Tag Archives: Overuse Injury

Physical Therapy for Golfer's Elbow

Physical Therapy for Golfer’s Elbow (Medial Epicondylitis)

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Physical Therapy for Golfer's Elbow

Golfer’s Elbow, medically known as medial epicondylitis,  is a painful condition where the tendons that attach to the inside of the elbow become inflamed due to repetitive use of the hand, wrist, forearm, and elbow. It often occurs with repetitive activities such as swinging a golf club or tennis racket, work or leisure activities requiring twisting and gripping such as shoveling, gardening and swinging a hammer. It can also appear in other sports-related activities such as throwing and swimming. Medial epicondylitis is most commonly seen in men over the age of 35 but can be seen in any population. If these symptoms sound familiar, than going to physical therapy for golfer’s elbow may be just what you need.

What is causing your elbow pain?

Medial epicondylitis affects the group of muscles that are responsible for bending the wrist, fingers, and thumb and that rotate the wrist and forearm. The tendons that connect those muscles to the medial epicondyle (bump on inside of elbow). Tendons are made up of collagen fibers that are lined up next to each other. The repetitive forces pull on those tendons creating pain and tenderness. Without treatment, those tendons can eventually pull away from the bone. Acute injuries to your elbow can create an inflammatory response which can cause redness, warmth, and stiffness in your elbow.

Medial epicondylitis is most often caused by an abnormal arrangement of collagen fibers. This condition is called tendinosis. During tendinosis, the body doesn’t create inflammatory cells as it does during an acute injury. Instead, fibroblasts are created which help make up scar tissue to fill in the spaces between the collagen fibers. This increase in scar tissue can lead to increased pain and weakness in the tissues. Physical and hand therapy is the most common nonsurgical treatment for medial epicondylitis. Your therapist will perform an evaluation where he/she will ask you several questions about your condition, pain level and other symptoms you may be experiencing. He/she will perform motion and strength testing on your entire upper extremity. Your therapist will also palpate your arm to determine which tendon(s) may be inflamed. He/she will use special tests designed to deferentially diagnose your condition from others that may have similar presentations, such as Cubital Tunnel Syndrome.

golf ball on tee

What to expect from Physical Therapy for Golfer’s Elbow

  • Pain Management: this can include Mechanical Diagnosis & Therapy, ice, ice massage, moist heat, electrical stimulation, and ultrasound.
  • Range-of-Motion Exercises: stretches and mobility exercises to help maintain proper movement in your elbow, forearm, wrist, and hand.
  • Strengthening Exercises: progressive resistive exercises to help build strength in your arm, elbow, forearm, wrist, and hand. These can include weights, medicine balls and/or resistance bands. This will also include your Home Exercise Program.
  • Manual Therapy: used to ensure full, pain-free movement is achieved and can include joint mobilizations, manual muscle stretches, and soft tissue massage.
  • Neuromuscular Re-education (Functional Training): used to help you return to your prior level of function for both home and work activities. Will include retraining proper movement patterns with necessary modifications based on the current level of function and patient limitations.
  • Patient Education: used to help retrain patients on proper postural control during everyday activities including dressing, self-care, work, and sports activities. This can include helping return a patient to their specific sport, such as making adjustments to their golf swing or throwing technique.

Once you’ve completed physical therapy for Golfer’s Elbow you’ll want to do everything you can to prevent this from reoccurring. This can occur by maintaining proper awareness of your risk for injury during your daily movements. Key things to keep in mind:

1. Maintain proper form during all repetitive movements both at work and at home.
2. Continue your Home Exercise Program in order to maintain proper strength in your shoulder, elbow, forearm, wrist, and hand.
3. Use proper posture and body mechanics with lifting or carrying to avoid any undue stress on your joints and tendons.

This information was written by Plymouth Physical Therapy Specialists, an outpatient physical and hand therapy group with fourteen locations in the surrounding Plymouth, Michigan area. At Plymouth Physical Therapy Specialists, they are committed to using evidence-based treatments in their practice. This means that their therapists utilize the most current and clinically relevant treatments in their approach to rehabilitation. For more information click here.

