolt B, Fortenbaugh D, Wilk KE, Andrews JR. Biomechanical comparison of baseball pitching and long-toss: Implications for training and rehabilitation. J Orthop Sports Phys Ther 41: 296–303, 2011.
16. Johnson BA, Salzberg CL, Stevenson DA. A systematic review: Plyometric training programs for young children. J Strength Cond Res 25: 2623–2633, 2011.
17. Lloyd RS, Oliver JL. The youth physical development model: A new approach to long-term athletic development. Strength Cond J 34(3): 61–72, 2012.
18. Marsh D. Little League elbow: Risk factors and prevention strategies. Strength Cond J 32(6): 22–37, 2010.
19. McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther 37: 108–114, 2007.
20. Morag Y, Jacobson JA, Miller B, De Maeseneer M, Girish G, Jamadar D. MR imaging of rotator cuff injury: What the clinician needs to know. Radiographics 26: 1045–1065, 2006.
21. Olsen SJ II, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med 34: 905–912, 2006.
22. Oyama S, Goerger CP, Goerger BM, Lephart SM, Myers JB. Effects of non-assisted posterior shoulder stretches on shoulder range of motion among collegiate baseball pitchers. Athl Train Sports Health Care 2: 163–170, 2010.
23. Sporting Goods Manufacturers Association. Single Sport Report 2011: Baseball. Available at: http://www.sbma.com/reports/21_Baseball-Participation-Report-2011
. Accessed: December 16, 2012.
24. Szymanski DJ. Resistance training to avoid Little League elbow and shoulder. NSCA’s Perform Train J 10: 15–20, 2011.
25. Szymanski DJ, Szymanski JM, Bradford TJ, Schade RL, Pascoe DD. Effect of 12 weeks of medicine ball training on high school baseball players. J Strength Cond Res 21: 894–901, 2007.
26. USA Baseball Medical and Safety Advisory Committee’s Youth Baseball Position Statement. Available at: http://mlb.mlb.com/usa_baseball/article.jsp?story=medsafety11
. Accessed: January 5, 2013.
27. Whiteley R. Baseball throwing mechanics as they relate to pathology and performance—A review. J Sports Sci Med 6: 1–20, 2007.
28. Wilk KE, Reinold MM, Andrews JR. Rehabilitation of the thrower’s elbow. Clin Sports Med 23: 765–801, 2004.