Arm Care Routine for Youth Baseball/Softball

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Spring is here (or eventually will be here if you live in the Northeast!) and with it, inevitably, will be an influx of baseball and softball players with arm injuries coming into my physical therapy clinic.  When I talk to these athletes, typically they tell me they do very little to take care of their throwing arms. Even at the youth level, athletes cannot simply jog out to their positions and play. It’s important for an athlete to properly train and prepare his or her body for the demands of the sport.  Today I want to review what arm care is and offer some simple tips that your youth athlete can use to help reduce injury and improve performance.

What is an arm care program?

If you Google “arm care,” all kinds of band exercise routines and weighted ball programs will show up.  Though these kinds of routines may be a component of a proper arm care program, a good routine should be more comprehensive than that.  Proper arm care should include a preseason program, pregame warm up, in game routine, cool down, rest and recovery.

Preseason program

It is unrealistic and even dangerous to expect athletes to be able to show up without preparing and participate in a highly repetitive throwing sport like baseball or softball.  Athletes generally are throwing much harder at younger ages than they have in the past and this leads to increased injury rates. Athletes should participate in a preseason regimen that includes both a long toss program and a strengthening program for the muscles related to the throwing motion (the rotator cuff, scapula muscles, core and hips).  You should work with a strength and conditioning specialist who is familiar with and, if possible, specializes in working with baseball and softball players. Playing other sports is also key as this helps keep your athlete in shape and improves overall athleticism.

Pregame and practice warm up

Pregame and practice is a time to get both your body and mind ready for the upcoming event.  It should include a dynamic warm up for the whole body, possibly some band work for the muscles around the shoulder and elbow, and some long toss.  Band work and long toss should be light, as athletes do not want to go in to a game or practice fatigued. Fatigue increases risk of injury by 36X.   

In-game arm care tips

During the game or practice, a player should keep moving to stay loose.  Baseball and softball are unique sports in that you may be standing for long periods and then suddenly need to sprint all out after the ball.  Moving, even if it’s lightly bouncing in place, will help keep your muscles warm and loose. Be sure to keep moving in the dugout, too, as it’s easy to tighten up during long innings.  Follow the new Pitchsmart guidelines for pitch count numbers which will help reduce the likelihood of overuse injuries.  Pay attention to the overall volume of throws as well. Sometimes we count the actual pitches in the game, but don’t consider how much throwing an athlete is doing before and after he or she pitches.

Postgame arm care for pitchers and position players

Postgame arm care should consist of light stretching and icing if the athlete finds it helpful.  I am often asked about whether to ice or not. My personal opinion is that unless an athlete finds that it bothers his or her arm, why not?  It’s easy to do and tends to help speed up the recovery process. Finding a good manual therapist who can perform soft tissue massage and stretching can also help that recovery process along.

Proper arm care is a key component to keeping baseball and softball players healthy.  It’s never too early to get your athlete on a good arm care program that will keep him or her on the field this season!

Complete Game Physical Therapy is ready to answer your questions, schedule your appointment, and get you back in the game!  Contact us today 978-710-7204 or email gcrossman@completegamept.com

What To Do When Your Arm Hurts After Baseball or Softball

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Believe it or not, spring is here!  And every spring, baseball and softball coaches and parents inevitably hear players say, “My arm hurts.”   It’s a good idea, therefore, to educate yourself about arm injuries in throwing sports and about the dangers of trying to play through pain.  Here are some tips to help you discern pain from soreness, some reasons why it’s important to avoid playing through pain, and some ways to address arm soreness.

Soreness vs. Pain in Baseball and Softball

It’s not unusual for athletes to experience shoulder or elbow soreness after throwing.  Common places to feel soreness are in the bicep (front of the arm), near the elbow or shoulder, in the tricep (back of the arm) near the elbow, and in the back of the shoulder (which is usually associated with the rotator cuff).  Before a coach shuts down a player’s pitching or a parent calls the doctor, it’s important to talk with the athlete about what he/she is experiencing.

Though it is always better to proceed on the side of caution, signs of simple soreness include:

  • Muscles feeling tired or tight.

  • Soreness that loosens up with light stretching or activity.

  • Soreness after the first few times throwing in the spring.

Signs that the soreness may be something more serious include:

  • Pain that is sharp in nature.

  • Pain that worsens with activity.

  • Symptoms that do not resolve after warming up.

Do Not Play Through Pain

Pain changes everything.  There are two primary reasons that playing through pain is a bad idea.  First, pain often is a sign that something is seriously wrong. Pain can indicate injury to structures in the arm such as the UCL (the Tommy John ligament) of the elbow, rotator cuff of the shoulder, or growth plates in bones of the elbow or shoulder.  Second, pain will alter motor control. It will diminish awareness of body position which can lead to not only decreased performance, but also to compensations which can result in injury in other areas.

Soreness Rules

The American Sports Medicine Institute has developed guidelines to follow if your athlete is experiencing arm soreness with throwing.  

  • If sore more than one hour after throwing, or the next day, take one day off and repeat the most recent throwing program workout.

  • If sore during warm up, but soreness is gone within the first 15 throws, repeat the previous workout. If shoulder or elbow becomes sore during this workout, stop and take two days off.  Upon return to throwing, reduce number and intensity of throwing.

  • If sore during warmup and soreness continues through the first 15 throws, stop throwing and take two days off.  Upon return to throwing, reduce number and intensity of throwing.

