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Author: drjallen

Physical Therapy for Golf in Tucson

Added on April 2, 2017 by DrJAllen

Physical Therapy for Golf in Tucson

Physical Therapy for Golf in Tucson

Physical Therapy for golf is something that has been happening for years behind the scenes. With players like Tiger Woods and others, in the past decade the sport of golf has become associated with a higher level of fitness and physical expectation than ever before. On the Tour, many golfers now have their own personal Physical Therapist to help them avoid injury and improve their physical performance on and off the course.

Golf is an extremely popular sport- particularly here in Tucson. Men, women, and children of all ages can be seen out on the greens at many of the local courses. Popularity continues to grow. With the rise in numbers of people playing golf, we have seen a rise in golf related injuries. Like any sport, the most important piece of equipment is the human body. Many think it's that new $2,000 driver! The best clubs in the world cannot compensate for a poorly tuned body—and that's where a Physical Therapist comes in to help. Physical Therapy for Golf is something you should consider if you have any of the following:

Common Injuries in Golf

  • Low Back Pain
  • Sciatica
  • Herniated Disc
  • Golfer's Elbow
  • Hip Pain
  • Shoulder Pain
  • Hand and Wrist Pain
  • Neck Pain

Things That May Increase Injury Risk

Each golfer is an individual with his or her own intrinsic risk factors. Many people have heard others say "golf is bad for your back". A Physical Therapist would redirect that statement to say "A poorly conditioned back is not good for golf"! So the body must be ready for the high demands that the golf swing can put on the body.

If a marathon runner trained for the marathon by only running a mile every day, most people would say they were crazy to think they would be able to do a marathon. As a golfer, if you are not conditioning your body for the demands of the golf swing, in a way it is the same thing. Golf is a repetitive sport that requires adequate conditioning and flexibility to do it right. There are certain things Physical Therapists look for to make sure a golfer is in good condition to perform the golf swing.Physical Therapy for golf in Tucson may address the following:

Common physical risk factors for golf injuries include (the body):

  • Poor flexibility in the Spine. With limited mobility, and the rotational demands of the golf swing, this can cause undue stress on the joints and discs in the low back
  • Poor Hip flexibility. When the hips lack mobility, stress is put on the lumbar spine. Poor hip flexibility can also cause a golfer to overextend the shoulder, creating strain in the muscles of the shoulders and elbows
  • Poor shoulder flexibility. From backswing to follow through, there is a lot of mobility required in the upper body. If the shoulders are tight and cannot move the way they need to, strain is put on other areas of the body- including the upper back, low back and elbows.
  • Limited Ankle Mobility. If the foot and ankle are stiff and cannot rotate, some other area of the body has to take up the slack and do more of the rotation. The knees and hips generally take the hit from this lack of mobility, but structures as high as the lumbar spine can even be affected.
  • Weakness in the "Core". The core muscles include the abdominal muscles, gluteal muscles and others. They serve to stabilize the spine and pelvis as large movements are undertaken by the rest of the body. If the "Core" is weak, this can cause abnormal movement and shearing in the spine, pelvis and hips. Not only can this leave you at risk for injury, but it can also affect how far you can drive the ball!
  • Weakness in the stabilizers of the shoulders and shoulder blades. Power comes from not only the lower body, but also from the shoulder blades and rotator cuff of the shoulders. Weakness in this area can have detrimental effects on the shoulders and elbows. Just like baseball pitchers need a strong upper body to deliver a 95 mile and hour fastball, golfers need upper body strength and stability for those long drives. With more power comes more distance.
  • Balance Problems. Have you ever tried to sink a put and found yourself off balance or losing your balance? Balance doesn't get the credit it deserves when it comes to golf performance. Being unsteady can cause minor to major injury as other parts of the body have to compensate for this lack of stability. And we know, golf is many times won in the short game. Improving balance just a little can have a direct effect on that putting accuracy!

