Team Ahmad’s Frank Alexander sat down with Baseball Health Network founder Steve Hayward for a timely conversation!

Frank: Young pitchers want to add depth to their arsenal of pitches they throw. What is the first off-speed pitch you teach to your athletes?
Steve: The first off-speed pitch I teach is a change-up. The change-up is much easier to learn and has a higher percentage for a young pitcher to throw for strikes. The arm and hand speed is consistent with a fastball, creating deception to disrupt a hitter’s timing and increasing the pitcher’s likelihood of getting a hitter out. ANY pitch thrown improperly will add unnecessary stress to the arm. Developing consistent, efficient mechanics is the key to keeping a pitcher healthy.

FA: What is your advice to a player who wants to throw a curveball?
SH: Curveballs have gotten a really bad rap when it comes to arm injuries. A lot of blame has been put on curveballs; but none of the research has proven it is more dangerous than any other pitch. There’s no set age when a player can start throwing a curve. A player can “develop” a curve as young as 10. My criteria to learn is when a player is can consistently control his direction to the plate and throw fastballs for strikes. “Developing” a curveball doesn’t mean throwing them live in competition – it means learning how to spin the ball in bullpens and practice. When they develop consistency, I allow them 5 curves per game. I want to emphasize that this is only for pitchers that are capable of throwing curves safely.

FA: Every athlete varies on stamina and the days they pitch. What is your recommended pitch-count for a high-school-age, multi-position athlete who may be called in to pitch in a game they are also scheduled to play the field?
SH: The problem with generic pitch counts is they are based strictly on age. Not taking the individual’s off-season programs or previous workload into consideration when deciding on a pitch count is irresponsible. In my opinion, it is one of the biggest factors contributing to the arm injury epidemic. Until I have a clear answer on how a player feels on that day, I can’t set a number for that outing. Body language is more of an indicator as he’s throwing more-so than a pitch count. A player can throw 100 pitches with minimal stress where in another outing, throw 50 pitches and struggle with control of both pitches and his body. This can lead to doubling the workload on a given pitch. The point is – the number of pitches won’t always tell the whole story.

FA: When a pitcher is coming back from surgery, what is your first order of business regarding mechanics since they haven’t thrown in a couple of months?
SH: My initial attention is directed towards making sure they are throwing naturally. I make sure the arm action is clean and smooth. I also check to see if they are creating consistent rotation with a 4-seam fastball, especially for the guys that are returning from Tommy John Surgery. These players have a tough time getting proper extension at the elbow and end up cutting the ball which creates a cutter or slider rotation. If the injury was caused by a mechanical issue, the slow pace of a rehabilitative throwing program allows them to improve where they were deficit at lower intensities.

FA: Dr. Ahmad’s mound throwing programs suggest the use of a radar gun for athletes to estimate their effort. What do you say to those athletes who “want to let it loose”?
SH: If a player focuses heavily on velocity in the rehab process, it creates a recipe for setbacks or re-injury. Either way, it will definitely affect a player’s return date. The daily goal is to complete the day’s throwing with no pain or discomfort. I prefer my guys to make a lot of throws at low to medium intensity. There is healing power in throwing but only when it’s done properly. Each player recovers differently and the decision as to when we start increasing and focusing on velocity is determined by the progress the player has made throughout the program.

FA: What is the best advice you could give to a parent who wants to keep their player’s arm healthy?
SH: First, start with the entire body. Way too many pitchers, at every level, have deficiencies and asymmetries throughout their body causing unnecessary stress on the throwing arm. Most arm injuries have little to do with the arm itself. If the body is functional and the delivery is efficient, the stress is distributed more evenly throughout the body instead of just the shoulder and elbow. Once those issues are addressed, a progressive throwing program is next. The arm needs to be fully conditioned prior to the season, and throwing at various intensities helps this process. Pitchers need to have an in-season maintenance and recovery throwing program as well. The last step is having the ability to communicate to the coaches and athletic training staff exactly how and what they are feeling. If an athlete learns how to listen to their body and pay attention to warning signs, they can stay ahead of potential arm issues.

Frank Alexander, a member of Team Ahmad, is a Physician Extender to Dr. Christopher Ahmad at Columbia University Medical Center.