Summary

Shoulder soreness is a common occurrence in youth baseball and softball.  Clear communication with the athlete is key to understanding exactly what is going on and what steps should be taken.  I hope these tips help keep your athlete on the field and injury free. At Complete Game Physical Therapy located in Lowell, MA we specialize in the treatment of athletes and active individuals of all ages, particularly athletes that participate in overhead throwing sports.  If you have any questions please contact us at 978-710-7204 or email at gcrossman@completegamept.com.

Complete Game Patient of The Month: Bill Elwell

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Our March Patient of the Month is Bill Elwell, who came to us here at Complete Game after having surgery for a total knee replacement. “At the time I started with Greg, my knee flexion was only degrees. Working out with Greg brought me up to 125 degrees.”

One of the differences that Bill noted in his time here is the hands-on approach we use. “Greg’s  hands-on approach was a pleasure because other PT practices I went to for other injuries were not that hands-on or one on one. They would give me heat or ultrasound and a bunch of exercises and go to another patient leaving me there unsupervised. Greg, on the other hand, would supervise and motivate from heat through exercise, to cool down and ice.”

As one of the patients to come to us in our new facility in Lowell, MA, Bill also noted that,  “The new facility is state of the art with everything imaginable.”

Bill’s daily life has definitely improved after coming to us. “After I graduated I kept up with my work out and I feel even better. When going down stairs before going to Complete Game I had to go down one stair at a time holding on but now I can go up and down like ‘normal’ people do.”

Bill’s last word on his experience here: “I enjoyed working with Complete Game and I really wouldn't change anything. I always speak highly of my time there.”

Thank you, Bill! We enjoyed working with you, too!

What is an Overhead Athlete?

A parent asked me this question at the last Arm Care Seminar I gave at my clinic, Complete Game Physical Therapy in Lowell, MA.  I love this kind of question because it makes me take a step back and think.  Sometimes I get so caught up in the specifics of rehabilitation and injury prevention that I need to remember to pause and consider the overall picture of who we are working with and how these patients are differ from the general population.  In this blog, I want to review what an overhead athlete is and how best to meet the unique demands of his or her training and rehab.    

Definition of the Overhead Athlete:

An overhead athlete is defined in Webster’s Medical Dictionary as “one who uses their upper arm and shoulder in an arc over head to propel a ball toward the opposing team.” This includes throwing sports such as baseball and softball, but it also includes volleyball, tennis, and track and field throwing events.  And though it doesn’t completely fit this definition, I would also include swimmers as overhead athletes.

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The Overhead Athlete and the Shoulder:

Shoulder health is obviously crucial for overhead athletes, so let’s briefly review shoulder mechanics and considerations here.  The shoulder is a ball and socket joint.  The socket is not very deep so the shoulder doesn’t have a lot of boney stability (which is why we have so much mobility in the shoulder).  An easy way to imagine the shoulder socket is to picture a golf ball on a tee.  The shoulder gains it’s stability from the rotator cuff (the muscles that surround the ball) and the labrum (the tissue that makes the socket a little deeper).  When all is balanced in the shoulder, the ball stays centered in the socket and everything works well.  Problems arise when there is an imbalance around the shoulder and the ball gets off center in the socket.  This imbalance can lead to shoulder pain, tendonitis, rotator cuff/labral tears, or even elbow problems as the athlete’s body tries to compensate.

Considerations for the Overhead Athlete:

Here are a few considerations for keeping the overhead athlete healthy.  It is not an all inclusive list, but just a few simple things you can do to help reduce the likelihood for injury.

  • Posture:  Watch your sitting and standing posture. If you have a slouched posture in which your shoulders round forward, the ball will sit forward in the socket.  If you are doing this all day and then try to perform an overhead sport, it will be very difficult for the joint to center properly.  Maintain good, upright posture with your head, shoulder and hip staying in line throughout the day.

  • Muscle Balance:  The muscles surrounding the shoulder are often out of balance.  The muscles in front of the shoulder tend to be stronger than the muscles in the back.  When you exercise, do extra work on pulling type exercises (rows) vs. pushing type exercise (presses) to help restore that balance.

  • Using Your Whole Body:  The shoulder can’t do it alone.  If you try to rely on just your shoulder to generate power, you will surely get hurt.  Perhaps you’ve heard a coach say, “Power comes from your legs.”  This statement is true.  Power is transferred through your core, so be sure to work your core and legs when you train or rehab.  Also, make sure proper mechanics are in place so that you are transferring power effectively and efficiently.

Simply, overhead athletes should train and rehab properly to meet the specific demands of their sport.  If either you or your child is an overhead athlete, be sure your trainer or rehab professional has a thorough understanding of these concepts.   Have a great season!

How to Avoid Having Chronic Ankle Sprains

At Complete Game Physical Therapy, ankle sprains are the most common acute injury suffered in sports that we see. In court sports such as volleyball and basketball ankle sprains have shown to account for up to 30% of time lost to injury.  Field sports such as soccer, football and even baseball also have a high rate of ankle sprains.  If you have an ankle sprain you should see a medical professional to get it taken care of as all too often people try to treat it with some rest and ice.  This injury can become chronic and cause many problems down the road including achilles problems, knee injury, or even back issues.  Below are some simple exercises you can use if you have a chronic history of ankle sprains or just want to avoid them in the first place.

