We’ve shared a lot about the stress the shoulder receives through the repetitive throwing motions that are associated with baseball pitching. Unfortunately, there were four times as many arm surgeries for collegiate pitchers and six times more surgeries for high school pitchers between 2000 and 2004 (Olsen et al. 2006).

There are multiple programs and exercises baseball pitchers can do to lessen their risk of overuse and injury, but sometimes exercise isn’t enough (in case you missed it, read more about a great injury prevention exercise program with TheraBand for adolescent baseball players here).

To compliment preventative exercise, athletic trainers and physical therapists everywhere are looking for therapies to help their athletes improve recovery, delay fatigue and reduce risk of injuries. When it comes to making a choice, there are mixed reviews on what to use and when.

Some like it hot, some like it cold

Traditionally, heat therapy is used before and during exercise to keep the muscles lose and warm, while cold therapy (cryotherapy) is used afterwards to help with healing and recovery. However, using cold therapy before and during exercise has been gaining attention as a potential solution to many problems associated with pitching.

Dr. Stacy Bishop, ATC, PhD and colleagues recently published a study, “The Effect of Intermittent Arm and Shoulder Cooling on Baseball Pitching Velocity.” They noted, “Researchers have found positive results using cryotherapy on the overuse symptoms of pain, swelling and inflammation. Cold therapy on the shoulder and legs has been shown to increase muscle fiber activation, help maintain repeated performance and improve sprint performance. Cryotherapy is also used to improve recovery.”

To test these results up against baseball-specific activity, the researchers designed a study to see if cryotherapy improved pitching performance in baseball players.

The effectiveness of cryotherapy on baseball pitchers

Eight trained collegiate pitchers with no history of elbow or shoulder injury were asked to throw fastballs at a rate of one pitch every 20 seconds.

The study consisted of three sessions:

  • The first session familiarized the participant with the pitching protocol.
  • 24-48 hours after the first session, the following two sessions simulated game pitching conditions:
    • Players threw 12 pitches per inning for five separate innings.
    • Between each inning, patients were randomly assigned to either:
      • An ice bag cooling of the deltoid and forearm (wetted ice inside ice wraps)
      • No treatment, sitting in a chair
      • Each subject was given six minutes of rest between innings.

There were three key measurements in the study:

  1. Pitch velocity
  2. Perceived exertion (Scale of 6-20)
  3. Perceived recovery (Scale of 1-10)

A home run

This study spoke largely to the positive effects of cryotherapy on baseball pitching performance and recovery. According to the authors, the group that received cryotherapy experienced:

  • Significantly higher mean pitch speeds in the fourth and fifth inning
  • Significantly higher mean pitch speed across all innings
  • Significantly lower rating of perceived exertion
  • Significantly improved perceived recovery

The researchers concluded, “The mechanisms responsible for the ergogenic effect of cryotherapy on high-intensity intermittent activity remain to be determined. Cryotherapy treatment during a pitching performance seems to be a practical treatment when applied intermittently.”

Check out our other baseball training, rehab and recovery resources on blog.PerformanceHealthAcademy.com


Bishop SH et al. 2016. The Effect of Intermittent Arm and Shoulder Cooling on Baseball Pitching Velocity. J Strength Cond Res. Apr;30(4):1027-32.
Olsen SJ et al. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med 34: 905–912, 2006.

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