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Originally Posted by CecilOne
Hand up to hold pitch, is it an actual time out?
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No. It is simply a directive to not pitch yet.
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If so, why one hand and no verbal?
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Tradition, probably for much the reason that Tom (Dakota) already stated.
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If so, may a runner leave a base?
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See Mike (Irishmafia's) answer.
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If not, what rule prevents the pitcher from pitching, other than a no-pitch for everyone not being set?
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No rule cite. It is simply a directive being given by the umpire to hold the pitch until all participants are ready.
Andy, both Tom and Mike have already answered your question in a manner I agree with.
This is a tool of the umpire that, in my opinion, should not be overused. I may use it once or twice in a 7 inning game on average. I have seen umpires who use it virtually for every pitch, and that sends the signal to me that they are not in sync with the game, or else that they do not understand the intent of that particular directive.