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
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TMJ Pain

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TMJ Pain

It is estimated that up to 25% of the population suffers from pain in the jaw at some point in their lives. (1) This pain is commonly referred to as TMJ or TMD, acronyms that stand for Temporomandibular Joint or Temporomandibular Dysfunction respectively. This can manifest in jaw or face pain with eating, talking, and singing, painful clicking/popping, restricted range of motion when opening or closing the jaw or resting muscular pain in the jaw. (1) If any of these listed symptoms apply to you, seeking physical therapy may help.

The temporomandibular joints are made up of your mandibular bone and the temporal bone of your skull. The joints include surrounding ligaments that help to control and support jaw motion as well as a disc which acts as a cushion for the joint.


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Running Warmup & Stretching?

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Running Warmup &amp; Stretching?

It is that time of year where many people are hitting the pavement and trails ramping up for races or just general fitness goals. Some may have gutted out the wintry weather and tried to sneak in runs during breaks in the rain or indoors on the always reliable treadmill. With an increase in volume of running, we often see repetitive stress injuries that can come with inadequate attenuation of forces. If you’ve been running long enough, chances are you know someone or have a running partner who dealt with a recalcitrant tendon issue, whether involving the Achilles tendon, peroneal tendon or patellar tendon. Or maybe you had to deal with it yourself. If so, hopefully you’ve packed your patience as the process can be frustrating. If you have ever had these injuries sideline you then you know how it can hinder your ability to compete in athletic activities. It’s helpful to understand the physiology of what is happening to the tendon in order to know how best to treat it, ideally while working alongside a physical therapist familiar with running and jumping injuries. 

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March for Larch

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March for Larch

Hiking is high on the list of PNW pastimes. It’s a great excuse to explore the mountains and enjoy every bit of the natural beauty that Washington State has to offer. Peak hiking season in Washington tends to run from late Spring through summer, as the snow melts and the temperatures get warmer. However my personal favorite is a short window of a few weeks in early Autumn– larch season. Larches are a variety of trees that may at first glance resemble a typical pine, but larches do not stay green year-round. Unlike their evergreen neighbors, larch tree needles turn a beautiful golden yellow color in the early fall. For two to three weeks at the end of September until the first snows in October, the Pacific Northwest is blessed with beautiful variation in the forests as those golden yellow pine trees reach peak color. It’s a short window before the trees begin to lose their pine needles as temperatures drop, so you don’t want to miss out on the annual larch madness.

Precautions for Hiking

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Tackling & Concussions

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Tackling &amp; Concussions

Football fanatics and players, we made it. We made it through the grueling summer dog days and have arrived here at the start of the season! I don't know about you, but this time of the year I always get extremely excited that football is ramping up, teams are practicing and games are in full swing. With this increase in football activity, it's inevitable that there will be an increase in sports related injuries, especially concussions. Within recent years, the sport of football has been under a lot of scrutiny about its danger to the athlete due to head trauma. Football is a violent sport with roughly 300,000 reported concussions occurring in the sport across the country per year, and 1.6 to 3.8 million cases of concussions occurring across all sports annually (as reported by UPMC sport medicine). The NFL and leagues around the country have made a valiant effort to make the game safer by implementing rules and regulations, and educating the player and coaches about proper technique to mitigate injury. Very rarely does that transcend down to the highschool, junior or peewee levels. This blog article is to help inform parents and kids about concussions, the signs and symptoms, proper recovery timeline, and proper tackling technique to help prevent concussions.

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Sacroiliac Joint Pain

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Sacroiliac Joint Pain

The diagnosis and treatment of the sacroiliac joint (SIJ) can be challenging and is highly debated within the research and among clinicians. While the existing research is focused on investigating variations of mobilizations and manipulations to treat SIJ dysfunction, it is deficient in how to enhance treatment and patient’s self-efficacy with specific exercises. With that in mind, I’ll aim for brevity in my review of the anatomy and biomechanics of the SIJ region so I can focus on existing research and a few “clinical pearls” that I have picked up through my continuing education and practice treating SIJ pain in the clinic. The pelvis can be thought of as a ring or bowl holding our internal organs. The interface between the sacrum (triangular bone at the base of the spine) and ilium bones form the sacroiliac joints. Because of this orientation, the SIJ is well equipped to help manage forces through the pelvis through a combination of bony connections, ligamentous attachments, and muscular attachments. While the sacrum is the attachment point for several major muscle groups (multifidus, erector spinae, latissimus doris, gluteus maximus, piriformis, and portions of the pelvic floor), the sacrum itself does not move in isolation, and it is heavily impacted by muscles attaching in and around the pelvis.