Ankle Dorsiflexion Mobilization - Ankle dorsiflexion is the the motion of moving your foot so your toes get closer to your knee.  This is an important movement in both sports and daily activity and is often limited following ankle sprains.  This restriction, if not addressed, can lead to many problems including plantar fasciitis and achilles tears, as well as knee, hip and even back problems.  A good exercise to prevent these problems is a simple ankle rock exercise:

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Keep your foot flat on the floor so your heel doesn’t come up and gently rock your knee forward.

Ankle Eversion Against Towel- Most ankle sprains are on the outside or lateral ankle which can cause the muscles along the outside of the lower leg and ankle to become weak.  A simple ankle eversion exercise using a towel as resistance can help strengthen these muscles back up.

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Hold the towel for resistance and gently push out against it with your foot.  Think windshield wiper motion.

Single Leg Balance-  Balance can be compromised following ankle sprains.  Basically, the message going from the foot to the brain on how the foot is positioned gets scrambled.  Retraining your ankle simply requires working on single leg balance.

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Stand on one leg while lifting the other leg up so the thigh is parallel to the floor.  If this is easy, try it with your eyes closed.

If you currently have an ankle sprain or any other medical condition that will impact exercise, please consult your doctor or other medical professional before trying the exercises.  Otherwise, these simple exercises can help reduce the after effects of ankle sprains whether you are an athlete, a former athlete or just trying to stay active.

 

Patient of the Month: Connor

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Complete Game is excited to introduce everyone to our Patient of The Month, Connor.

Connor is a very active college freshman who attends Bryant University.  He came to us after his second shoulder surgery...not one surgery on each side, but the second surgery on the same shoulder. The rehab process was extremely long and we had to wait a long time for healing to take place. The shoulder was very stiff and it took many sessions of work to get the mobility back.

The good news: once mobility was back, we focused on strength and stability and he was soon back to full activity.

Connor hopes to get back to track and field next season and with his determination and work we are sure he will! Inspired by Connor's recovery? Want to learn more? Complete Game Physical Therapy invites you to come see us at our new location at 1703 Middlesex Street in Lowell. 

 

Some Tips to Help Keep You Injury-Free This Ski Season

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With all the snow we’ve had so far this winter, it’s shaping up to be a great ski season.  Once these freezing cold temperatures clear, lots of folks will be eager to head for the slopes.  Every year, I see patients in physical therapy who have suffered ski related injury.  You can help reduce the likelihood that you will be one of those who suffer a ski related injury this season with a few tips that will help you stay healthy and have fun on the slopes.

  1. Exercise.  Skiing can be very strenuous, so preparing your body with some regular exercise can be helpful.  Simple body weight squats, step ups or lunges are a good place to start.  Always think about the alignment of your legs when doing these exercises.  Keeping your toe, knee and hip in line as you squat or lunge will help reduce your likelihood of injury, particularly knee injury.  Core work is also important.  Planks are a great way to work core strength and stability.  Biking is also helpful as it develops leg strength and builds endurance.  

  2. Proper equipment and technique.  Be sure that you have the right size skis and that your bindings are set at the right tension (also known as DIN).  Your local ski shop tech (or, if you’re renting skis, a tech at the mountain) should help with this.  It’s often a good idea to take a lesson too.  Ski schools usually offer refreshers, quick one hour group classes, which are affordable and helpful if you haven’t been on skis for a while. 

  3. Fatigue.  Fatigue is a major contributor to injuries in all sports and it’s particularly problematic during the dreaded “last run” in skiing.  Injuries on the last run are so prevalent that, often, skiers won’t even say the words “last run” because they think it’s bad luck.  There are a few reasons for increased injuries at the end of the day.  You are tired which leads to increased injury risk, ski conditions tend to be worse (especially in the east where it tends to get icey), and other skiers are tired so there is increased risk of collisions.  Be extra careful at the end of your ski day.

There is nothing better than spending a day on the slopes.  These simple tips can help reduce the likelihood of injury and keep you carving turns all day long.  Have a fun and healthy ski season this year!  

If you do experience an injury during your skiing day and need post-injury rehab, choose Complete Game Physical Therapy and we can have you back on the ski-lift in no time! Call us at 978-710-7204 for an appointment at our new location at 1703 Middlesex St. Lowell, MA 01851.

Complete Game 2017: A Look Back At An Exciting Year

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If you’re like us, you’re wondering how 365 days could go by so fast! This was an incredibly busy year with milestones and new patients. Since it is almost time to turn the page to a new year, we are focused on what lies ahead and making 2018 as equally exciting as 2017.

In 2017, we celebrated our first full year in business and saw over 180 new patients. We built great relationships with these patients as we helped them return to the sports and activities that they love and we are still in touch with many of them. We continue to have strong connections with area doctors, trainers and coaches which are all great referral sources for our patients.

We work with many Youth Athletes and Youth Sports Organizations. We provided PT services and consulting for Boston Jr Rangers hockey program and provided free injury risk screening for many youth programs including Tewksbury Youth Softball, Nor’Easters Baseball, and Storm Lacrosse. We support many area sports programs including Tewksbury Youth Softball, Tewksbury High School Baseball, and Northern Essex Community College Baseball.

Greg continues to grow as a resource in community by writing a health column in the Tewksbury Town Crier every other week.

And most exciting of all…..we outgrew our current clinic!

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Our new location will be opening at 1703 Middlesex St, Lowell, MA. This new, larger space near the Merrimack River will have new equipment and is in a very convenient location that is accessible from routes 3 and 495.

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With our new Lowell location, we will continue to develop our relationship with Lowell Jr. Spinners Baseball and Mill City Volleyball. Being a great community supporter and attending events and establishing relationships with groups and organizations around Lowell.

