Throwing Program Guideline: Return from injury

Throwing Program Guideline: Return from injury by Dr. John Mishock at Mishock Physical Therapy

Throwing Program Guideline: Return from injury

By Dr. John Mishock, PT, DPT, DC 






  1. Dynamic warm-up: Perform the dynamic warm-up prior to throwing.
  2. Throw and holds: Hold the baseball and go through the throwing motion without releasing the ball (10 times).
  3. Rest-recovery: After each set of throws, rest 60-90 sec. (Perform push-ups, front planks, and side planks)
  4. Phase progression: Progress to the next phase of the program each week or determined by your physical therapist if no arm soreness. If soreness, follow the mentioned soreness rules for the progression of the program.
  5. Arm care program: Perform shoulder strengthening and core exercises following each session of the throwing program.
  6. Frequency: 2-3 days per week with 1 rest day between throwing days.
  7. Younger baseball players: Modify the program based on level.

Throwing Program Guideline: Return from injury by Dr. John Mishock at Mishock Physical TherapyThis program is a guide for softball or baseball players during pre-season or winter workouts. The goal is to build throwing tolerance to reduce or eliminate elbow and shoulder injuries and improve throwing performance. If you have questions contact Dr. Mishock at

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, repeat the previous workout, stop, and take 2 days off of throwing. Upon return to throwing, drop back 1 step and progress through the program.
  3. If soreness is evident for more than 1 hour after throwing, or the next day, take 1 throwing day off and repeat the most recent throwing program workout. Ice the shoulder after throwing.
  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

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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

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