Hip, Knee, Osteoarthritis, Running
Mandie Majerus
Bone Stress Injuries

What is a bone stress injury (BSI) and how do I know I have one? How long will it take to get me back to running? As a physical therapist who treats a lot of runners and as a lifelong runner myself, I have always had a passion for keeping runners running. The act of running can make someone’s day tick along better, can help with consistent sleep, calm the nerves and can even make a runner more fun to be around. It can be social or an act of solitude. It can be alarming for a runner when they start to experience a nagging pain that doesn’t warm up or even worsens as they run. Pain that doesn’t dissipate with a warm-up routine or is vague at first but then becomes localized or intensifies through the run can be a sign of a bone stress injury or BSI. BSI is a general term indicating mechanical load is exceeding the bone’s structural ability to withstand the load. However, BSIs occur on a continuum. One end of that continuum is a stress reaction, the other end can be stress fracture or even a full fracture of the bone. The runner recognizes this as pain that isn’t normally present. BSIs can occur for many reasons whether due to biomechanics or from a nutritional standpoint or a combination of both. As high-school and college cross-country runners prepare now for this upcoming season, they should be aware of the common causes and ways to prevent bone stress injuries.

Bone Stress Injuries
Physical Therapy, Fitness, hiking, Knee
Mark Bouma, PT, DPT, OCS, COMT, FAAOMPT, CFI
Raking Leaves

Mark Bouma, PT takes readers through the areas to watch out for while raking leaves. The fall changes in the PNW is a time of beautiful color but also typically wet and heavy leaves.

Patellofemoral pain is largely a diagnosis of exclusion. There can be many causes of knee pain and it is important for your healthcare provider to properly assess your individual condition. Many individuals have anterior knee pain with prolonged sitting with flexed knees.

There are three common provocative diagnostic tests that are most closely correlated with patellofemoral joint pain:

  • Squatting

  • Climbing Stairs

  • Eccentric Step-Down Test

Research has linked several key factors that may contribute to an individual developing patellofemoral pain. These factors are not present in everybody who has symptoms, but there are often impairments in one or more of these areas found during a physical therapy exam.

Raking Leaves
Physical Therapy, Fitness, Knee, Football, Hip, Neck pain, Running
Victor Kolar, PT, DPT, CSCS, TPIc
Turkey Bowl

Victor Kollar, PT takes you through the areas to think about as you get ready for your annual turkey bowl football game.

Turkey Bowl
physical therapy, Fitness, Physical Therapy, Ankle
Ben Wobker
Riq Woolen: Foot & Ankle Injury

The Seattle Seahawks have been dealing with a challenging season on the injury front, and the ankle injury to standout cornerback Tariq Woolen has added yet another layer of complexity. Woolen, a key figure in Seattle's defensive scheme, has demonstrated elite skills throughout the season, allowing a league-low 27.3% completion rate and an astonishing 1.7 passer rating when targeted. His injury has not only affected the team's defensive depth but has also posed significant challenges in maintaining consistency in coverage. In this article, we delve into the details of Woolen’s injury, its implications for the Seahawks, and what the team can do moving forward.

Riq Woolen: Foot & Ankle Injury
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
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Weighted Ball Training

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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.


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Little League Shoulder

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Little League Shoulder

Little League shoulder, also known as proximal humeral epiphysitis, is a common overuse injury that affects young baseball players, typically between the ages of 11 and 15. It is characterized by pain and discomfort in the shoulder joint, specifically in the upper arm bone (humerus) near the growth plate.

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Couch to 5K

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Couch to 5K

Like many of us do in the New Year, I made it a goal to become more healthy and active in 2023. One of my goals was to Become A Runner– a tall order for me. To be completely honest, running and I haven’t had the best relationship. For me, running had to involve chasing a ball to be interesting… football, basketball, volleyball, softball, even spikeball. Running for the sake of running itself has never been at the top of my list. I’ve come up with a lot of excuses to avoid it:  running is boring, it’s no fun to run on a track/treadmill, and most frequently, “running hurts my…(insert painful body part of the week)”. At the time, I automatically assumed that jogging would exacerbate my pain, rather than help it. However, as a physical therapist I have plenty of opportunities to treat runners, and have helped each return to their sport one by one. With my resolutions this year, my thoughts began to shift: if I could help others manage their injuries and return to running, then why couldn’t I do the same for myself? I decided to take on the challenge of performing my own case study, with myself as the patient: Can this couch potato successfully build his way to running a 5k?

