View From The Bleachers
by Laura Warren

BS Physical Therapy, Medical College of Georgia, 1979
MS Physical Therapy, University of Tennessee, Memphis, 1997
and mother of a 14 year old pitcher
  

The wonderful world of ice.....

Why  does ice feel so good.?  When is it needed?  For a pitcher, when do they need to start using ice and where does it go?   Physiologically, cold/ice tends to cause a numbing effect to soft tissue such as muscle, ligaments and tendons.  It also tends to cause a decrease in the inflammation in the soft tissues.  After a game or after a heavy practice, ICE, not heat,  should be applied.   Even with no particular injury, it's best to keep those soft tissues happy.  Once my daughter was throwing really forcefully, she was beginning to need to have ice routinely.  I would suggest by the time the fast ball is thrown 40 miles/hour they need ice.  I have ordered a shoulder sleeve cold pack for my daughter to use.   We just keep it in the freezer or cooler and she puts it on after the game or practice.  It covers the front of the shoulder and back over the shoulder blade as well as down the arm to the just above the elbow.  If a specially made cold pack isn't available, a loose sack of ice can be put over the shoulder and secured with an elastic bandage or with cellophane.   The ice needs to stay on for 10-20 minutes only.  Because ice will decrease the muscle's extensibility (looseness), you shouldn't use ice in between innings or between games  which are only a short time apart.  This would require a longer warm up time again for the pitcher, or she would risk injury from tissues which are not stretched out and ready to throw.   If there is discomfort  present which is still there or worse by 2 days, it's time to talk to the trainer, a physical therapist, or the physician for a more thorough evaluation.   Because heat can cause an increase in the circulation initially, it is not good to use after practice.  If an injury or overuse has occurred, the heat can make it worse by causing some micro-bleeding into to area.  If there is general soreness a day or so after pitching, heat could be used, but not initially.