Avoid common baseball injuries

10 Ways To Avoid Common Baseball Injuries

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Avoid common baseball injuries

According to an article published by the Journal of Athletic Training, youth baseball players reported throwing-arm pain 74% of the time. They also reported that UCL reconstructions between 2003 and 2014 increased 343%, with 56.6% in those aged 15 to 19 years. With the increase injuries related to the pitching athlete, we wanted to take a minute and focus on what you can do to help prevent common baseball injuries from happening to your athlete.

WHAT ARE COMMON BASEBALL INJURIES?

  • The most common baseball injuries include mild soft tissue injuries, such as muscle pulls (strains), ligament injuries (sprains), cuts, and contusions (bruises).
  • Although baseball is a non-contact sport, most serious injuries are due to contact — either with a ball, bat, or another player.
  • The repetitive nature of the sport can also cause overuse injuries to the shoulder and elbow.

.

WHAT CAN YOU DO TO PREPARE FOR THE SEASON?

  • Physical exam. A pre-season physical exam is important for both younger and older players. The goal is to prevent injuries and illnesses by identifying any potential medical problems. These may include asthma, allergies, heart, or orthopedic conditions.
    Warm-up and stretch. Always take time to warm up and stretch.
  • Warm-up with some easy calisthenics, such as jumping jacks. Continue with walking or light running, such as running the bases.
  • Gentle stretching, in particular your back, hamstrings, and shoulders, can be helpful. Your team coach or athletic trainer may provide a stretching program.

.

10 WAYS TO AVOID COMMON BASEBALL INJURIES

ASMI GUIDELINES TO HELP PROTECT PITCHERS FROM SHOULDER AND ELBOW INJURIES:

Pitching

.

1. Don’t throw too much:
Daily, weekly and annual overuse is the greatest risk to a pitcher’s arm health. Numerous studies have shown that pitchers who throw more pitches per game and those who do not adequately rest between appearances are at an elevated risk of injury. While medical research does not identify optimal pitch counts, pitch count programs have been shown to reduce the risk of shoulder and elbow injury in Little League Baseball by as much as 50% (Little League, 2011). The most important thing is to set limits for a pitcher and stick with them throughout the season.

2. Don’t pitch through arm fatigue:
Individuals are 36 times more likely to develop shoulder and elbow injuries when routinely pitching with arm fatigue.

3. Don’t pitch more than 100 innings per year:
If an athlete throws over 100 innings they are 3.5 times more likely to be injured than those who did not exceed 100 innings pitched.

4. Don’t throw more than 8 months per year:
Athletes who throw > 8 months per year are 5 times as likely to suffer an injury requiring surgery of the elbow or shoulder. Pitchers should refrain from throwing for at least 2-3 months per year and avoid competitive pitching for at least 4 months per year.

5. Don’t pitch on consecutive days:
Pitchers who pitch on consecutive days have more than 2.5 times greater risk of experiencing arm pain.

6. Don’t play catcher following pitching:
If the player catches the following pitching they are 2.7 times more likely to suffer a major arm injury.

7. Don’t play on multiple teams at the same time:
There is an increased risk of injury due to the difficulty in monitoring pitch limits and rest time. If the player is on multiple teams, make meticulous efforts to keep track of the number of pitches thrown to allow adequate rest.

8. Don’t forget the shoulder in strength and conditioning programs:
Numerous studies have shown that deficits in upper extremity strength and mobility are strongly correlated to serious arm injuries. Shoulder and forearm strengthening exercises can build strength, endurance and motor control which can prevent injury.

9. Be cautious with throwing curveballs and sliders:
While existing research has not consistently shown a strong connection between the curveball and injuries, Yang et al., found that amateur pitchers who threw curveballs were 1.6 times more likely to experience arm pain while pitching and Lyman et al, found that youth pitchers who throw sliders are 86% more likely to experience elbow pain.

10. Be cautious with the radar gun:
Radar guns do not directly cause harm to a pitcher, however, the gun may cause the pitcher to throw beyond their normal comfort level. This could create an arm strain.

