physical therapy, Ballet, Cross-Fit, Fitness, Physical Therapy
Ben Wobker
Relative Energy Deficiency

If you're a runner, you may have heard of the Female Athlete Triad, a term once used to describe a combination of low energy availability, menstrual dysfunction, and bone health issues. However, our understanding of these conditions has evolved, giving rise to a broader concept: Relative Energy Deficiency in Sport (RED-S). This condition is not just for elite female athletes; it affects athletes of all levels and genders. Let’s break down what RED-S is, why it's important, and how you can protect yourself as a runner.

Relative Energy Deficiency
weight lifting, Fitness, Softball
Ben Wobker
Softball Injuries

Softball is a popular and engaging sport enjoyed by millions of people worldwide. While it provides excellent physical exercise and fosters teamwork, like any sport, it comes with its risks of injuries. Understanding the most common injuries in softball and how to prevent and treat them can help players stay safe and enjoy the game longer. In this blog, we’ll explore the top injuries suffered by softball players and provide tips on prevention and recovery.

Softball Injuries
Baseball, Physical Therapy, shoulder Pain
Terry Phillips, PT, DPT
Strength Training for Golfers

While the game of golf has been around for several centuries, it hasn’t been til recently that the concept of a golfer training their bodies to help them with their sport has become more common. Since Tiger Woods took the game by storm almost 30 years ago, with his long drives and overall ability to dominate his competition, the world of golf fitness has also seen somewhat of an explosion. Now, golfers at almost all levels recognize that while working on their swing, chipping, and putting is important, it’s almost equally as important to put work into their bodies as well to ensure they can meet the demands of what today’s game asks of them. However, to the everyday golfer, there can still be a lot of uncertainty as to what training for the sport of golf looks like. This article aims to clarify that uncertainty and provide direction on how to dial in their gym sessions to help them on the course further.


Strength Training for Golfers
Baseball, Physical Therapy, shoulder Pain
Terry Phillips, PT, DPT
Weighted Ball Training

Integrating weighted balls into a pitching routine can be an effective way to improve arm strength, velocity, and overall pitching performance. Here's a general guideline on how to incorporate weighted balls into your routine:

  1. Consult with a professional: Before incorporating weighted balls into your routine, it's essential to consult with a pitching coach or a sports medicine professional who can assess your current abilities and provide guidance on the appropriate weight and progression for your specific needs.

  2. Start with a warm-up: Begin your pitching routine with a thorough warm-up to prepare your muscles and joints for the increased stress of throwing weighted balls. Perform dynamic stretches, light cardio exercises, and arm-specific warm-up exercises to increase blood flow and flexibility.

  3. Progress gradually: Begin with lighter weighted balls and gradually increase the weight over time. It's important not to start with weights that are too heavy, as this can lead to injury. A recommended progression might be to start with balls around 4-6 ounces and gradually increase to 8-10 ounces.

  4. Focus on proper mechanics: Throughout your pitching routine, maintain proper pitching mechanics. The added weight of the balls may change the feel and timing of your delivery, so it's crucial to concentrate on maintaining a smooth and efficient motion. Work with a coach or use video analysis to ensure your mechanics are not compromised.

  5. Incorporate specific drills: Use a variety of pitching drills that specifically target different aspects of your mechanics and arm strength. For example, you can incorporate long-toss drills with weighted balls to improve arm strength and distance, or use weighted balls during bullpen sessions to work on pitch command and velocity. However, ensure that you don't exclusively rely on weighted balls and include regular pitching with standard baseballs as well.

  6. Pay attention to recovery: Pitching with weighted balls places increased stress on your arm and shoulder. Allow adequate time for recovery between sessions to avoid overuse injuries. Incorporate proper rest, stretching, and strengthening exercises for the shoulder and arm into your routine. Listen to your body, and if you experience any pain or discomfort, consult a professional.

  7. Monitor progress: Track your progress over time by measuring factors like velocity, accuracy, and overall pitching performance. Keep a record of your pitching sessions and note any changes or improvements you observe. This feedback will help you make adjustments to your routine as needed.

Remember, integrating weighted balls into your pitching routine should be done carefully and progressively to minimize the risk of injury. Consulting with a professional and maintaining proper technique are crucial for safe and effective implementation.


Weighted Ball Training
Physical Therapy, Baseball, Pitching
Joe Midgett
Early Sports Specialization

Early Sport Specialization (ESS)

Before I explain why, lets briefly get on the same page with a definition for Early Sport Specialization (ESS). Typically ESS refers to year-round (for at least 8 months) intensive training or competition in an organized sport by young athletes (<12 years of age) while excluding all other sports.

Injury Risk

One of the most studied problems with early specialization is increased injury risk compared to peers. The biggest factor contributing to this increased risk was participation in any individual sport for greater than 8 months of the year3. This is especially true in baseball pitchers where pitching for more than 8 months per year was correlated with a 500% increase in risk for Tommy John surgery. (I discuss this and other risk factors for UCL injury in my blog “Minimizing the Risk for UCL Injuries in Throwers” *hyperlink). Across all sports there is an increased injury risk of 1.81 times in highly specialized athletes compared to their multi-sport peers5.



Early Sports Specialization

concussion

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Early Physical Therapy after Concussion

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Early Physical Therapy after Concussion

Within the last decade, physical therapist’s role in concussion management has emerged. A landmark research article released in 2018 makes a strong suggestion that physical therapists are great entry points into the medical management of the recently concussed athlete, even within the first week.

