Throwing Program Guideline: Return from Injury

free download: Dr. John R. Mishock's 'Throwing Program Guideline: Return from Injury.

Throwing Program Guideline: Return from Injury

By Dr. John Mishock, PT, DPT, DC 






1. Proper warm-up is essential. Perform the dynamic warm-up prior to throwing.
2. Perform 5 throws and holds prior to each set of throws.
3. After each set of throws, rest 3- 5 min. Perform shoulder stretches (Cross-body, Over-head, behind-back)
4. Progress to the next phase of the program each week if no arm soreness or re-injury. If soreness, follow the mentioned soreness rules for the progression of the program.
5. Arm care program: Perform band strengthening exercises following each session of the throwing program.
6. Perform 2-3 days per week with 1 rest day between throwing days.
7. For the younger baseball player, throwing will not progress past the phase needed to compete at their level.
Optional: Have a physical therapist or chiropractor perform manual therapy on the shoulder

Throwing Program Guideline: Return from Injury' created by Dr. John R. Mishock, providing guidance and instructions for returning to throwing activities after an injury.

Download the PDF: Throwing Program Guideline by Dr. John Mishock at Mishock Physical Therapy

Arm Soreness Rules and Guidelines

It is common to feel muscle soreness following throwing and or exercise. This is typically a dull, diffuse ache in the muscle secondary to a buildup of lactic acid (a byproduct of muscle metabolism). This is often referred to as DOMS, or Delayed Onset Muscle Soreness. However, if the athlete experiences sharp pain, stop all throwing activity until pain ceases, and follow the soreness guidelines which are listed below. If the pain continues, contact your physical therapist or physician.

Arm Soreness Rules

  1. If there is no arm soreness, advance step by step through the throwing program. Do not advance more than 1 step per week.
  2. If the arm is sore after the first 15 throws, stop and take 2 days off of throwing. Upon return to throwing, drop back 1 phase and progress through the program.
  3. If soreness is evident for more than 1 hour after throwing, or the next day, take 2 throwing days off and repeat the most recent throwing program workout. Use heat on the shoulder after throwing. Heat will help increase circulation and promote healing. Ice vasoconstricts and leads to poor circulation and reduced healing time.
  4. If the arm is sore during the first 15 throws but reduces to no soreness continue with the program.
  5. If soreness does not decrease or continues with all throwing, seek physical therapy or medical consultation.

We can help!

If pain or limited function limits you from doing the activities you enjoy, call Mishock Physical Therapy for a Free Phone Consultation (610)327-2600.  Email your questions to Visit our website to learn more about our treatment philosophy, our physical therapy staff, and our 7 convenient locations in Gilbertsville, Skippack, Phoenixville, Boyertown, Limerick, Pottstown, and Steiner Medical at

Schedule your visit by calling 610-327-2600 or visiting this link:

Gilbertsville – Skippack – Phoenixville – Boyertown – Pottstown – Limerick

Visit our website to read informative articles, meet our physical therapy staff, and learn about our treatment philosophy. Email your questions to

Dr. Mishock is one of only a few clinicians with doctorate-level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He has authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, and “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon and

New patient scheduling: 610-327-2600