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Our focus on reducing the likelihood of youth sports injury continues  with our free injury risk assessments for area youth sports programs. We will also be continuing to develop our “Pitcher’s Arm Care Program” and “Annual Movement Check Up” programs.

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We want to thank you all for being a part of our success in 2017! There is so much more for Complete Game in the coming months!

Complete Game PT Patient of The Month: Boston Junior Rangers

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This month we couldn’t pick just one individual Patient of The Month, so we picked an entire team!

I have provided PT services for their  last season and I am working with them  this season as well. The Boston Junior Rangers were established in 2008 and are based at Breakaway Ice Center in Tewksbury, Massachusetts. The team strives to compete in championships, but the main goal of the organization is to develop its players to their maximum potential. The young players on the team are in their late teens and early twenties and many go on to play at the collegiate level.

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With such passionate players, of course there will be time when strains and other injuries occur. I have been privileged to work with this team (and also The North Shore Vipers, which is a girls youth program team and the youth program for the Boston Junior Rangers) on the common injuries that occur in hockey.

Ryan Blair, the Head of Hockey Development for the Junior Rangers, has been very pleased with the services. "Complete Game has helped out our Jr. hockey program a lot over the past year. Greg provides each player with his undivided attention and makes sure each players needs are met. Complete Game is a great and convenient way for our players to receive physical therapy. The quality of care is excellent and Greg has been great with our players."

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At Complete Game we love working with hockey players of all ages and we wish them luck on their upcoming season!

3 Quick and Easy Moves to Help Reduce Injuries in Youth Ice Hockey

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Believe it or not summer is coming to an end and youth hockey season is already starting up.  I know this past week I was in the hockey rink with other parents saying, “I can’t believe summer is over and we are already back here!”  This season I’m helping out coaching my son’s team and, of course, my thoughts always go back to injury prevention strategies for the players.

I’m going to discuss here warm up strategies for youth hockey.  Injury prevention for hockey is  huge topic and please refer to USA Hockey for more extensive information related to topics such as proper equipment, playing technique, etc.  Here I wanted to give you 3 quick and easy things you could have your youth hockey player do before they get on the ice to help reduce their likelihood for injury.

Hip and knee injuries are very common in the sport of ice hockey.  Warm up exercises have shown to reduce injuries in other sports such as soccer, basketball and football.  Yet hockey players tend to take the ice with little to no warm up.  

Being the parent of a youth hockey player myself I understand that the reality is most often you will be rushing to get your kid to the rink on time and the kids are crammed into tiny locker rooms with little space to get their equipment on never mind have room to warm up.  With that in mind here are 3 easy moves any hockey player can do with limited time and space before taking the ice.

  1. Hip Flexor Stretch:

This simple stretch will warm up the muscle in front of the hip, a common place for injury in hockey.  Perform this 3 X for 20-30 second hold each side.

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2.) Groin Stretch

Another simple stretch that helps prep an area that is a common place for injury in hockey.  Again this should be done 3 X for 20-30 seconds each side.

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3.) Squats

This last exercise is a great one to both get increased blood flow to muscles but also work on a movement pattern that is very helpful to hockey.  ‘When squatting the athlete should focus on keeping their hips, knees and feet in line and sit back into their hips.  This can be done with skates on prior to going out on the ice.  2 sets of 8-12 repetitions should be performed.

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This is by no means a comprehensive warm up for ice hockey but these 3 simple moves can help both reduce the likelihood for injury and improve performance.  Here’s to a healthy and fun hockey season for your youth athlete!

Complete Game Physical Therapy  is ready to help your student athlete with their PT needs. Give us a call at 978-710-7204 or email Greg at gcrossman@completegamept.com.

Patient of the Month: RJ

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Complete Game PT is happy to introduce our Patient of the Month for August, RJ.

 Rj is a college baseball player who is currently recovering from labrum and rotator cuff surgery. “As a throwing athlete I would like to get back to where I was throwing a ball before my injury. I started Complete Game right after my surgery. Anyone who has had Labrum or rotator cuff knows you can’t do anything till the pain goes away. I could not drive, tie my shoes, etc. Now I can do whatever I want including throwing which is the most important thing.”

Rj’s treatment entails a number of different things. “First we start with heat to warm up my shoulder. After, Greg will do deep tissue work and then stretch my shoulder. After, he has me do different types of exercises to trigger different muscles that are used to throw. I use kettle bells, med balls, light dumbbells, and bands. Lastly, Greg puts me on a GameReady machine so i can ice my arm.”

We send exercise assignments home with our patients and RJ is no exception to this homework. “I am assigned to do almost every exercise Complete Game gives me. These entail; static and dynamic stretching multiple times throughout the day and doing the band work that we do at Complete Game. “

All of this effort and work has definitely paid off. “Since I have been with Complete Game PT after my surgery, my discomfort has significantly improved. It has been a little over a year since surgery and now I don't even think about my shoulder or feel pain doing everyday things.”

RJ has found so many positives in his experience here. “To anyone considering going to Complete Game PT I would definitely go. I have recommended to almost everyone i know that needs Physical Therapy. Especially if you are an athlete. You get 1 on 1 time with a physical therapist that knows how to push you. Very easy to communicate with and caring. Greg wants you to get healthy and get you back out on the field. In the end, that’s the ultimate goal.”