Common risk factors outside the body:

Risk of injury is not limited to the problems in the body, but can also be linked to factors that are outside the body.

·       Environmental conditions. Playing on a course that has a lot of uneven terrain or one that is poorly maintained can put a player at risk for spraining an ankle or other injury

·       Weather. In the Southwest high levels of heat can predispose a golfer to a heat related illness like heat exhaustion or heat stroke. It's important to stay hydrated and cool especially in the summer heat. Having an early tee time can help reduce risk of a heat related condition.

·       Equipment. Poorly fit clubs, or clubs that are damaged can put the athlete at risk. (Golfers feel free to use this as evidence that you need that next new $2,000 driver!)

·       Other factors- Hitting the ground with a club, injuries from golf carts and being hit by an errant ball are all real possibilities while you are out there. Stay alert and be especially careful if you are taking part in any alcohol consumption while you are driving the golf cart!

Injury Prevention

Other ways to avoid injury include:

  • Have a PRO look at your swing mechanics to make sure bad swing mechanics are not causing undue stress on the body
  • Make sure you warm up prior to driving balls on the range or playing a round of golf
  • Selecting clubs with a larger grip may help reduce injury risk
  • Using softer grips
  • Drink plenty of water or sports drinks to avoid heat related problems
  • Avoid alcohol consumption while playing
  • Perform a specific strength and conditioning program provided by your Physical Therapist
  • Have a golf PRO help you select equipment and make sure of proper fit

Fun Facts

  • Players that hit more # of balls in a week have a higher risk of injury
  • Players that warm up prior to playing have 50% fewer injuries than those that don't
  • Follow through phase is the phase with the highest potential risk for injury
  • Did you know that having the strength to "stop and slow down" the follow through is the most important factor in prevention of injuries in that phase?
  • Having adequate flexibility is the #1 most impactful thing you can do right now to decrease your injury risk

Do you have any of these?

  • Golfer's elbow
  • Low back pain
  • Sciatica
  • Back sprain
  • Herniated disc
  • Shoulder Pain
  • Rotator cuff injuries
  • Cervical or neck pain

A Physical Therapist can help you find the problems in your body that may be causing these conditions. Mention this article to Bodycentral Physical Therapy schedulers and you can receive a free consult with one of the Doctors of Physical Therapy to see what we can do to help. Visit www.Bodycentralpt.net for more information on how Physical Therapy can help you.

 

 

Baseball and Softball Injuries-Don't Let Pain End Your Career!

Added on April 13, 2016 by DrJAllen

Baseball and Softball Injuries-Don't Let Pain End Your Career!

I've heard it all too often "If I had just listened to my body and got help, I might have made it in MLB."

Ask Blake Eager his story and he will tell you "I wish I had this type of evaluation and treatment available to me when I was pitching". Blake pitched for the NY Mets organization and had a career ending injury. Currently he is coaching with Hills Baseball and works with Bodycentral Physical Therapy to keep pitchers healthy while improving performance.  He also works with the Baseball and Softball Sports Physical Therapists at Bodycentral with video analysis of pitchers.

Too often we are seeing more and more career ending injuries that could have been prevented if they had been treated in the early stages. There are many things that can cause injury in baseball and softball players, but overuse tends to be the creator of most long term problems. Some of the things we know about pitchers in particular:

1) Bad Pitching Mechanics have been linked to overuse and breakdown injuries- Players should get a good foundation at a younger age so as they mature and start throwing harder, their bodies are in optimal alignment with pitching. Simple things like a stride length that is too short can cause problems in the elbow and anterior shoulder. A pitching coach that understands the optimal pitching mechanics is essential.