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Ankle Sprains

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Ankle Sprains

It’s a beautiful fall morning and you are walking your dog along a path near your house.  The birds are singing and the trees are bright green with new buds of growth.  As you place your right foot down on the trail, your ankle gives way and it feels like you stepped into a hole.  You lurch to your right off the trail and narrowly recover your balance to prevent a fall.  You immediately notice a familiar sharp pain along the outside of your ankle.  As you examine the trail behind you, you notice a very small pebble on the flat trail where your ankle gave way.  Why do these tiny pebbles continue to cause your ankle to roll every 3-6 months?
Up to 70% of people who sustain an acute ankle sprain may develop chronic ankle instability with the likelihood of additional ankle sprains.  When you sprain your ankle, the connective tissues (ligaments) are stretched or torn.  Each subsequent sprain leads to further weakening (or stretching) of the ligaments, resulting in greater instability and the likelihood of developing additional problems in the ankle. 

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SpikeBall

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SpikeBall


Summer is here, which means change is upon us. Whether you spend this time of year gardening, spring cleaning, or taking in the sunshine doing yard work, these kinds of activities require a lot of lifting which could cause a low back strain. I recently moved and I could not help but notice my back feeling sore the next week or so. I was humbly reminded that I am no longer in my early twenties– gone are the days of lifting and carrying with pure strength and little care for form. I quickly learned that if I want to continue being helpful for future moving days, I have to maximize proper movement strategies to minimize all those aches and pains. As your local physical therapist, I wanted to highlight good lifting mechanics and provide some helpful tips that will limit your chance of injury for your next moving day.

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Sleep & Rehabilitation

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Sleep &amp; Rehabilitation

Sleep hygiene is a term that is becoming more popular as we learn how important sleep can be for our health. This term encompasses different strategies to establish daily habits that can ultimately increase the quality and quantity of your sleep providing you the necessary rejuvenation after a long day.

● Exercise

● Relax the mind

● Limit alcohol and caffeine

● Set your biological clock

● Set up sleep-friendly environment

● Limit naps and manage restlessness

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Standup Paddle Boarding

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Standup Paddle Boarding

As the mornings are getting longer and Lake Washington is getting calmer, it’s the perfect time to start training for our summer water sports! As a water sports enthusiast in the Pacific Northwest, it can be hard to keep on top of training for water skiing and wakeboarding in the winter, but it is not too late to get yourself summer ready. Although waterskiing is my summer sport of choice, many of these tips can apply to wakeboarding and wake skating as well.

Importance of pre-season training

The most common injuries while water skiing are lower extremity sprains and strains. This is often hamstrings, glutes, or low back, but ankle sprains can also occur following a fall if your ski is pulled off your foot.1 I also see injuries to the shoulders and upper back, frequently due to poor conditioning and training. While accidents happen, sprains, strains, and post-exercise soreness can often be prevented with appropriate conditioning and sport specific training.

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Heat or Ice?

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Heat or Ice?

Ice or Heat: Body Pain’s Greatest Question

Life has a funny way of leaving its mark on us and quite often it can hurt! By now you’ve likely experienced some kind of injury that caused bruising, swelling, and worst of all pain, either acute or chronic. With any injury therein lies the proverbial question, “should I use ice or heat?” The concept of applying these thermal modalities can seem relatively simple and straight forward but it can become confusing as not every injury presents the same. Thus it makes senses why I’m frequently asked which one should be used for a particular injury. Sometimes I’ve suggested that both are appropriate depending on the situation. Improper use of these modalities can slow your recovery, so it is important to base your decision on physiology and what is most safe and effective.

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Little League Elbow

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Little League Elbow

Chances are that you have heard the term Little League elbow. Most have encountered

it in the media, during youth playing days, or from their own children. As a medical

provider specializing in youth throwing and overhead athletes (baseball, softball, tennis,

etc.), I’d like to provide some clarity around something that is commonplace yet poorly

understood. This article answers the questions: What is Little League elbow? What

causes it? How do you treat it? How is it prevented?