RJ’s had a different experience with physical therapy in the past. “In high school I had to go to PT for the same shoulder. My experience there is very different then the one at Complete Game. At the other PT it was a crunch for time. You have 30 min or an hour and had to get so many exercises done in so little time. At Complete Game I do not feel rushed and I can take my time with my exercises and do them right. Also, at the other place we worked only shoulder and not other parts of my body that we hurting. At Complete Game I also came in with hamstring issues and they made that a focus as well. Complete Game has just been a great experience. What I enjoy the most about Complete Game PT is the atmosphere. Greg makes it easy to get the work done. He is very energetic and easy to communicate with. He makes you excited to be there and forces you to get better that day.”

If you are looking for a different physical therapy experience, contact Greg today!

Preseason Screening For The Youth Athlete

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As summer comes to an end and fall sports seasons are around the corner many youth athletes will be headed to their doctor to get their required pre participation sports physicals.  Though requirements vary from state to state most states at this point require some form of physical before kids participate in school sports.  These are very important in that they screen for cardiac, neuromuscular, or respiratory issues.  A brief general musculoskeletal exam is also performed but this is limited by the physicians time constraints as well as limited space of a physician's exam room.  

The greatest risk factor for future injury is previous injury.  If there is something we can do to help reduce the likelihood of injury in the first place we will be much more likely to prevent problems down the road.  I have 2 young children who participate in sports myself and want to do whatever I can to protect them.

Fortunately there is something we can do.  Research-validated testing has shown to reduce injury rates in athletes of many different sports as well as the US military.  A system such as Move2Perform that identifies and addresses side to side asymmetries as well as deficits with fundamental movement patterns is a great tool to help reduce the likelihood of injury for your youth athlete.  

Getting a more thorough musculoskeletal screen by a healthcare provider such as a physical therapist may not only help reduce the likelihood for injury for your athlete but also help improve their performance.  As the saying goes “An ounce of prevention is worth a pound of cure” and though it may take some time out of your day for the testing you may save yourself time, money, and help keep your child safe in the long run.


Complete Game PT is here to help with your questions and concerns as your kids go back to school and back to sports. Call us today 978-710-7204

Patient of the Month: Sarah

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Complete Game PT is happy to introduce our July Patient of The Month: Sarah.

Sarah came to Complete Game PT after she had surgery on her right shoulder to fix a labrum tear. “When I first started, I could barely move my arm,” Sarah said. “My pain definitely decreased as the weeks went on. In the end, I was able to lift a five pound weight over my head.” Sarah admits that others she had spoken to had dreaded going to PT. “I never felt that. There's such a personal touch.  And, Greg knows when to push you and when to back off.”

Sarah’s treatment here at Complete Game started with warming the shoulder with a heating pad and a massage.“Then I would do basic arm movements, each week building up more mobility and strength. I started PT without using any weights and then added weight as I gained strength. During my first PT session, I did simple hanging arm circles...and it hurt like crazy...but by my last session, I was doing push-ups with little pain,” Sarah explained.

Sarah’s customized exercise plan for her surgery didn’t end when the PT session ended. Greg carefully went over all of the exercises and provided a sheet detailing the instructions for the exercises to be followed at home. “I was pleasantly surprised by how well my recovery went after such a painful surgery and I know it had a lot to do with the encouragement and care of Greg Crossman at Complete Game PT,” Sarah said. “I can now make a bed, swim in a pool, and lift a glass of wine without pain.”

Sarah points out that Greg found the perfect balance of personal touch and professional excellence when he worked with her. “During my sessions, I was able to see his interactions with other patients from all different walks of life.  He is as caring and professional with a young athlete trying to get back into their sport, as he is with a construction worker trying to get back to his job, as he is with a mom trying to get back into doing all the millions of things she has to do!”

When asked if she would recommend Complete Game PT, Sarah is enthusiastic in her reply. “I would absolutely, 100% recommend going to Complete Game PT with Greg.  In fact, I've already recommended him to anyone who could potentially have need for PT.  Greg Crossman is so friendly, so helpful, and so professional.  He wants the best for each and every patient.”


If you or your athlete are recovering from an injury or experiencing any discomfort or pain, give Complete Game Physical Therapy a call at 978-710-7204, email Greg at gcrossman@completegamept.com, or browse our website. Also check us out on Facebook and Twitter for more tips on staying injury-free.

Tourney Time: Keys to Keeping Your Ballplayer Injury-Free During Playoff Season

Introduction

With summer baseball/softball leagues as well as Little League and Cal Ripken League tournaments going on, many youth ball players have shifted from league play to tournament play. Tournament play presents unique challenges to keeping athletes healthy as it is a format many players are not accustomed too. Coaches and players often feel more pressure to win.  Having a child involved in tournament play myself and seeing some of the situations these kids are put in, I thought I would provide, based on the latest research, some things to watch out for that can lead to increased risk for injury.

Pitch Counts for Youth Baseball

These guidelines are based on extensive research and are widely considered the standard for youth baseball. You would think that these guidelines would be adopted in all youth tournament play, but unfortunately this is not the case. For example, see the pitch count regulations for Cal Ripken Baseball Tournament play below.

  • As you can see from the 9-12 year old regulations, a pitcher is allowed up to 40 pitches with no rest days required and 75 pitches with only 2 days rest required.  These tournaments often can go on for a week or more so you could be in a situation where your child is allowed to pitch up to 40 pitches on back-to-back-to- back-to-back days. This would never happen in the Major Leagues. How can it be permissible in youth baseball? A study in the American Journal of Sports Medicine in 2016 that looked at risk factors for “Tommy John” injury found that proper rest between pitching appearances can be just as important as following pitch counts. It is essential that parents and coaches are aware of this and make the right decisions for athletes.