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Kids and Curveballs?

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Kids and Curveballs?

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: Should Kids Throw Curve Balls in Little League?

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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?

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Patellofemoral Pain Syndrome

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Patellofemoral Pain Syndrome

What is Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome (PFPS), also known as “runner’s knee”, is a broad term that describes pain in the front of the knee and around the kneecap. It’s one of the most common overuse injuries of the knee. Although it’s more common in individuals that participate in sports with lots of running or jumping, it can occur in nonathletes as well.

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Mom Posture

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Mom Posture

There are a number of body changes that mothers experience during and after their pregnancies that can cause unique challenges and that often get overlooked in prenatal and post-partum care. These challenges involve increasingly new spine stresses, adaptations, and difficulties maintaining a “neutral spine”.


A neutral spine is the ability to maintain the natural curves of the spine that allow for shock absorption when we stand and walk and allow for our center of mass to be maintained at our belly button region. Women are often challenged through their pregnancies to maintain neutral spine postures due to the fast changing size of the babies and the increased distribution of weight in their mid section.   


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Baseball Pre-Season

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Baseball Pre-Season

As we approach early March, it may seem difficult to believe, but baseball and softball season is rapidly approaching. Before you know it, the local diamonds will be full of kids, teens, and so on, playing the game they love. With the excitement of the beginning of the season looming, a common question that may come up for parents is “How can I get my child ready for this upcoming season?” This can be a particularly difficult thing to navigate for parents and children alike as there are many opinions they can get from coaches, teammates, doctors, and so on. The goal of this article is to provide a clear set of principles that parents and coaches can use to guide their child’s preparation for this upcoming spring.

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Plantar Fasciitis

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Plantar Fasciitis

The early signs of Plantar Fasciitis include:

  1. Pain or burning sensation in the heel or the bottom of the foot, especially in the morning or after sitting for a long time.

  2. Stiffness in the foot, especially in the heel area.

  3. Tenderness in the heel or arch area when touched.

  4. Swelling or redness in the heel area.

  5. Pain that worsens after standing, walking or running for long periods of time.

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What is a Deadlift?

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What is a Deadlift?

A deadlift is a strength training exercise in which a weight is lifted from the ground to a standing position, typically using a barbell. It works several muscle groups including the legs, back, and arms, and is considered a compound exercise that can help to build overall body strength.

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Imagery

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Imagery

Last Thursday night, Seattle’s beloved wide receiver Tyler Lockett suffered a finger fracture

injury during a game against the San Francisco 49ers. The injury occurred when Lockett

attempted to catch a pass and his finger was accidentally stepped on by a 49ers player. Finger

fractures can be painful and can affect a person’s ability to grasp or hold objects. In Lockett’s

case, the injury could potentially impact his ability to catch and hold the football.



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Thoracic Outlet Syndrome

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Thoracic Outlet Syndrome

In the baseball world, the most common injuries sustained by the throwing arm are well publicized. Rotator cuff and labral tears as well as Tommy John surgery have gotten a lot of focus over the years as major potential risks throwing athletes face as they continue their athletic careers. One of the less commonly discussed injuries which can nevertheless have serious implications is thoracic outlet syndrome. Thoracic outlet syndrome (TOS) is a unique condition which many baseball athletes have experienced at some point in their careers. This article will discuss what thoracic outlet syndrome is, how it can impact a throwing athlete’s career, and what can be done to treat it.

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The Journey of a Lifetime

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The Journey of a Lifetime

If you are looking for a story filled to the brim with inspiration, look no further.  What would it take to motivate you to ride your bike across the United States?  For 67-year-old Ray Wittmier, and longtime friend, 68-year-old Gene Woodard, it was a girl named Maya.  Ray and Gene are “honorary uncles” to Maya, a 13-year-old who was diagnosed with a Wilms tumor on her kidney at the age of 7.  

I first met Ray in early August 2021 about a week after he received a total knee replacement.  From the moment I began working with Ray, it became clear that he was fully committed to his rehabilitation.  He possessed the mindset and determination for a successful outcome.  I could tell by the way he approached his rehab that he had lofty movement goals and I was excited to help him on his journey.  


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Stress for Success

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Stress for Success

Stress – we have experienced it at some point in our lives. A normal thing to feel, especially while navigating through a global pandemic. Stress can take on many forms. It could be what you feel during your Zoom work meeting, the adrenaline rush you get sprinting to the front door for your food delivery, or what you feel melt away when you’re biking down the Burke-Gilman on a sunny day. The effects of stress can greatly impact our lives. Understanding what stress is and how it can affect our mental state, physiological function, and motor control is our best way to use stress for our benefit.

