Introduction: A recent US Major League Baseball (MLB) rule change requires baseball pitchers to deliver pitches within 12 sec. Purposes: To examine the effect of three, between-pitch rest intervals on throwing performance during a simulated 7-inning game and muscle damage during post-game recovery. Design: A randomized counter-balanced study. Methods: Seven intercollegiate pitchers threw 15 pitches per inning for 7 innings with rest interval trials of 8, 12, and 20 sec between pitches and 5 min between innings. Pitchers threw aimed fastballs at their best effort. Trials were separated by >=2 weeks. Results: Progressive decreases in pitching speed and accuracy below baseline (1st inning of 20-sec trial) occurred after 4th inning during the 8-sec and 12-sec trials, but not the 20-sec trial. Plasma creatine kinase (CK) elevated 48 h later for the 8-sec and 12-sec trials (+105% and +75%, P
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