Dear Readers,

Welcome to the latest edition of "The Overhead Athlete's Edge," as we dive into a hotly debated topic: weighted balls. Are they truly the game-changer they're hyped up to be, or are they just another passing trend? Join us as we unpack the science, explore the benefits, and weigh the risks associated with incorporating weighted balls into your training regimen. Whether you're a pitcher, a tennis player, or a volleyball setter, discover whether these tools can truly give you the edge you're looking for in your overhead game.

In Focus: Unleashing Potential - The Weighted Ball Effect on Velocity

So you want to get your throwing shoulder stronger. You practice throwing with a heavier ball. It makes sense. But does it? Lets see what the research says.

The research here is mixed. Some studies show an increase in shoulder rotation strength with an increase in pitching velocity following a 4-6 week program. In Reinold and Macrina’s 2021 study, they found a 3.3% increase in average pitching speed compared with the control group after a 6-week weighted ball program.¹ Multiple sources additionally cite a significant increase in range of motion into shoulder external rotation. It seems likely that this increase in range of motion can positively affect the force, momentum, and ultimately the velocity of throwing.

So do I think weighted ball programs are a good way for overhead athletes to improve their strength and throwing potential? Generally speaking, not really. I think there are better ways to “strengthen” and smarter ways to improve velocity when training in a group setting. Individually speaking, I think there are some cases where an athlete may benefit from a specific throwing program under close supervision from his or her strength and conditioning coach or sports physical therapist.

Expert Insights: Injury Prevention - The Weighted Ball Edition

While you may think weighted balls = increased velocity, studies show that not every athlete increases throwing velocity and/or strength following these programs. And the risks of training with a weighted ball program prove to be high.

Dr. Fleisig, a renowned sports MD with a focus on injury prevention in baseball, studied how throwing mechanics using a weighted ball on flat ground caused significantly increased stress on the ulnar collateral ligament (UCL aka the Tommy John Ligament). He found that the increased weight of the ball alters biomechanics and increases stress on the UCL.²

Dr. Okoroha, known for his research involving weighted ball training in athletes in throwing sports, found increased elbow stress in youth pitchers while throwing with a weighted ball, and that as the weight of the ball increases, the stress on the UCL increases.³

Reinold & Macrina, a physical therapy duo that has done groundbreaking research in developing rehabilitation and return to play guidelines for overhead athletes, found a 24% injury rate in high school pitchers during play following a 6-week weighted ball program. They went on to find a significant increase in range of motion of the throwing arm into external rotation, which can decrease stability at the shoulder, increase stress on those elbow structures, and lead to injury.¹

Dr. Bell’s Take On All of This: Personally, I use weighted balls to enhance my own arm strength, and I use them with some of my athletes when I have a specific purpose during our training. I don’t recommend them for group training or unsupervised strengthening activities. Variables that I consider when using a weighted ball program with an athlete:

1. Weights of the ball

2. Actual drills/exercises performed

3. Volume of throwing in a training session

4. Frequency of training

5. Supplemental exercise or training program

6. Point in the season

7. Age of the athlete

8. Strength and Body Type of the Athlete

9. How far along post-injury or surgery

10. Goals of Training

A few tips for preventing injury:

• Start with a 5.5-7oz ball which is just heavier than a standard baseball. Increase weight incrementally.

• Prioritize form and mechanics over weight, distance, and velocity.

• Stick to 15-20 high-effort throws, twice per week during high intensity phases of training. More max effort throws won’t generally increase your velocity.

• Avoid overexertion to stay out of that “injury zone.”

• Adjust and readjust the training regimen depending on an athlete’s throwing mechanics as the weight of the ball increases, if the athlete experiences pain or other symptoms during training, or if there is fatigue or soreness following a training session.

Before starting any structured weighted ball program, I ensure that rotator cuff strength is optimal, shoulder range of motion is where I want it to be, and I look for excellent mobility in the spine and lower extremities. I rule out any sites of pain, particularly around the front of the shoulder and inside the elbow. Ideally, I’'ll confer with your pitching or throwing coach to observe mechanics. If all these aspects are ideal, I proceed with the program.