Neck Pain

Neck Pain

Neck pain and Physical Therapy If you are having neck pain, physical therapy is often recommended. After ruling out serious conditions by your physical therapist or your physician, the real work begins.

Your PT will put together a treatment program that may consist of:

  • Manual therapy: to help with tissue healing and/or restoration of joint mobility.

  • Exercises: to help strengthen your neck and core to improve neutral postural alignment.

  • Pain relief: consisting of appropriate modalities such as ice, heat, ultrasound, or electric stimulation.

  • Patient education: on tips to help reduce stress on your neck in your work and home environment.

When asked about neck pain one of our favorite physiatrists Dr. Gary Chimes, MD stated that, “Neck pain can be one of the most debilitating issues that we see. It can not only effect your physical ability, but also create issues with sleep, mood, concentration, performance, and emotion.”

The best news of all is that insurance covers physical therapy sessions! A physical therapist can work with you and modify your treatment program until your goals are met. Come see a PT today!

Backcountry Skiing

Backcountry Skiing

As most people learned to punt last year, outdoor recreation was one of the activities that people could do to keep busy while social distancing. There was an explosion in Nordic (cross-country) and backcountry skiing. These often get confused as the same thing but they are very different sports requiring quite different equipment and are different altogether than resort skiing. With resort skiing, injuries tend to be more traumatic such as occurs when crashing at a high speed or misjudging a turn. Resort or inbounds skiing was covered in a past blog so we will turn attention to Nordic and backcountry skiing now. In these disciplines, injuries tend to result from repetitive stress. Pole length, pole grip and pole adjustability are very important with Nordic and backcountry skiing to avoid overuse. It can be helpful to understand the benefit of sport-specific training when one has a good grasp of what each sport requires. This is especially important when starting a new sport as it will help to develop appropriate training habits while learning form and ultimately will optimize performance.

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Tyler Lockett

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Tyler Lockett



Learning to visualize these scenarios prior to an event may regulate your emotions, have better control of your environment, and honestly, you may end up with a positive outcome with all the repetitions and practice.


Sharpen your skills, and be as detailed as possible. I know that when I used to play basketball I remember being at the free throw line, 4th quarter, my team was down by 5 points in the playoffs. When I got to the line I noticed the fans in the crowd going crazy, cheerleaders stomping on the floor, and teammates at the free throw line sweaty, huffing, and puffing. Both coaches yelling at their players to get them ready after the 2nd free throw attempt. As I stand at that free throw line, I can feel the sweat drip through my jersey, down my arms. I could even see the sweat drip onto the free-throw line. Everything felt slow, I couldn’t hear anything, and it felt like I had tunnel vision. It was just me, the basket, and the ball. 


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Winter is Coming

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Winter is Coming

Winter is coming! With another La Nina year in the forecast, the PNW is in for another cold and wet season. For all of you powder dogs out there, this means one thing– SNOW. I’ve been waiting since August for snowboarding season to come along, and the time has finally come. It's time to shred the gnar! I picked up snowboarding a few seasons ago and it has become my latest obsession (possibly even more than spikeball). One of the reasons I’ve learned to love it so much is because it allows me to get outside during the winter. The Seattle area is notorious for its gray, gloomy, and dark winter days, and that plays a huge role with my mood at this time of year. My perspective has changed completely since learning how to get out on the slopes each season. Now I actually get excited for those drizzly days, because that means more freshies up at elevation and all the more epic of runs on the upcoming weekend. 


Just starting out on your snowboarding journey? For all you first timers out there, know that you will be spending a lot of time on your butt during the first few times you’re on the mountain. Generally speaking, snowboarding is usually harder to learn, but easier to master; alternatively, skiing is easier to learn but harder to master. However, don’t let this discourage you– the growing pains are worth it once you start completing those S-turns. To start off, you can figure out if you prefer a “goofy” or “regular” stance before even setting foot on the snow. This video by LWPT’s own Katie Hutchins Do You Ride Regular or Goofy? || REI will help you determine which foot will be your lead foot. Understanding which stance you are more comfortable with will play a huge role in your ability to balance and turn. Knowing the basics before going to the mountain will help make a day on your tushy a little easier. You can also watch this video How to Snowboard - the basics of riding for your first day | REI to learn how to navigate the mountain on your first day. 


Precautions for Hiking