Don’t redshirt this season. Physical therapists can work with athletes to make sure certain muscle groups can accommodate the strain and movements necessary to perform well in your sport. Be proactive and work towards a great season with PT!

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gardening ergonomics

Gardening Ergonomics

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It’s that time of year again. Time to exchange snow shovels and winter boots with gardening tools and watering cans. While the warmer weather brings on a new sense of happiness and energy, we need to remember to use proper body mechanics and follow general safety to avoid muscle aches and potential serious injuries. The number one injury associated with gardening is low back pain.

Here are a few tips to make your gardening experience more enjoyable and less painful.

LIFTING:
Lifting heavy objects such as bags of soil, planters and mulch improperly can lead to low back strains and/or sciatic pain. Other options include moving half of the soil/mulch to a separate pot before lifting the bag or planting in to smaller pots that are easier to maneuver. Using a garden cart or wheelbarrow can also assist with moving heavy gardening materials. Remember to lift with your legs, avoid simultaneous lifting and twisting and keep heavier objects close to your body to avoid injury.

PLANTING:
Prepping the soil can also be a difficult and tedious task requiring prolonged forward bending and frequent changes in position. Try prepping the planting bed by using long-handled gardening tools. Once the soil is ready, plant from a kneeling position using either a kneeling stool or a cushion. Remember to avoid twisting at the spine. Those with known chronic low back pain may want to consider planting in to pots, flower boxes or raised flower beds to avoid further injury.

WEEDING:
Most people dislike weeding their gardens and flower beds. Options to reduce the need to do so include using plants as ground cover or using mulch in your flower beds to minimize weed growth. If using a weed spray, look for bottles that have a sprayer hose to allow you to stand upright while treating your problem areas.

MOWING THE LAWN:
Another task that most people find tedious. When able, use an electric start mower. The action of pulling a cord to start your mower is the most common cause of low back injuries. If you must use a pull start mower, remember to bend at your knees and maintain the natural curve of your spine while reaching for the cord. Make sure you tighten your abdominal muscles just before pulling the cord in order to support your spine. If using a push mower, remember to maintain proper upright posture and take breaks as needed.

Remember to listen to your body. Take frequent breaks and change positions when you start to experience aching, cramping or fatigue. Stay hydrated and wear sunscreen. If you do happen to experience low back pain or any other injury, remember to contact your physical therapist. They can help alleviate your symptoms as well as educate you on proper body mechanics.

gardening

GARDENING STRETCHES
Stretching before you start gardening can help you from experiencing pain later. Here are some stretching techniques to help get you started!

1.) Fold your hands together and turn your palms away from your body, but this time extend your arms overhead. You should feel the stretch in your upper torso and shoulders to hand. Hold for 10 seconds and repeat eight times.

2.) Place your hand just above the back of the elbow and gently push your elbow across your chest toward the opposite shoulder. This is a stretch for the upper back and shoulder. Stretch both the right and left arms. Hold for 10 seconds and repeat eight times.

3.) Raise one arm overhead. Bend the elbow. Place the opposite hand on the bent elbow and gently push the elbow back further. This is a stretch for the triceps. Stretch both the right and left arms. Hold for 10 seconds and repeat eight times.

4.) Extend an arm in front of you, making sure the elbow is completely straight. With your palm down, take the opposite hand and bend in the wrist downward. Then turn the palm up, and stretch the wrist backwards. This stretches the forearm and wrist muscles. Hold for 10 seconds and repeat eight times.

The warm-up exercises were developed by professional hand therapists who are occupational and physical therapists specializing in the treatment of the hands, arms and shoulders. These exercises and tips have been designed to supplement more commonly known gardening safety practices that concentrate only on preventing back injuries.
For more information visit: www.asht.org

athletic trainer

Who is an Athletic Trainer?

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Athletic trainers hold at least a four year degree from a BOC (Board of Certification) accredited institution. They are licensed, certified health professionals working with athletes on and off the field. Generally they are the first responders when injuries occur during sporting events.

Athletic trainers work closely with coaches and parents and will refer athletes to other health care professionals such as physicians, physical therapists and surgeons when needed.