2) Weakness in the Rotator Cuff and Scapular Muscles- Let's face it- There's nothing "natural" about the pitching motion. It's a whirlwind of stressors on the body that requires a huge Braking system. Pitchers create momentum and have to slow it down and stop it as the pitch is released. This requires massive amounts of strength and control. If the rotator cuff (muscles in the shoulder) is weak or out of its perfect ratio in regards to strength, then the pitcher is asking for trouble. Weakness in the shoulder blade muscles also is a major disadvantage. You wouldn't want the brakes to go out on your car---that would cause a crash or massive destruction. The same is true in the rotator cuff and scapular muscles- these are the brakes. If these are too weak or aren't working to their potential--- the pitcher is headed for a crash....or Tommy John surgery or worse. Working with a PT specializing in baseball and softball injuries is key to find these specific issues and get them corrected!

3) Training and Throwing Schedule is Out of Control- More is better right? Pitch more, get better, faster...WRONG. More is better works for cheese on your pizza....but with pitching, more can be just that...More. More pain, More breakdown, More overuse injuries. A balance must be achieved between work and rest so the body can recover. Pushing through fatigue or pain is a bad idea. Throw one more pitch today----lose that Major League career tomorrow. Getting a balanced pitch and recover plan is essential.

4) Weakness in the Lower Body and Core- Show me a pitcher with elbow pain and I'll show you a pitcher that has lower body weakness. Pitching starts with the control and strength in the legs and transfers to the core. Pitchers with lower body weakness break down sooner and pitching mechanics suffer. If you have a pitching related injury, you need the entire body evaluated (Not just the part that hurts). Patients look at me crazily at times when they have shoulder pain and I'm testing the Left hip strength.....it's related...truly.

So What can you do if you want to pitch faster, get better at the craft.....but also decrease your chances of injury?

Bodycentral and Blake Eager have combined forces to provide the components for this recipe to success. Kenzie Fowler has joined forces with Bodycentral for Fastpitch Softball Players that want the same--- better performance, and decrease risk.

The Elite Baseball and Elite Softball Programs available at Bodycentral Physical Therapy Include:

1) Injury Treatment- If there has been an injury, our Sports Physical Therapists with treat the area prior to any performance training. Most of this is eligible for insurance coverage. Hands on treatments like instrument assisted soft tissue mobilization, joint mobilization, dry needling and other strategies are combined with rehabilitation exercises.

2) Injury Prevention Strategies- Our team of Sports Physical Therapists and Conditioning Specialists combine to provide preseason risk screens for teams. We recently screened players in Canyon View Little League as part of the safety program in their league. Strength training, and other strategies are included in these packages. Many of these services are provided free to organizations on a first come- first serve basis. Please email Jennifer Allen for more information or to have your group screened. mailto:jen@bodycentralpt.net

3) The Elite Plan- This is the big one. This is for reducing injury risk and improving overall performance. This is what you would expect to see at the professional level of play. This includes video analysis of pitching, a full Medical Musculoskeletal head to toe evaluation as well as a strength and conditioning program developed specifically for the athlete. These evaluations are baseball and softball specific, and will highlight problems associated with pitching. With this evaluation, we find the areas that are potential trouble makers and get that addressed before they contribute to injury. Blake Eager and Kenzie Fowler are involved with this evaluation process so they bring Player and Coach insight into the Plan. They evaluate pitching from the coaching perspective and give players specific drills to improve in this area.

For More Information on these programs or to sign up-  mailto:info@bodycentralpt.net

Dr. Jennifer Allen is a Board Certified Sports Specialist and heads the Baseball/Softball sports medicine team at Bodycentral Physical Therapy. She is the creator of the Elite Baseball and Softball programs at Bodycentral Physical therapy, and lectures in the areas of Biomechanics and Baseball/Softball injuries. She worked with the Arizona Heat Women's Professional Fastpitch Softball team in Tucson, AZ, and currently volunteers as the Canyon View Little League Safety Officer. For more information visit: http://www.BodycentralPT.net

 

 

 

 

 

 

 

What is a Running Biomechanics Gait Analysis?

Added on June 4, 2015 by DrJAllen

What is a Running Biomechanics Gait Analysis?