Technique Spotlight: Enhancing Shoulder Stability and Mobility - “Inverted Kettlebell Program”

Here is what I love about this exercise series: the inverted kettlebell position really challenges your grip and forearm strength, while the unstable nature of the bell on top of the handle requires more stability and control through the shoulder joint, the scapular muscles, and the core stabilizers. Performing these exercises in a series challenges the endurance of your muscles, which is critical in repetitive overhead sports.

What does this have to do with weighted ball programs? Well, this is one of the series of exercises I like to see an athlete do without pain or compensatory movement patterns before I will progress to a weighted ball program. We can also use this exercise series to accommodate the arm to heavier weights by increasing the weight of the kettlebell and the complexities of the movements we perform.

Dr. Bell’s Tips:

1. Alcohol or clean the handle! This seems silly, but if you are using someone else’s equipment that is sweaty and gross, your grip doesn’t stand a chance

2. ALWAYS finish each exercise with the kettlebell directly over your shoulder. Do not place your shoulder in a position of instability with heavy weight overhead

3. Use a spotter if possible to prevent injuries

4. Start with a light weight, sometimes a 5lb kettlebell is all you need! You might think it’s not enough weight at first, but 2 minutes into the series you will be thankful you didn’t start with the 20lb weight

5. ALWAYS keep your wrist in a strong neutral position, don’t let it bend back and forth as you move your arm

Success Story: Overcoming Adversity

This month, we are thrilled to highlight Meghan K., a professional handball player for Team USA and a key defender for the San Diego Sea Dragons. Meghan's impressive athletic journey also includes her time as a goalkeeper for Penn State University.

In October, Meghan underwent labral surgery on her throwing shoulder after a dislocation caused by a hard dive. She spent six months rehabbing at a traditional physical therapy clinic before coming to us, facing mobility issues and weakness in her rotator cuff and scapular region that hindered her ability to throw.

Since starting her rehab with us, Meghan has made remarkable progress. Our team initiated a tailored return-to-play and performance regimen, and Meghan has excelled in her throwing program. Her dedication and hard work have put her well on the path to rejoining Team USA for their international appearance in August.

Good luck, Meghan! We're cheering for you!

Ask the Expert: Do You Use a Weighted Ball Program in Your Training?

Sometimes. I use weighted ball throwing programs mostly during the offseason when I can really ramp up my training, and proceed with caution and decrease the weight and intensity when throwing midseason.

Here is what my warm-up would look like before I start throwing drills: (low volume and weights, not with the intention of fatiguing the arm)

1. Elbow and Forearm Strengthening

2. Shoulder Mobility Drills

3. Rotator Cuff and Scapular Work

4. Core Activation

5. Lower Body Mobility

6. Double-handed medball throws

Stay Connected: Join Our Community

Connect with our vibrant online community of fellow overhead athletes, coaches, and sports enthusiasts by giving us a follow on Instagram @TheTrainingRoomOC. Share your experiences, seek advice, and stay updated on the latest developments in sports performance physical therapy for overhead athletes. Together, we can elevate our performance and achieve new heights in our respective sports.

Closing Note:

Thank you for embarking on this journey with us through the world of sports performance physical therapy for overhead athletes. We hope you found this issue of "The Overhead Athlete's Edge" insightful and empowering. Stay tuned for more valuable information and inspiration in our next edition. Until then, keep honing your skills, pushing your limits, and trusting the process!

Best regards,

Dr. Sam

Reference Articles:

1. Reinold MM, Macrina LC. The Safety and Efficacy of Weighted Baseballs. IJSPT. 2021;16(2):594-596

2. Fleisig GS, Diffendaffer AZ, Aune KT, Ivey B, Laughlin WA. Biomechanical Analysis of WeightedBall Exercises for Baseball Pitchers. Sports Health. 2017;9(3):210-215

3. Okoroha KR, Meldau JE, Jildeh TR, Stephens JP, Moutzouros V, Makhni EC. Impact of ball weight on medial elbow torque in youth baseball pitchers. J Shoulder Elbow Surg. 2019;28(8):1484-1489