Factors that Affect Pitch Counts

Though the pitch count guidelines above are helpful, there are factors that may reduce the number of pitches that should be thrown.

  • Stressful Innings: not all innings are created equal. There is definitely a difference in stress on a pitcher's arm between times when they are cruising along and throwing free and easily, and when they are having tough innings when they have runners on base and are throwing 20 pitches or more in an inning.  
  • Hot Days: on particularly hot or humid days, pitchers are more likely to become fatigued (more on fatigue later) which can cause their mechanics to break down and leave them at increased risk for injury.
  • Pitchers’ Physical Make Up: a pitcher’s size can relate to increased risk for injury in a way that may be counterintuitive to what you may think. A study in the medical journal Arthroscopy in 2015 showed that taller kids who throw harder are at increased risk for injury. It is recommended that coaches and parents are more careful with taller kids who throw harder.

Preventing Injury for Catchers and Fielders

  • Pitching and Then Playing in the Field: Particularly in the younger levels of youth baseball, the pitcher tends to be one of the best athletes on the field. You will often see coaches take kids from the mound when they are done pitching and put them at shortstop, 3rd base or, worst of all, catcher. Be careful with this practice, as you have to take into account the overall volume of throws the athlete is making. The safest practice if you are going to keep the pitcher in the game when they are done on the mound is to move him to the right side of the field, 1st base, 2nd base or right field.

  • Catcher: Though pitchers get much of the attention, catchers also are making a tremendous number of throws. Often catchers make many more throws than pitchers do in a given game and catchers may be asked to play multiple days in a row or even multiple games on one day. Care should taken as to the number of throws catchers are making and proper rest should be taken if catchers are starting to show signs of fatigue.

  • Middle of the Field:  A similar idea holds true with middle infielders and center fielders.  Most of the action in the game is in the middle of the field so care should be taken, especially if playing multiple games in a day and multiple days in a row. Attention should be paid not only to throws made during play, but also warm up throws between innings.

Fatigue

  • Fatigue and overuse have shown to be the two greatest factors for injury in youth baseball and softball players. A study by the American Sports Medicine Institute in 2006 found that pitching while fatigued increased likelihood for injury by 36x. I just want to repeat that: If a kid pitches while tired, he or she is 36x more likely to be injured!

  • A nice study came out in the Journal of Strength and Conditioning Research in 2014 finding that the best indicators for fatigue are velocity and accuracy. A drop in velocity or loss of control is the best way to tell if a pitcher is fatigued. It’s crucial that a coach not only keep a close eye on the pitcher, but is also in close communication with the catcher about how the pitcher is looking.

Summary

I understand how tournament play can lead to increased emphasis on winning. It is imperative, however, that coaches and parents keep things in perspective and don’t let a “in it to win it” attitude place players at risk. Following proper pitch count guidelines, paying attention to overall volume of throws in the field, and monitoring for signs of fatigue are a few ways that coaches and parents can help protect their players and help ensure that these athletes will enjoy the game for years to come.

Patient of the Month: Kyle

Because we love what we do and who we work with, at Complete Game PT we’ve decided to feature a Patient of the Month each month. June’s Patient of the Month is Kyle.

Kyle came to Complete Game several months ago after suffering a back injury that occurred while he was swinging in baseball. Since working with Greg, Kyle has found his discomfort significantly decreased.

“It’s going great,” said Kyle. “I strained my nerve while swinging and couldn’t throw, couldn’t hit – I couldn’t do anything involving baseball. Even sometimes while I was driving or sleeping – everything hurt. But now I’m doing great.”

Kyle is even back to playing baseball now, which he is thrilled about. “I’m playing baseball all the time. This past season went great, and now I’m starting up my summer team, so it’s going great.” Kyle remarked.

A typical physical therapy session for Kyle at Complete Game starts off with a massage. “Then,” Kyle said, “I’d work on strengthening with bands and different balls and weights to strengthen the muscles around my back.”

Kyle would “definitely” recommend Complete Game Physical Therapy to anyone suffering an injury or living with pain. “Every single time I came here, it didn’t feel like a chore. I came here to get stronger. You’ll feel better, too.”

If you or your athlete are recovering from an injury or experiencing any discomfort or pain, give Complete Game Physical Therapy a call at 978-710-7204, email Greg at gcrossman@completegamept.com, or browse our website. Also check us out on Facebook and Twitter for more tips on staying injury-free.

Low Back Pain Q&A

Nearly everyone has had or will have a low back problem at some time in their life. Whether it’s a little discomfort or something more serious like a disc problem or a spinal fracture, the prevalence of lower back pain is astounding. The World Health Organization estimates that 60-70% of those in industrialized countries will experience non specific lower back pain in their lifetime, with that number rising. At Complete Game Physical Therapy, we see many patients with lower back pain - anyone from youth athletes to the older population. With that in mind, I thought I would review some of the common questions I get about lower back pain here.

  1. Should I just rest it? Bed rest used to be the common recommendation for cases of back pain. Recent research has shown us that this may not be the best option. The Clinical practice guidelines from the American College of Physicians now strongly recommends those with low back pain stay active. The same goes for the National Institute of Health whose recommendations are to return to daily activities as soon as possible and perform light stretching while avoiding movements that aggravate pain.