Waterskiing & Injury Prevention

Waterskiing &amp; Injury Prevention

As the mornings are getting longer and Lake Washington is getting calmer, it’s the perfect time to start training for our summer water sports! As a water sports enthusiast in the Pacific Northwest, it can be hard to keep on top of training for water skiing and wakeboarding in the winter, but it is not too late to get yourself summer ready. Although waterskiing is my summer sport of choice, many of these tips can apply to wakeboarding and wake skating as well.

Importance of pre-season training

The most common injuries while water skiing are lower extremity sprains and strains. This is often hamstrings, glutes, or low back, but ankle sprains can also occur following a fall if your ski is pulled off your foot.1 I also see injuries to the shoulders and upper back, frequently due to poor conditioning and training. While accidents happen, sprains, strains, and post-exercise soreness can often be prevented with appropriate conditioning and sport specific training.

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Moving Day

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Moving Day


Summer is here, which means change is upon us. Whether you spend this time of year gardening, spring cleaning, or taking in the sunshine doing yard work, these kinds of activities require a lot of lifting which could cause a low back strain. I recently moved and I could not help but notice my back feeling sore the next week or so. I was humbly reminded that I am no longer in my early twenties– gone are the days of lifting and carrying with pure strength and little care for form. I quickly learned that if I want to continue being helpful for future moving days, I have to maximize proper movement strategies to minimize all those aches and pains. As your local physical therapist, I wanted to highlight good lifting mechanics and provide some helpful tips that will limit your chance of injury for your next moving day.

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Scoliosis Treatment

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Scoliosis Treatment

Adolescent Scoliosis

In the United States, adolescent scoliosis was aggressively screened in primary & secondary educational institutions then subsequently over-diagnosed due to the relatively high general population prevalence of 0.47% - 5.2%. The presence of scoliosis does not always necessitate professional intervention, in fact only 10% of scoliotic curves require medical intervention. Additionally, Schroth method certification is the gold standard for physiotherapy-specific scoliosis exercise (PSSE), and clinicians with Schroth background are not always readily available.

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What is a Squat?

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What is a Squat?

What Is a Squat? A Physical Therapist’s Perspective

Are you a fitness fanatic? A weekend warrior who hits the gym once a week? Or are you someone who has never exercised before? Regardless of the answer, the reality is that you probably squat multiple times a day. Look no further if you have ever asked yourself: is squatting safe? Or Should I be squatting? The purpose of this blog is to provide you with an overview of what happens during a squat, how it is performed, and who should be doing it.

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ACL Series Part 3: Rehab

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ACL Series Part 3: Rehab

Right now, I am 1.5 years post ACL surgery, but 3.5 years post ACL injury. I will be recalling my experience starting at the time of injury all the way through my individual Physical Therapy experience. This will be a multi-part series that tells my story, plus various research facts and personal details along the way.



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Reducing Fall Risk

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Reducing Fall Risk


Falls have become the leading cause of injury for older adults. 27.5% of individuals 65 years and older have reported at least one fall in the past year.1 These falls can lead to serious injuries that involve broken bones or head trauma. Each year over 800,000 people in this age group are hospitalized due to a fall injury and 95% of hip fractures are caused by a fall.2 However, falls are preventable. Working to recognize the modifiable risk factors in our lives can help reduce the chance of fall and injury.




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ACL Series Part 2: Surgery

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ACL Series Part 2: Surgery

Right now, I am 1.5 years post ACL surgery, but 3.5 years post ACL injury. I will be recalling my experience starting at the time of injury all the way through my individual Physical Therapy experience. This will be a multi-part series that tells my story, plus various research facts and personal details along the way.



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Hip Osteoarthritis

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Hip Osteoarthritis

Osteoarthritis is one of the most common orthopedic conditions among physical therapy patients. Osteoarthritis (OA) describes degeneration of cartilage and, eventually, bone in a moving joint. The development of OA can be the result of a previous injury or specific joint condition but is most often idiopathic in nature.1 Knees, hips, and thumbs are notorious for developing OA as a result of the large, repetitive forces these joints have to absorb over the course of a lifetime.2 The term OA refers to a wide spectrum of joint degeneration and can sometimes be used to describe a joint that appears damaged on an X-ray but doesn’t hurt or cause a decline in function (asymptomatic osteoarthritis). Various studies of the general population in the U.S. estimate that 20-28% of adults aged 60+ have evidence of hip OA on an X-ray, yet only 4-10% of this population have pain or poor function due to hip OA.3,4 Although an X-ray may show hip joint degenerative changes, treatment generally does not occur until someone begins to have symptoms.