Ellis’s research group published their article stating that contact with a physical therapist within the first week after their concussion can be important for athletes. The reasoning stems from the fact that physical therapists can administer and devise a rehabilitation program to help the athlete retain as much of their physiological conditioning during their recovery process. Ellis’s group cites an article that states after a short period of time without any exercise, there are deleterious effects to the athletes physiology and exercise tolerance.1

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How Physical Therapy Can Help Those Who Have Sustained a Concussion.

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As popularized throughout sports, concussion has been a trending topic throughout all media outlets. In the last decade expert scientists, physicians, and other healthcare providers have strived to address the wave of questions and concerns raised by those affected and their loved ones. 

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Though most of the literature reviews and studies sports related concussions, I believe much of the information can be applied to the many individuals with general concussions. With winter in full effect, concussions can be caused not only from winter sports, but also from accidents caused by ice (motor vehicle accidents, slip and falls, etc).

 

This past summer, I attended a Seattle Pediatric Sports Medicine conference that had a panel of healthcare providers who manage patients with sports-related concussions. They discussed the current topics on concussion management and how they approach each case. Most members of the panel were a part of the University of Washington Concussion team.

 

The University of Washington does a great job in providing information on the background and general symptoms of concussion. You can access their tremendous resource here. 


 

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The main points I took from the conference is that current up-to-date acute treatment of concussion does not require the affected individual to sit in a dark room until symptoms to diminish. These individuals don’t require prolonged avoidance of TV or phone screens. Additionally I learned that chronic traumatic encephalopathy (CTE) is still in its infant stages of research and scientists are unable to conclude that multiple concussions are the actual causes of CTE. The most important fact I was reminded of was that concussion treatment requires a team approach, which can sometimes include physical therapy. 

How Physical Therapists Can Help

 

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According to the most recent consensus statement released by the Concussion in Sport Group in 2016, “Sports related concussions can result in diverse symptoms and problems, and can be associated with concurrent injury to the cervical spine and peripheral vestibular system… the data support interventions including psychological, cervical, and vestibular rehabilitation.”1 You can read more here on the 2016 Berlin Concussion Consensus Statement.

 

Most concussion symptoms tend to resolve after 2 weeks. However if there are lingering symptoms, seeing a physical therapist may be a great option to help with an individual's recovery. Here is how we can help.

 

Neck Rehabilitation

 

Sustaining a concussion can result from multiple types of head trauma. What affects the head likely affects the neck. The body will do everything it can to protect the head and often stiffen your neck. With pain playing the role of your alarm system, it’s with no surprise that the neck becomes extra guarded and irritated when you try to move it. Physical therapists can improve your cervical and thoracic spine mobility and implement strategies and interventions to decrease your discomfort. From manual therapy to progressed therapeutic exercises, PT interventions can help improve neck function.

 

Vestibular Rehabilitation

 

Vestibular specialized physical therapists can help those after concussion who continue to feel dizzy or off-balanced. Symptoms may include but are not exclusive to dizziness, vertigo (room spinning), disequilibrium (off balance, nausea), and visual impairment. Seeing a physical therapist who specializes in vestibular rehabilitation can be a valuable member on your team. After a thorough evaluation, they can provide you strategies and exercises to help your vestibular system adapt.2

 

Benign Paroxysmal Positional vertigo (BPPV) is the most common vestibular pathology that can occur after head trauma. Symptoms include head motion-induced vertigo, normally triggered when rolling in bed or turning the head quickly. This vertigo lasts for seconds, often followed with a fog or lightheadedness lasting for hours afterward. If diagnosed correctly, this can be treated with great success by a trained professional.3 You find more information here.

 

Lower Limb Injuries Risk Reduction

 

Though not mentioned in the 2016 Consensus, within the sports concussion literature there has been growing evidence on how concussions may have an influence on future lower limb injuries. What is proposed is that after a concussion, the joints, muscles, and tendons in your legs have an impaired ability to detect where they are in space. Though this may not fall into the category of concussion rehabilitation, orthopedic rehabilitation can help address proprioception and neuromuscular control impairments for athletes who are looking to return to play.4

 

As for other common symptoms stemming from a concussion, other professionals including neurologists (migraine/headache specialist), neuropsychologists, speech therapists, and vision therapists would be great resources to consult. Ask your concussion management team if physical therapy is right for you and your symptoms and find a local clinic that has a clinician there to help you.

 

References:

 

1.     McCrory P, Meeuwisse W, Dvorak J, et al Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016 Br J Sports Med 2017;51:838-847.

2.     Gurley JM, Hujsak BD, Kelly JL. Vestibular rehabilitation following mild traumatic brain injury. NeuroRehabilitation. 2013;32(3):519-528. doi:10.3233/NRE-130874.

3.     Benign Paroxysmal Positional Vertigo (BPPV). American Physical Therapy Association. https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=52822493-32f3-4d4c-8c56-8e18c41b2f85. Published September 1, 2015. 

4.     Kardouni JR, Shing TL, Mckinnon CJ, Scofield DE, Proctor SP. Risk for Lower Extremity Injury After Concussion: A Matched Cohort Study in Soldiers. Journal of Orthopaedic & Sports Physical Therapy. 2018;48(7):533-540. doi:10.2519/jospt.2018.8053.

 

Information provided on lakewashingtonPT.com and all of its web pages is intended for general educational and entertainment purposes and is not intended to be medical advice to you or any other person. You should always consult with your own medical provider about your health and medical questions and never rely on this or any other web site alone to make medical decisions. Never delay seeking medical advice or disregard any medical advice you have received from your provider because of anything you read or hear on this website.