After a shoulder or elbow injury, your arm needs time to get used to the stress of throwing. Throwing too soon can hurt tissues that are still healing.

Returning to throwing involves slowly building your arm back up so it can handle throwing again. Most people follow a throwing program. This is a plan that raises your throwing distance, effort, and number of throws in small steps.

Your doctor, physical therapist (a specialist who helps you move better and get stronger), or athletic trainer will guide you through each step. The goal is to protect your healing arm while you get your strength and control back.

Before you start a throwing program, your doctor or rehab team will check that your arm is ready. You may be ready when:

• You can move your arm through its full range of motion without pain.
• You have enough strength in your shoulder, the muscles around your shoulder blade, and your forearm.
• You have finished a plyometric exercise program. Plyometric exercises are quick, powerful moves, such as throwing a weighted ball against a wall. These exercises help get your arm ready for the stress of throwing.

There are things you can do that may help protect your arm as you work through your return-to-throwing program. You may be told to warm up your whole body before each session. A warm-up may include jogging, stretching, and some resistance band exercises for your arms.

Your doctor or rehab team may recommend icing your shoulder or elbow for 15 minutes after every session. They may also recommend resting at least 1 day between sessions. This gives your tissue time to heal. Throwing outside of your scheduled sessions can slow your healing.

Some mild soreness is normal as you work through the program, but pain is a warning sign. If you feel pain during a session, stop and rest until you are pain-free. Then start again at a lower level of the program. Contact your doctor or rehab team if your pain gets worse or does not go away with rest, or if you notice swelling or new symptoms.

The sample program below is for a baseball player. If you throw in another sport, such as football, your program may look a little different. For example, a quarterback may measure throwing distance in yards instead of feet and make a different number of throws in each session. Your rehab team will build a plan around your sport.

Your throwing program is made just for you. It's based on things like your strength before the injury, your body mechanics, and your age. Body mechanics means the way your body moves when you throw.

The program increases your throwing distance, effort, and volume little by little. Volume means the number of throws in each session. Effort means how hard you throw. Some rehab teams use a wearable sensor on your arm to track effort. If you don't have one, your trainer or rehab team can show you how to judge your effort. You move to the next step only when your arm handles the current one without pain.

Your program may look different depending on your injury and whether you had surgery. Here is one example for a baseball player:

• Weeks 1 and 2. Throw from 30 to 45 feet, using 25% to 50% of your full effort. Make 15 to 25 throws per session, with at least 1 rest day between sessions.
• Weeks 3 to 5. Throw from 60 to 90 feet, using 50% to 75% of your full effort. Make 30 to 50 throws per session. Increase only one thing per week, either distance, effort, or volume.
• Weeks 6 to 8. Throw from 90 to 120 feet, using 75% to 85% of your full effort. Make 40 to 60 throws per session.
• Weeks 9 to 12. Try throwing from the mound or your fielding position, using 85% to 100% of your full effort. Make 50 to 75 throws per session. Start with a fastball. Move on to other pitch types as your rehab team advises.