Athletic trainers hours are determined by sports schedules. Typically they are available after school and stay until sporting events have concluded.

IN THE TRAINING ROOM ATHLETIC TRAINERS

  • Prepare athletes for competition by taking preventative measures such as equipment fitting, taping and bracing
  • Assess athletes with acute and chronic injuries to determine their participation status
  • Perform sport-specific rehabilitation on injured athletes
  • Provide opportunities for strengthening and conditioning
  • Work with sports staff on proper warm up, game day preparation and on/off season conditioning
  • Educate athletes, coaches and parents on sports medicine strategies, nutrition and sports psychology

running back

DURING THE GAME ATHLETIC TRAINERS

  • Support athletes during sporting events
  • Manage any type of musculoskeletal issues including:
  • Shoulder, hip, knee, elbow, hand and ankle injuries
  • Facial injuries
  • Neck and back injuries, spinal cord injuries and traumatic brain injuries like concussions
  • Triage and wound care
  • Heat-related illnesses
  • Fractures and dislocations
  • Catastrophic injuries

This information was written by the Center for Physical Rehabilitation, an outpatient physical therapy group with five locations in Western Michigan. The Center specializes in all inclusive physical therapy services, such as: Sports Medicine, Orthopedic Post-Surgical and McKenzie Therapy. Our state-of-the-art facilities are conveniently located around Grand Rapids with extended hours. Independent and locally owned since 1994, we have the freedom to work with the most qualified healthcare professionals. For more information click here.

shin splints

7 Ways Physical Therapists Treat Shin Splints

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shin splints

Here are 7 ways a physical therapist can help treat pain and symptoms associated with shin splints:

Pain Reduction: The RICE principle is the first step to recovery (rest, ice, compression, and elevation). Manual therapy and Kinesiotaping may also be used to speed up recovery and reduce swelling.

Gait and Footwear Analysis: An analysis of how a person walks and runs in an important part of treatment. The wrong mechanism of walking can transmit a great deal of force through the shin to the knee and hip. In such situations, physical therapists will correct gait patterns and recommend footwear with shock absorbing capacity.

Muscle Stretches and Strengthening: The tibial and peroneal muscles are attached to the shin and must be stretched adequately before any form of exercise. Physical therapy includes various stretches of the goot that will help stretch and warm up these muscles. Strengthening damaged muscles can also help.

 Activity Modification:  Physical therapists may suggest alternative activities to minimize stress on the shinbones. These can include swimming and cycling.

Increase Range of Motion (ROM): Exercises for the hip, knee, ankle and foot improve blood circulation, reduce inflammation and relieve pain. A home exercise program may also be implemented.

Arch Support:  The absence or collapse of a normal foot arch can lead to shin splints. Physical therapists will recommend appropriate orthotics that can be custom made for the patient and provide the appropriate amount of arch support.

Return to Sport: If you are an athlete, your therapist may tailor exercises that are specific to strengthening the areas needed to perform your sport. Modified use of your muscles may also be discussed and implemented. Return to your sport may be gradual to prevent re-injury.

To learn more about shin splints please visit our PT & Me injury center on this website by clicking here.

Safe Lifting Practices for Back Injury Prevention

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Whether at home or at work safe lifting practices can keep your back healthy and safe. Before lifting heavy objects decide how you will lift carry & place the item before you pick it up. Test the weight of the load by moving or tipping it. Figure out if you can break the load down by placing the contents of large containers into a number of smaller ones before moving them. Is the path clear? What is the weight of the load? How much stress will be placed upon your back? Is there traffic, a tripping hazard, a doorway to go through, or a stairway to go up or down? Avoid carrying an object that requires two hands to hold, either up or especially down a flight of stairs. Use the elevator. Plan a rest stop, if needed. Knowing what you’re doing and where you’re going will prevent you from making awkward movements while holding something heavy. Clear a path, and if lifting something with another person, make sure both of you agree on the plan.