Gait analysis is a systematic way to look at running or walking biomechanics. This generally includes the use of multiple high- speed video cameras and computerized software programs that can slow the videos down for the evalutor to look at mechanics frame by frame. Specially trained evaluators look at what happens at each joint in the body with each phase of the gait cycle. Simple things like a larger than normal stride length can cause problems from hamstring and ITB pain, to heel pain and plantar fasciitis. By looking at all the little motions and how they come together as a whole, a trained evaluator can use these movement patterns and deviations to determine where breakdowns are occurring in the body. Combining the musculoskeletal (strength, flexibility & balance) findings with the video biomechanics analysis gives a wealth of information that can be used to create a "Blueprint for Success" for each individual. Each runner or athlete is different- and their programs should be specifically designed for their unique issues. This is definitely not a "One Size Fits All" type of program.

In addition to video analysis, a good running or walking evaluation should include a head to toe musculoskeletal assessment for flexibility, strength, and balance. Each joint should be evaluated to look for stiffness and limited motion, as well as hypermobility- or too much motion. Shoe wear and current orthotics should also be evaluated for wear patterns and to make sure they are providing adequate support to the runner or walker.

There are many injuries that are often caused, at least in part, by poor biomechanics. Runners and athletes whose sports require a high level of running and jumping can benefit from a high quality gait analysis to avoid overuse injuries.

The following are a list of common injuries that may be in part caused by poor biomechanics:

 

  • Shin Splints
  • Plantar Fasciitis
  • Achilles Pain/Tendonitis
  • IT Band Problems
  • Low Back Pain or Sacroiliac Pain
  • Hip Pain
  • Knee Pain

A specific strength, flexibility, & balance program, good biomechanics, and the appropriate shoe wear are important for healthy running and walking activities. Training regimens that increase mileage too quickly, or ones that do not allow adequate rest between bouts of training- or training for multiple races without rest can also contribute to chronic aches and pains.

If you are experiencing pain that comes and goes, or pain that is nagging and you cannot figure out the cause-- this type of evaluation may be right for you.

If you have pain (even after trying all those exercises you found on the internet), this type of evaluation may be right for you.

Dr. Jennifer Allen is a Physical Therapist, Board Certified Clinical Specialist in the Areas of Orthopaedic and Sports Physical Therapy, as well as a Certified Hand Therapist. Sports Programming at Bodycentral Physical Therapy includes Biomechanics assessment, video movement assessment, Injury Prevention, and individual and team performance enhancement. For more information visit www.BodycentralPT.netor call 520-325-4002.

Biomechanics analysis to ensure healthy running and walking activities

 




 

 

Hip Injuries in Baseball & Softball

Added on April 29, 2015 by DrJAllen

Hip Injuries in Baseball & Softball

When we talk about overuse injuries in baseball and softball, we generally discuss upper extremity conditions. Although those injuries are the most common, we are seeing more awareness and discussion of injuries to the hip.

How Do Injuries to the Hip Happen?

The activities of batting and throwing place high demands on the hips and put them at risk for injury. For instance with overhand pitching, during the wind up phase, a flexion and rotational force is placed on the hip. During the cocking phase, the hips are further apart and more loading stress is placed on them. As the pitcher moves from acceleration through the follow-through phases, the hips go through additional loading and rotational stresses. With Softball pitching, rotational forces occur in both the hips as the pitcher moves from a static standing position through the follow-through phase.

With Batting, during the stance or coiling phase, torque is placed on the back hip. As the batter moves through acceleration and follow-through, additional rotational forces are placed on the hips.

