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Why Icing After Pitching Isn’t Great For Your Child

Icing after a baseball game is an often-used recovery or injury rehabilitation practice for pitchers.

However, recent research conducted by Electronic Waveform Lab shows that icing damaged tissue after exercise does not improve recovery and can actually delay the healing process.

40 years ago, Dr. Gabe Mirkin coined the term RICE (Rest, Ice, Compression, and Elevation) to treat acute sports injuries. In 2014, nearly 40 years later, Dr. Mirkin retracted his statements stating, “Subsequent research shows that rest and ice can actually delay recovery.”

Why Does Ice Do More Damage Than Good? 

Inflammation is a natural, necessary response to the tissue damage that results from pitching in a baseball game. Due to the inflammation, blood vessels dilate, and the damaged tissue receives an influx of nutrients and cells that begin the process of tissue repair.

This process is necessary for the tissue to remodel and prepare for the future stresses involved in pitching. While icing may decrease pain in the short term, it can actually do more harm than good, as it slows down the recovery process.

Active Recovery: An Alternative To Ice

As part of his 2014 retraction of RICE protocol, Dr. Gabe Mirkin reported, “Mild movements help tissue to heal and the application of cold suppresses the immune responses that start and hasten recovery.”

One of the best alternatives to using ice is active recovery — including low-intensity muscle activation techniques. The goal is to find practical active recovery and loading methods that won’t aggravate the tissue or cause additional damage.

Try to activate the muscles to achieve the largest amount of pain-free, low-stress, and non-fatiguing muscle activation. This technique can act as a “pump” to remove excess waste products from the area and facilitate the release of proteins that accelerate recovery.

If you need in-depth injury rehabilitation or performance physical therapy techniques in Chevy Chase, our team of experienced physical therapists can help!

Arm Care in Baseball is More Than Pitch Counts

The number of shoulder and elbow injuries in youth baseball pitchers is on the rise and we consistently see these injuries for performance physical therapy. In response, consistent efforts have been made to better monitor the amount of stress taken by pitchers after each visit to the mound.

For many years, this was done by simply limiting the number of innings an athlete could pitch and setting a specific number of rest days between outings. More recently, pitch counts have become the standard for tracking a pitcher’s workload. However, while this change is an improvement, pitch counts do not tell the entire story.

What pitch count fails to account for is the varying intensities between throws. For example, a throw at 100% effort has a very different intensity than a throw at 50%. This is why efforts have been made in recent years to more accurately track the intensity, or workload, of a pitcher while on the mound.

A Better Method to Track Stress: Workload

According to athletic physical therapy, a more reliable measure of stress is the acute to chronic workload ratio (ACWR). Acute workload refers to the average workload of a single day over the past 9 days, whereas chronic workload refers to the average one-day workload over the past 28 days.

Research by sports scientist Tim Gabbett has shown that spikes in acute workloads, such as quickly increasing pitch count to more than the body is used to, can increase the risk of injury.

Calculating Your ACWR

There are two main ways to calculate the acute to chronic workload ratio.

The first is to use a series of formulas using pitch count and a subjective rating of perceived exertion (RPE), ranging on a scale of 1–10.

  1. Calculate acute workload by multiplying the number of high-intensity throws (around 70% of full effort or more) by the athlete’s RPE.
  2. Calculate chronic workload by calculating the weekly acute workload average of the past four weeks.

Once you have the acute and chronic workload, divide the acute workload by the chronic workload to get the ACWR.

The second and perhaps much simpler method is to use wearable technology. For example, in recent years, technology has become available to track the stress on a pitcher more accurately after an outing.

Sensors such as the MotusTHROW can accurately measure the amount of force placed on an athlete’s elbow during each throw. This data can be applied to calculate the ACWR to safely and effectively determine when a pitcher needs rest or is ready for their next high-intensity outing.

If you’d like to learn more about keeping your son or daughter safe on the mound, our experienced athletic physical therapy and injury rehabilitation team in Bethesda can help!