Play Ball... Play Safe

by Wesley K. Cox, M.D.

An Orthopedic Surgeon's guide to youth baseball injury prevention, treatment, and rehabilitation for Parents, Coaches, and Players.

Dr. Wesley K. Cox

Meet Dr. Wesley K. Cox

Wesley K. Cox M.D. is a board certified orthopedic surgeon specializing in disorders of the shoulder, elbow, and sports medicine. Dr. Cox received his Bachelor of Science degree in microbiology at Auburn University where he graduated Magna Cum Laude. He then completed medical school in Little Rock at UAMS where he was twice awarded the Washington County Medical Society scholarship and a member of Alpha Omega Alpha, the medical honor society.

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Are Leg Strength and Power Important to Baseball Pitching?

Are Leg Strength and Power Important to Baseball Pitching?
It is amazing that the perception is out there that you need a stronger arm to throw the ball harder. It couldn’t be more false unfortunately. The research states quite the opposite actually. Please don’t misunderstand, there needs to be focal training programs for the shoulder and scapular muscles that will not only aid in velocity, but more importantly decrease the risk of injury.

The theory of proximal to distal kinematic sequencing is important to understanding the power behind the throw. The throw is actually initiated by the lower body and progresses through the core before accelerating the arm and finally the hand. When the sequence is out of order, it is thought that energy is lost, performance decreases, and other body segments step up to compensate, which in turn leads to injury. For example, if the stride leg cannot absorb the stress during landing a ripple of force can move up to the trunk creating “whip-like” action forcing the shoulder to catch up thus loading the structures of the shoulder and elbow. Over time this will lead to some form of injury.

What Can We Conclude?
It is a small body of research that explores this area, however, the findings are very conclusive.

1. Proximal to distal kinematic sequencing occurs during the throwing mechanic.
2. Leg drive is important for throwing velocity and improving strength, power, and endurance should transfer to more efficient throwing.
3. While all leg muscles are involved on the pitching motion (Campbell 2010) focus on the gluteal muscles during training will be of great benefit due to the relation of the gluten and pelvic rotation (Oliver 2010).
4. The adductors (groin) is thought to be more involved (Yamanouchi 1998) then previously suggested and not activated during most standard exercises. More specific exercises need to be devoted in order to strengthen and condition this group.

The theory of kinetic chain sequencing is important but most likely one of many factors associated with injury and power loss. A combination of training sequencing and leg strength will reduce the risk of injury and increase power undoubtedly which is why proper coaching and strength programs are important. Make sure if you choose to participate in a strength and conditioning program, the coach has an understanding of the concept and research out there and that you are just doing a “work out” that may ultimately harm you.


It’s difficult to overstate the importance of water in our diet. By not drinking as much as we should, we’re allowing a host of issues to potentially affect us. Overall, 2/3rds of the body is water. But did you know:?
– Muscle consists of 75% water
– Brain consists of 90% of water
– Bone consists of 22% of water
– Blood consists of 83% water

From a functional standpoint, water:
– Gets nutrients and oxygen into our cells
– Helps protect vital organs by helping them absorb nutrients more efficiently.
– Regulates body temperature
– Helps get rid of toxins
– Helps our metabolism

Lack of water leads to:
– Sluggishness
– Headaches
– Muscle cramping
– Kidney stones
– Constipation
We need to take in at least half of our body weight in ounces of water each day.

So, if I weigh 100 pounds, I need to take in at least 50 ounces of water. Fruit drinks, coffees, sodas and sports drinks do not count. You can drink the other stuff, too. But that doesn’t count toward the water intake.

Now if you’d like to take it further, drink at least 25% of that total within the first 30 minutes of waking up in the morning. That, mixed with a protein-laden breakfast does an amazing job of helping us stay even-keeled throughout the day.

Train To Train Phase of Long Term Athletic Development (Phase 4)

Train to Train-Phase 4
Ages: 12-16 Male/11-15 Female

Focus training on the overall athlete based on their physical, mental, emotional and cognitive ability. Typically, during this developmental age range, young players begin to play sports for competitive organizations. It is important that the training process maintain a “player centered” approach. This phase coincides with the growth spurt, which enters the window of trainability that focuses on stamina. It is important to maintain flexibility during this phase. Children will often lose this as they begin to focus more on sport specific activities. During the Train to Train period, many children will make the decision to pursue competitive athletics or move into the active for life phase. Active for life should focus on healthy lifestyles in the recreational realm of athletics.

Those that continue the pursuit of competitive athletics should begin mental training, more advanced technical instruction, and tactical instruction. I would strongly discourage the desire to specialize in one sport prior to the age of 15 years old due to the benefit from other sports. It is encouraged that parents be active participants in their child’s athletic life due to the injury risk that is prevalent at this age.