These are all normally occurring stresses that are just part of the games of baseball and softball. With normal stresses, there is a potential for injury. The potential for injury increases with the following risk factors:

1) Poor Biomechanics- Improper technique with any of the phases of batting, throwing or pitching can cause increase pressures and torque in the hip

2) Deficits in Mobility or Functional Movement- limitation in movement in any of the joints of the Lower body or Spine can contribute to increased problems in the hips

3) Deficits in Strength & Endurance- Weakness in the muscles of the hips or general "core" muscles can cause instability and result in increased pressures in the hips with activity. Fatigue can also play a part in these types of injuries- Arm fatigue is monitored for pitchers to alleviate the possibility of upper extremity problems, but we should also be monitoring lower body fatigue. If the lower body is weak or starts to break down, pitching accuracy will suffer and may be the first sign of fatigue.

4) Deficits in Proprioception/Balance- strength and flexibility are important, but being able to have balance on one leg and being able to shift weight and control motion is an important aspect in injury prevention. With poor balance, or awareness of body position, joints may move beyond their limits or may place undue strain on soft tissues that support them

5) Joint Abnormalities: abnormalities inside the joint may predispose players to certain types of joint "impingement" or pinching with movement. Repeated strain at these end ranges of motion can create pain and inflammation

Symptoms of Hip Injury

Symptoms of hip problems may be subtle at first and may just be tightness in the hip or buttock area. Other symptoms may include groin pain or aching into the thigh. As symptoms worsen, pain may be experienced at night or with the first few steps after sitting for a prolonged period. These symptoms are a sign that something is wrong in the area- the player should seek medical advice at the onset of these symptoms.

 

Screening for Risk Factors

A comprehensive baseball or softball program should include Pre-season screening, followed by preseason and off-season corrective actions to address any problems or deficits found during the screening process.

An ideal screen should include the following:

1) A regular pre-season Physical

2) Biomechanics Assessment- video assessment in slow motion during hitting/throwing or pitching

3) Flexibility & Strength screening

4) Screens of Specific Functional Movement Patterns

5) Balance & Stability Screens

The best injury treatment advice is to Avoid injury in the first place. Prevention strategies are the Key to keeping players healthy during their careers- if that is Little League Baseball...or all the way through the Majors.

Treatment for Hip Related Injuries

There are many conservative Physical Therapy treatments available for these types of hip injuries. Hands-on techniques, or manual therapy are an important part of rehabilitation as well as specific exercises to fix any muscle imbalances that may exist. Prior to returning to play, video biomechanical analysis is vital to look at throwing, pitching and hitting. This will help identify any mechanical or technique issues that could be causing problems in the hips.

Dr. Jennifer Allen is a Physical Therapist, Board Certified Clinical Specialist in the Areas of Orthopaedic and Sports Physical Therapy, as well as a Certified Hand Therapist. Sports Programming at Bodycentral Physical Therapy includes Biomechanics assessment, video movement assessment, Injury Prevention, and individual and team performance enhancement. For more information visit www.BodycentralPT.netor call 520-325-4002.


 

 

 

 


 

Fastpitch Softball Injury Treatment and Prevention

Added on April 1, 2015 by DrJAllen

Fastpitch Softball Injury Treatment and Prevention

Fastpitch Softball Injury Treatment and Prevention

Spring is in full swing and we are right in the middle of Fastpitch softball season, one of my favorite times of the year. Along with the good, we sometimes as healthcare practitioners see the bad. This time of year, particularly in the early season, we begin to see the overuse injuries that are common with the sport.

A lot of emphasis is put on the prevention of injury in baseball players, and I couldn't agree more with what we do in the field of sports medicine to prevent and treat those injuries. We are getting better at identifying risks for injury and are addressing them to a higher degree in baseball.

I do feel we can do a better job for fastpitch softball players. Pitchers in fastpitch softball have repetitive use of the pitching and throwing arm, and are at risk for injury just as our baseball players are. There is a misconception that pitching a softball is somehow "safer" and less problematic than pitching a baseball. As time goes on, we are discovering that this is really not true. Forces on the shoulder and elbow can reach up to 95% of what are experienced in baseball pitchers (1, 2). Girls and women participating in fastpitch softball are susceptible to similar injuries in the shoulder and elbow as our baseball players.