  2. Should I use ice or heat? This is a question I get all the time and the answer is really “it depends.” People’s bodies tend to react differently to ice or heat; some may tolerate heat really well and not ice, and for some it’s the other way around. I tend to tell people what ice and heat actually do and typically when each works best. Then they should try for themselves and see what works best for them.  

Heat is a vasodilator which will increase blood flow to the area. This is good to improve mobility but will also increase inflammation to the area. Heat tends to work best if you are feeling stiffness, in the morning and before exercise.

Ice is a vasoconstrictor which will constrict the blood vessels and push blood and inflammation from the area. This will help reduce inflammation but also will increase stiffness in the area. Ice tends to be used best in the presence of pain, at night, and after exercise.

3.) What about “Icy Hot” or “Tiger Balm?” These are topical analgesics which can help temporarily reduce the pain but do not fix the underlying problem. These treatments will dull the superficial nerve endings that send pain signals to the brain and can be helpful to help you sleep or move a little better. These treatments should be only used temporarily while you are returning to your activities and working on what caused the problem in the first place.

These are a few common questions I tend to get in the clinic relating to lower back pain and some strategies to help. If you are experiencing lower back pain, you should be evaluated by a qualified medical professional and set up on a treatment plan to help relieve your symptoms and get you back to the activities you love. At Complete Game Physical Therapy, we specialize in the treatment of athletes and active individuals with any musculoskeletal problem including lower back pain. If you need help, call us today at 978-710-7204.

Patient of the Month: Jaryd

Because we love what we do and who we work with, at Complete Game PT we’ve decided to feature a Patient of the Month each month. May’s Patient of the Month is Jaryd.

Jaryd came to Complete Game after tearing his ACL for the third time in three years. He’s currently working on strengthening his left knee and leg following his last surgery in August of 2016. Jaryd really enjoys his treatment plan at Complete Game. When he comes in, he starts on the stationary bike for a ten minute warm up. “Greg will then stretch my leg and give me a knee massage (which I highly recommend!) Then, Greg will show me a series of exercises that I will need to complete. We are usually really focusing on my left knee and exercises to strengthen that leg. Lots of squats, lunges, and bridges. We end will an ice bath in the game ready ice machine. (Another one of my favorites!)”

Of course, as every physical therapy patient knows, Jaryd has regular PT “homework.” Jaryd works independently at home on the exercises that Greg showed him during his visit, and does the exercises every other day. “My most important homework is not to re-tear my ACL!” Jaryd jokes.

He has definitely noticed a difference since working with Greg. “My discomfort has decreased over the past few months with my visits to Greg. Every scheduled PT visit Greg will increase the workload to a tolerable limit. I’m even (slowly) getting back to playing tennis and running.”

You need to do your PT with Greg at Complete Game,” Jaryd advocates. “Greg will give you his all to make sure you receive the proper care to get back to your 100% - whether it’s getting you back to playing sports or getting you back to being pain-free.” In fact, Jaryd has enjoyed working with Greg so much that he has followed Greg from his old practice to Complete Game. “I got to know Greg at his former practice. He was my PT after my second ACL surgery, and I have loved working with him so much that I followed him up to Tewksbury and to Complete Game PT. Complete Game is different from other practices because you get a one-on-one experience in a small setting with Greg solely focused on you. I have loved my experience at Complete Game PT!

If you or your athlete are recovering from an injury or experiencing any discomfort or pain, give Complete Game Physical Therapy a call at 978-710-7204, email Greg at gcrossman@completegamept.com, or browse our website. Also check us out on Facebook and Twitter for more tips on staying injury-free.

3 Ways to Avoid Knee Injuries in Baseball and Softball

Though shoulder and elbow injuries tend to get the majority of attention with overhead throwing sports such as baseball and softball, knee injuries also do occur. During the World Series last year, Kyle Schwarber got a lot of attention after returning to play 6 months after tearing his ACL during a collision with another outfielder. Just this season in Boston, both Dustin Pedroia and Pablo Sandoval have gone down with knee injuries. The Mayo Clinic performed a study last year and found over 2,000 knee injuries in the MLB from 2011-2014.

Common Knee Injuries In Baseball and Softball

Ligament Injuries: These have been found to be the most common injuries to knees in baseball/softball. The MCL is the most common ligament injured - this is the ligament that runs along the inside of the joint. The ACL the second most common ligament injured, and this is a major ligament that runs through the center of the joint. Injury to knee ligaments can occur through contact injuries or non contact injuries where the knee buckles.   

Cartilage (Meniscus) Injury: The cartilage in the knee provides padding and a smooth covering for the joint surfaces. Injury to the meniscus often occurs when the foot is planted and the player pivots on the leg, and also can happen due to falling directly onto the knee.

Patellofemoral Syndrome: Patellofemoral syndrome is pain around the kneecap area and is most common with catchers.

Ways to Help Avoid Knee Injury in Baseball and Softball

  1. Proper warm up and preseason training: Research has shown that strengthening certain muscles around the hip and knee can help prevent knee injuries from occurring.  Proper warm up is key as well; some injury prevention programs such as Fifa 11+ is designed for soccer can be adapted to baseball.

  2. Proper technique: Using proper form with running bases, fielding the ball, or especially catching goes a long way to prevent knee injuries. Working with a coach or instructor on proper form then practicing it on your own will help you reduce the likelihood of injury.

