Ice, Aleve, or Ibuprofen plays an integral role in most pitchers’ post-outing routines. But why?

When I evaluate a new client, parents often rave about their son’s “post-game ritual” of icing right away and popping two Aleve. When I ask why they are using ice and anti-inflammatories, they always give the same answer: to stop inflammation and help recover. Yikes! There are many problems with this routine.

Problem #1 – Pain

A pitcher should not have elbow or shoulder pain post game or the day after. Muscle soreness in the upper back, rotator cuff, and deltoid is normal after an intense outing, but pain is a big no-no.

Ice, Aleve, and Ibuprofen all have analgesic or pain relieving properties. So, if a pitcher is using these modalities on a regular basis, we have no idea how their body is actually responding to throwing because the pain is masked. Being in touch with how the body feels allows us to monitor injury risks factors such as mechanical flaws, excess volume in sport or training volume, and potential sickness that may be exacerbated by lack of recovery.

Problem #2 – Delayed Recovery

Every musculoskeletal injury goes through 3 stages of recovery:

    1. Inflammation

    2. Repair

    3. Remodeling

The following video by Kelly Starrett discusses how reducing inflammation is the wrong approach for recovery. If pressed for time start watching at 4 minutes. Don’t get bogged down by the sciency nature of the information. This is a must watch for athletes, coaches, and parents.


Problem #3 – Ulnar Nerve

The Ulnar Nerve is often the source of pain for athletes and non-athletes alike. Much of this can be attributed to neck pathologies and poor posture, but one thing is for sure, if you throw ice directly on the elbow about half the athletes will say it makes them feel better and the other half say it’s the most painful thing they have ever experienced.

Ulnar Nerve Transposition surgeries are common when conservative treatments no longer work and the patient experiences continual radiating pain, or pins needles with hand weakness. This portion of the elbow can be very finicky and painful, thus why I see no need to place ice directly on the elbow post throwing.


Problem #4 – Gut Health and Ulcers

Gut bacteria play an essential role in a normal digestive tract. NSAIDS can damage the mucous coating that protects the lining of the stomach. Once these bacteria damage the stomach lining, powerful stomach acid may irritate or destroy portions of the stomach. This is where ulcers often form.

Stomach ulcers can lead to excessive gas, bloating, pain or more sever issues of bleeding ulcers and cancer.

So, some changes need to be made in the common post-game routine of pitchers. Instead of settling for the conventional use of Ice, Ibuprofen, or Aleve, pitchers should follow these steps to improve recovery time and arm health:

A New Post Throwing Routine

    1. Restorative Movement/Increased Blood Flow Right After Outing-
      Full Body Active Warm-up

    2. Restorative Nutrition-
      PN Injury Guide

    3. Restorative Sleep-
      7-10 Hours of Deep Sleep

    4. Restorative Movement/Increased Blood Flow Next Morning-
      Full Body Active Warm-up

This model of recovery is what I recommend to our pitchers and athletes who feel they need to improve their recovery techniques post game.


-Ice and NSAIDS are not inherently bad. Instead, their application is often incorrect, as they have more applicability in a post surgical setting.

-Pain and/or swelling after throwing is not normal and should be a huge red flag that something is not right. When pain or swelling is evident seek a medical professional to evaluate the issue. Common causes are overuse, poor pitching mechanics, or orthopedic/movement/strength limitations at the ankle, hip, spine, shoulder, or elbow.

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