Common Injuries/Painful Areas:

Anterior shoulder pain (pain in front)        

-       During the softball pitching motion, when the arm is in the "pitch delivery phase", there are significant distraction forces on the shoulder which make the Pectoralis major and Subscapularis muscles susceptible to injury. The Pectoralis Major is a large anterior chest muscle and the Subscapularis is part of the Rotator Cuff. These forces are similar to the forces seen in baseball pitchers.(1)

Elbow Pain

-       Distraction forces at the elbow make those tissues susceptible to overuse injury

 

Posterior Shoulder pain (pain in back of shoulder)

-       The posterior shoulder muscles (deltoid, infraspinatus, and teres minor) are injured while contracting to decelerate the arm during delivery of the pitch. Shoulder joint laxity can be a problem that leads to this type of pain problem. (1)

 

Prevention & Treatment: Bullet Points to Recognize as Factors

-       Proper pitching mechanics- Many factors can affect the ability to maintain good pitching mechanics. Musculoskeletal restrictions, weakness, and problems with balance can contribute to break downs in mechanics.

-       Pitching while fatigued. There are pitch counts available for baseball for different ages to help as a guideline to prevent arm fatigue. Best advice is to stop throwing when arm fatigue starts, regardless of pitch count. Below is a recommendation for fastpitch softball pitch counts as described by S. Werner, PhD.

-       Lower Extremity and "core" strength- Hip position and lower body control is important in the ability to produce force during the pitching movement. Weakness in the lower body can result in more reliance on the arm for force generation, and can lead to injury.

-       Shoulder and Scapular stability- strength and stability in the arm is important, but in addition to that, there must be adequate strength in the muscles that stabilize the shoulder blade. If scapular stability is not present, that again results in smaller shoulder muscles generating and controlling forces.

-       Treatment of the softball athlete and return to play must consider all of these issues. Video Throwing and pitching analysis is an integral part of diagnosis and treatment of the "causes" of painful conditions. A thorough musculoskeletal and entire body functional analysis is important to identify restrictions that can lead to upper extremity overuse. Rehabilitation of the throwing athlete should include hands on treatment, video analysis and biomechanical analysis, and a progressive return to overhand throwing- followed by return to pitching. Missing any of these components can put an athlete at risk at developing another injury.

 

 

 

Fast pitch softball pitch count recommendations as suggested by SL Werner, PhD based on her research (3):

       10U – 60 Windmill pitches per day max followed by one day rest

       12U- 70 pitches per day max followed by one day rest

       14U- 80 pitches per day max followed by one day rest

       16U- 90 pitches per day max followed by one day rest

       18+- 100 pitches per day max followed by one day rest

Dr. Jennifer Allen is a Physical Therapist, Board Certified Clinical Specialist in the Areas of Orthopaedic and Sports Physical Therapy, as well as a Certified Hand Therapist. Sports Programming at Bodycentral Physical Therapy includes Biomechanics assessment, video movement assessment, Injury Prevention, and individual and team performance enhancement. For more information visit www.BodycentralPT.netor call 520-325-4002.

 

References:

1.     Barrentine SW, Feisig GS, Whiteside JA, Escamilla RF, Andrews JR. Biomechanics of windmill softball pitching with implications about injury mechanisms at the shoulder and elbow. J Orthop Sports Phys Ther 1998;28: 405-414.

2.     Werner SL, Murray TA, Levy M, Smith SL, Plancher KD, Hawkins RJ. Reports to the coaches: softball pitching at the 1996 Olympic Games (monograph on the Internet). Steadman Hawkins Sports Medicine Foundation; 2001 Available from: http://www.shsmf.org/main/olympics/olympics1.html

3.     Leland, G. (Fastpitch Softball TV Show). (2014, April 16). How to Softball Drills & Tips: Softball Pitch Counts. Retrieved from http://www.youtube.com

 

 

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