Accelerated Muscle Recovery in Baseball Pitchers Using Phase Change Material Cooling

Abstract

The purpose of this study was to document recovery following a pitching performance and determine if prolonged post-game phase change material (PCM) cooling of the shoulder and forearm accelerates recovery. Methods: Strength, soreness and serum creatine kinase (CK) activity were assessed prior to, and on the two days following pitching performances in 16 college pitchers. Pitchers were randomized to receive either post-game PCM cooling packs on the shoulder and forearm, or no cooling (control). PCM packs were applied inside compression shirts and delivered cooling at a constant temperature of 15°C for 3 hours. Strength was assessed for shoulder internal rotation (IR), external rotation (ER), empty can test (EC) and grip. Results: Total pitch count was 60±16 for 23 PCM cooling games and 62±17 for 24 control games (P=.679). On the days following pitching IR strength (P=.006) and grip strength (P=.036) were higher in the PCM cooling group versus control. One day after pitching IR strength was 95±14% of baseline with PCM cooling versus 83±13% for control (P=.008, effect size d 0.91) and 107±9% versus 95±10% for grip strength (P=.022, effect size d 1.29). There was a trend for greater ER strength with PCM cooling (P=.091, effect size d 0.51). The EC strength was not impaired after pitching (P=.147) and was therefore unaffected by PCM cooling (P=.168). Elevations in soreness and CK were not different between treatments (Treatment by Time CK P=.139, shoulder soreness P=.885, forearm soreness P=.206). Conclusion: This is one of the first studies to document impairments in muscle function on the days following baseball pitching, and the first study showing a novel cryotherapy intervention that accelerates recovery of muscle function in baseball pitchers following a game. 2

Don't Lose Your Cool With Cryotherapy: The Application of Phase Change Material for Prolonged Cooling in Athletic Recovery and Beyond

“…A central effect from local 15 • C PCM cooling was since confirmed by the reduction in core temperature and increase in heart rate variability evident during PCM treatment in individuals at rest (Kwiecien et al, 2019). These findings suggested that prolonged PCM cooling delivered a systemic, and not just a local effect; and might explain, in part, the accelerated recovery evident from PCM cooling following eccentric exercise (Kwiecien et al, 2020a), soccer match play (Clifford et al, 2018;Brownstein et al, 2019) and baseball pitching (Mullaney et al, 2020). However, the central effect occurring from PCM cooling remains to be directly elucidated in individuals following exercise.…”

“…Importantly, the protection provided by the PCM cooling after an initial bout of eccentric exercise did not interfere with the repeated bout effect, whereby an initial bout confers an adaptive protective effect for a subsequent bout of damaging exercise (Kwiecien et al, 2020a). Similarly, 3 h of 15 • C PCM cooling has also been shown to accelerate recovery of quadriceps strength following soccer match play (Clifford et al, 2018;Brownstein et al, 2019; Table 1) and shoulder internal rotation strength and grip strength following baseball pitching (Mullaney et al, 2020; Table 1). Alleviating strength loss at a rate faster than normal could allow athletes to be better prepared for subsequent performance, giving them a competitive advantage over the opposition.…”

“…While prolonged cooling using 15 • C PCM was shown to be successful in accelerating recovery following eccentric exercise (Kwiecien et al, 2018(Kwiecien et al, , 2020a, soccer (Clifford et al, 2018;Brownstein et al, 2019), and baseball pitching (Mullaney et al, 2020), no benefit of accelerated recovery from 15 • C PCM cooling was found when administered for 3 h in runners following a marathon (Kwiecien et al, 2020b; Table 1). It is possible that the efficacy of prolonged cooling using 15 • C PCM is dependent on the mode of exercise stress resulting in muscle damage, i.e., mechanical vs. metabolic stress.…”

“…To date, PCM cooling has only been studied in exercise recovery models with benefits shown for reducing strength loss and soreness after isolated eccentric exercise (Kwiecien et al, 2018(Kwiecien et al, , 2020a, accelerating recovery in professional (Clifford et al, 2018) and semi-professional soccer players (Brownstein et al, 2019), and improving strength recovery in baseball pitchers (Mullaney et al, 2020). These studies have answered some fundamental questions and provide some good "proof of concept" that continuous and prolonged PCM cooling application can help recovery of muscle function, reduction in soreness, and does not seem to attenuate acute adaptive responses (Kwiecien et al, 2020a).…”

“…Furthermore, 15 • C PCM packs can be applied concurrently to multiple athletes, or even entire teams at a time. Recent evidence suggests that prolonging the duration of cooling for three (Clifford et al, 2018;Brownstein et al, 2019;Mullaney et al, 2020) to 6 h (Kwiecien et al, 2018(Kwiecien et al, , 2020a is well tolerated by recreational and professional athletes alike and can accelerate more than just subjective recovery following exercise. Therefore, this narrative review will aim to summarize the current evidence in support of prolonging the duration of cooling by using 15 • C PCM, for its capacity to accelerate and aid recovery following exercise.…”