Who this is for: players returning to throwing after an injury or a layoff, cleared by Dr. Pettit or their physical therapist. This is the general (non-surgical) program; after surgery, your specific post-operative protocol governs and this page is used only when we tell you to start it.
The rules that make it work
- Throw every other day. Never on consecutive days during the program.
- Complete each step 2–3 times without pain before moving on. A healthy player typically finishes in about 6 weeks, but the calendar never overrules symptoms.
- Warm up before every session: jog to a light sweat → dynamic stretching → one set of 10 reps of your band/rotator-cuff routine (Thrower's Ten) → easy warm-up throws starting at 30–45 feet.
- Crow-hop every long-toss throw (hop → skip → throw). Flat-footed throwing stresses the arm with poor mechanics.
- Throw on an arc at comfortable effort — this is not maximum-distance showing off; it is progressive tissue loading.
Phase I — Long toss
Pitchers (flat ground caps at 120 feet)
Throwing at 120 feet produces roughly the same elbow stress as pitching off a mound — pitchers do not need 150/180-foot phases.
| Step | Distances | Structure |
|---|---|---|
| 1–2 | 45 → 60 ft | 25 throws, rest 15 min, 25 throws (step 2: three sets of 25) |
| 3–4 | 60 / 75 ft | ~50 throws mixed at the two distances |
| 5–6 | 75 / 90 ft | ~50–54 throws mixed |
| 7–8 | 90 / 120 ft | ~50–54 throws mixed |
| 9 | 60 ft flat ground | Pitching mechanics at 50% effort — then begin Phase II |
Position players (45 → 180 feet)
| Phase | Steps | Structure |
|---|---|---|
| 45 ft | 1–2 | 2 sets × 25 throws, then 3 × 25 (10–15 min rest between sets) |
| 60 ft | 3–4 | same pattern |
| 90 ft | 5–6 | same pattern |
| 120 ft | 7–8 | same pattern |
| 150 ft | 9–10 | same pattern |
| 180 ft | 11–13 | finishing with 75 pain-free throws at 180 ft |
| Return | 14 | Position-specific throwing at 50% → 75% → 100% effort |
The soreness rules — follow these exactly
- No soreness: advance to the next step as scheduled.
- Sore during warm-up but gone within the first 15 throws: repeat the previous session. If soreness comes back during that session — stop, take 2 rest days, and drop back one step.
- Sore more than 1 hour after throwing, or the next day: take 1 rest day and repeat the most recent session.
- Sharp pain, especially in a joint: stop throwing and call the office. Dull muscle soreness is expected; sharp joint pain is not.
Phase II — Return to the mound (pitchers)
- Fastballs only, 50% effort: 15 throws building to 65 throws at 75% over ~8 outings. Use a radar gun to keep yourself honest about effort — everyone throws harder than they think.
- Fastballs + batting practice throws: 50–60 pitches at 75% with 15–45 BP throws mixed in.
- Breaking balls begin (~30 at 75% effort) only after fastball steps are pain-free — never earlier.
- Simulated game: add about 15 pitches per outing until game-ready.
While you rebuild
Strength work happens on throwing days, after throwing. Keep up your arm-care program (Thrower's Ten), sleep 8+ hours (adolescent athletes sleeping under 8 hours are 1.7× more likely to be injured), and never spike your weekly throwing volume — build gradually and avoid doubling your workload week over week.
Based on: Reinold, Wilk, Reed, Crenshaw & Andrews, JOSPT 2002; ASMI Interval Throwing Program (2019 revision); Wilk et al., Advanced Throwers Ten, Phys Sportsmed 2011; Milewski et al., J Pediatr Orthop 2014. This program is general education — your individual instructions from Dr. Pettit and your physical therapist always take precedence.
Frequently asked questions
How long does the program take?
About 6 weeks for a healthy player returning from a layoff — but progression is symptom-driven, not calendar-driven. Each step must be completed 2–3 times pain-free before advancing.
Can I throw every day to finish faster?
No. Throwing days alternate with rest days on purpose — tissue adapts during the rest day. Rushing the program is the most common way players end up back at the start.
What's the difference between soreness and pain?
Dull, diffuse muscle soreness that warms up out of the arm is expected. Sharp pain — especially in the elbow or shoulder joint — is a stop sign: shut it down and call us.
When can I throw breaking balls again?
Only in the final mound stages, after fastball steps are completed pain-free — never during the long-toss phases.
See Dr. Pettit
5 locations across Cincinnati & Northern Kentucky · (513) 354-3700