  3. See a physical therapist: Physical therapists are experts in assessing movement and identifying imbalances that are likely to lead to injury. They will help you with exercises to address imbalances and help not only reduce your likelihood of injury, but also improve your performance. Having a therapist who is familiar with the movements associated with baseball and softball is key.

At Complete Game Physical Therapy, we’re experts in the treatment of baseball and softball players. Contact us at 978-710-7204, or shoot us an email at gcrossman@completegamept.com, or browse our website. Also check us out on Facebook and Twitter for more tips on staying injury-free this season.

INTERESTED IN LEARNING EVEN MORE ABOUT DEALING WITH KNEE PAIN IN BASEBALL OR SOFTBALL ATHLETES? ENTER YOUR INFORMATION BELOW TO RECEIVE MY FREE REPORT, "7 QUICK AND EASY WAYS TO STOP KNEE PAIN"

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Patient of the Month: Thomas

Complete Game Patient of the Month Pic.jpeg

Because we have so many amazing patients with unique stories, at Complete Game PT we’ve decided to feature a Patient of the Month each month. April’s Patient of the Month is Thomas. Thomas is a 12 year old baseball player who came to us last fall after suffering his 2nd incidence of “little league elbow” in the past year. He worked with us not just to rehabilitate his elbow, but also to strengthen his shoulder and core muscles to help him reach his goals and return to his favorite sport, baseball.

Thomas was ecstatic to get back to baseball, thanks to Complete Game. “My experience at Complete Game Physical Therapy was great. They not only helped me with my injury but gave me exercises for my elbow and shoulder to make sure it doesn’t happen again. I was given a home exercise program of bands and stretching that I had to complete every day,” says Thomas. “This really helped with my recovery.”

Thomas is so excited that it’s finally baseball season - and that he’s back and better than ever. “I am not only back to playing baseball but now throw harder and hit the ball farther than before!”

Thomas’s mom, Heather, also was thrilled with Thomas’s recovery, and their experience at Complete Game. “Our experience at Complete Game was fabulous. The atmosphere was warm and inviting and helped make the rehabilitation process fun for Thomas.” Heather drove over 45 minutes each way to come see Greg at Complete Game and “would never even consider going anywhere else. Because of the care Thomas received at Complete Game he was able to return to baseball months before anyone thought he would. Thank you!”

Thomas’s amazing recovery is due to his hard work and to the fact that Complete Game PT utilizes state of the art rehabilitation methods and clinical expertise to help him meet his goals. We were also able to work directly with his baseball coaches and instructors to make sure he was fully ready to return to baseball and make sure he uses proper mechanics so the injury won’t occur again. This has also lead to improved performance (4 home runs already this spring!).  Great job, Thomas!


At Complete Game Physical Therapy, we specialize in the treatment of youth baseball and softball players. If you or your athlete is experiencing shoulder or elbow pain, or you want more info on how you can prevent it call us at 978-710-7204, email me at gcrossman@completegamept.com, or browse our website. Also check us out on Facebook and Twitter for more tips on keeping yourself and your athlete injury-free.

How to Avoid Common Youth Throwing Injuries

youth throwing injuries.jpg

Every year I see youth baseball and softball players who have been diagnosed with “Little League elbow” or “Little League shoulder.” This can be scary for the athlete as well as the parent. With Little League and youth baseball & softball seasons starting up over the next few weeks, I thought it would be a good time to review this common youth sports injury and give a few ways to help reduce the likelihood of getting it.  

What is Little League Shoulder and Little League Elbow?

Little league shoulder, otherwise known as proximal humeral epiphysiolysis, and little league elbow (known as medial epicondyle epiphysiolysis) are very similar injuries. They both involve the growth plates at the ends of the bones becoming irritated due to overuse or increased stress. This will cause inflammation in the skeletally immature growth plates and can be quite painful. The good news is, rest and physical therapy can help the athlete fully recover from this injury. If left untreated though this can progress to a growth plate fracture or avulsion fracture which could end your athlete’s season, or even worse.

Preventing Little League Shoulder and Little League Elbow

The most common cause of these injuries is overuse, which causes overstress to the arm and the growth plates. Below are a few steps you can take to help reduce the likelihood or even prevent this injury.  

  • Gradually build up the intensity of throwing at the beginning of the year: Don’t start off throwing as hard as you can or pitching in games. Following a progressive throwing program that slowly builds up your arm is the best way to start the season.
  • Proper throwing mechanics: Using good mechanics by using your legs and core muscles to take stress off your arm is key to preventing this injury.
  • Follow pitch count and rest guidelines: Following pitch count guidelines like those found at Pitch Smart is a good way to prevent injury. Pitching while fatigued increases the athlete’s likelihood of injury by 36 times!
  • Don’t pitch or throw with pain!

Hopefully this gives you a better idea of what this injury is and how to prevent it. These are just a few tips for reducing the likelihood for injury for youth baseball and softball players. For a more in depth review on this subject check out my free report “7 Arm Care Tips for Youth Baseball/Softball.”

- Greg at Complete Game PT

At Complete Game Physical Therapy, we specialize in the treatment of youth baseball and softball players. If you or your athlete is experiencing shoulder or elbow pain, or you want more info on how you can prevent it call us at 978-710-7204, email me at gcrossman@completegamept.com, or browse our website. Also check us out on Facebook and Twitter for more tips on keeping yourself and your athlete injury-free.

Interested in learning even more about preventing arm and shoulder injuries in Baseball or Softball athletes? Enter your information below to receive my free report, "7 Arm Care Tips for Youth Baseball/Softball"

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