U.S. Senate for the opportunity to present. I have disclosure, none are really about interval throwing programs, they're not really relevant here. So I think, oh my goodness, can you guys advance to the next slide? Yeah. Okay, so question number one is, when are you ready to throw? And we had a great presentation already from James Carr, so certainly kudos there. I think my criteria, I was pleasantly surprised to hear are similar to theirs. You got a pain-free, no motion arc deficits, no rotational strength deficits. I would add there, you need to have a normally moving scapula, and you also need to have good core strength. And I've learned a little bit today about that posterior shoulder endurance test, that PSET, I'm gonna add that onto mine, I don't have it yet. And the plyometric's critical. Everyone's gotta do plyometrics before they can throw. Next slide, please. The other thing, and this is the overview. I think this is, when I give the player the progression, I have this discussion. I say, this is not a competition. We're not gonna skip steps. I don't want you doing this with your team, where there's this competitive absence. I wanna do it with a trainer, with a friend, with your parents. You need a field where you have some marked distances, you alternate days throwing a hit, you don't throw consecutive days. And in general, in a distance-based formula, you want, the throw should be on an arc, not a line. So you want enough force to get it on an arc, to that distance, not, I'm gonna throw that distance with the same force I would throw to throw 180 feet. Next slide. The other thing I tell them is that mild pain is okay. And this is from a study that we did with Brandon Erickson, where we looked at a simulated game in high school throwers and showed that as you get to 90 pitches in a normal high school player with no injury, we get to, pain scores about one or two out of 10, fatigue scores up to three out of 10. So when we're doing our throwing programs, it's totally okay to have mild pain. If you get to moderate, severe pain, if your pain score is four out of 10, it's too much, we need to back off. Next slide. Okay, the other thing to tell players is that many players will take an occasional step back. And we're gonna get into this a little bit more, but I tell players, this is okay. If you have a day that you're sore, we're gonna take an extra day off, we're gonna go one step back on the program, we're gonna get back on the wagon. That's okay, that does not mean necessarily things are going wrong. Next slide. Okay, so this is my program, and I'm gonna be the first to admit that this is ASMI's program. I learned this when I was lucky enough to visit them, and I've been forever indebted about that. I will tell you that since then, I have definitely tinkered with it, but the basic outline is here. You can find this on their website. I've put it into an Excel document. You can format it however you'd like, but the basic idea is this. So you start at lower distances, you increase the distances, you increase the number of throws. For fielders at the beginning in red, these are when you cannot play in any games at all. Once you get to 120 feet, I say it's okay to play in the infield. Once we get to 180 feet, you can play any position on the field. For pitchers, in red means you face no live batting. Once you get to yellow, you're facing live batting, and once you get to green, then you can face live batting in a competition setting. Next slide. Definitely, you're gonna wanna have modifications to this program. If you're covering a team, if you have an in-season injury, you need an accelerated program. So this is for the athlete that's already, it's in-season, it's a minor injury, they're already in shape, they've had a brief amount of time off. This is a two-week accelerated version to get us back in play when it's August, when it's July, when you need to get back. Next slide. Okay, now the next thing to say is you might have looked at my program and said, okay, it takes about 11 weeks. You may then ask, well, how long does it actually take in practice? And this is data from a study Chris Camp did where after UCLR, the actual time to return to play, you'll see is much, much longer. Next slide. This is the actual graph of how long it takes, and you'll see that by the time you get to 24 months, you've got that 90% return to play, but that if you look at 12 months, only 60% of players have returned to play by that time point. This can take much, much longer. So this is the step back, and I tell our players this all the time. This is gonna be slow. We're gonna take this at your own pace. This is not a competition to the finish line. The goal is to get you back. The goal is not necessarily to get you back quickly. Next slide. So I definitely have an extended protocol, and this is a modification-best-in-minds protocol. You're gonna need this as well. So for your UCLR, you're trying to get back at a higher-level throw, you want a protocol that takes longer so we can get that eight months, we can get that nine months, and say, okay, this is how long it's gonna take if we start throwing at four months. This is how long it takes us at one year to get back. That's a much more reasonable timeline, especially depending on the injury and depending on the player. Next slide. Okay, now I think the next thing to understand is that long toss is as much force as pitching, and here we owe a debt to Glenn Fleissig, who's done an incredible amount of careful research on this. Basically, this is the data. Once you get to 37 meters, or about 120, 150 feet, you're putting as much force, sometimes even more force, through the arm as when you pitch through the mound. So I tell our players this. If we can get you to 120, 150 feet, it's all fine-tuning from there. If you can put that much force through your arm, we're gonna be fine, and the problems we're gonna see are leading up to that point. Next slide. And we found this through a subsequent study I did with Eric Mockney. This is looking at ball velocity as compared to distance. Next slide. And then this is data looking at modus, where you can see the arm speed. By the time you get to 120, 150 feet, it's basically about as high as it's gonna go. Next slide. And the same thing is true of torque. Once you get to 120, 150 feet, that's about as much torque as you're gonna put through your elbow. Next slide. The arm speed data is the data I trust the most. Certainly Chris Camp has shown us that the modus data's not perfect, but the arm speed data you get from modus is actually accurate. Next slide. The next thing to talk about, and this I think is really important. You may have noticed, looking at the pitching algorithm, that by the time you get on the mound, we're asking pitchers to throw at 50% effort. So when this has been studied, actually 50% effort for a pitcher means 85% effort. So pitchers cannot judge 85% effort. They can't throw 85, they can't throw 50% effort. They're gonna throw 85 when you tell them 50. So I think it can be very helpful to have a radar gun to show that to a pitcher, to say, you just pitched this many miles an hour. This compares to your max in this way. We are pitching at more effort than you might think. That sometimes can give the pitcher the confidence to proceed, or at least the confidence to understand, okay, if it's sore, that's the reason why. Next slide. So here are our conclusions. I think you wanna go slow. You don't wanna repeat, you don't wanna hesitate to repeat steps, but you don't wanna skip steps. You wanna have a variety of programs to address players in different situations. Once you get to 120, 150 feet, your forces plateau. Tell the players that. It's all fine tuning from there. Consider a radar gun once you get on the mound to judge effort. Next slide. Thank you so much.

throwing readiness criteria

pain-free

motion arc deficits

rotational strength deficits

moving scapula