KEY STEPS FOR SAFE LIFTING PRACTICES

Establish a Base of Support: Use a wide, balanced stance with one foot in front of the other. Make sure that you have firm footing and that your feet are a shoulders-width apart. This staggered stance gives you the stability of not falling over and being able to secure the load.

Keep Your Eyes Up: Looking slightly upward will help you maintain a better position of the spine. Keeping your eyes focused upwards helps you keep your back straight.

Get a Good Grip: With your palms and make sure you have an adequate hold on the object. Be certain you will be able to maintain a hold on the object without having to adjust your grip later. You can use gloves to help maintain an adequate grip, but don’t rely on gloves because they can desensitize the fingers and make you unable to feel the object.

Lift Gradually with Your Legs: Without using jerky motions. By using your leg strength, your chance of lower back injury is greatly reduced.

Tighten you stomach muscles: As you begin the lift and keep you head and shoulders up.

Pivot – Don’t Twist: Move your feet in the direction of the lift. This will eliminate the need to twist at the waist.

Weight: A lighter load normally means a lesser risk of injury. The weight of the object should be within the capacity of the person to handle safely.

Handling: It is easier to pull or push a load than it is to lift, put down or carry.

Keep the Load Close: Holding a 20lb object with your hands 20 inches from the body creates more compressive force on your low back than holding it 10 inches away. This is because the muscles in your back have to work to counterbalance the weight when it is further from the body. As the compressive force on your low back increases, so does the risk of muscle strains, ligament sprains and damage to the disks in the spine.

Frequency: The more times a load is handled, the more tired the muscles become, making it easier for the person to be injured.

Distance: The farther the load has to be moved, the greater the risk of injury.

Duration (TIME): Where the job involves repetitive movements, reducing the time spent on handling will help to ensure the movements are not causing unnecessary strain.

Forces Applied: Forces should be applied smoothly, evenly and close to the body. Forces exerted should be well within the capacity of the person, and the person should maintain proper posture.

Nature of the Load: Loads that are compact, stable, easy to grip, and capable of being held close to the body are much easier to handle.

Terrain: Rough ground, steep slopes, slippery and uneven floors, stairs and cluttered floors make moving a load awkward and increase the chance for injury.

Environment (Climate & Lighting): If it is too hot, too humid, too cold or the lighting is inadequate, the capacity to work safely is reduced.

Condition of the Workplace: Safe and comfortable working conditions, with adequate space to perform the task, and tools and equipment that are well-maintained, make their job safer.

Age/Gender: Young and old workers alike may be at an increased risk of injury from manual materials handling activities. Ensure abilities of employees are in line with functional job requirements.

Training: Proper training for the specific task is vital to reduce injury.

Team Lifting: If one person cannot lift or move a heavy, large or awkward object safely, organize a team lift. Team lifting reduces the risk of injury, reduces fatigue and makes the task much easier.

Raise/Lower Shelves: The best zone for lifting is between your shoulders and your waist. *Put heavier objects on shelves at waist level, lighter objects on lower or higher shelves.

Avoid Lifting from the Floor: Lifting from the floor can greatly increase your risk of injury for two reasons. Firstly, it is difficult to bring objects close to your body when picking them up from the floor, especially large objects where your knees can get in the way. Secondly, your low back must now support the weights of your upper body as you lean forward, in addition to supporting the weight of the item you are lifting. Lifting the same 20lbs from the floor more than doubles the amount of force on your low back when compared with lifting is from waist height. Even a one pound object lifted from the floor increases you risk of injury if you use a bent over posture.

Get Help When You Need It: Don’t try to lift heavy or awkward loads on your own. Even though the muscles in your upper body may be strong enough to handle the load, the muscles, ligaments and disks in your lower back may be injured because of the additional forces they have to withstand. Get help from a co-worker, and whenever possible, use a cart, hand truck or other mechanical device to move the load for you.

This content was written by Fit2WRK who has partnered with PT and Me to give a comprehensive look into the services physical and occupational therapists provide. For more information on Fit2WRK click here.

Achilles Tendinitis

Treatment Options for Achilles Tendinitis

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The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run and jump.  Although the Achilles tendon can withstand great stresses from running and jumping, it is also prone to tendinitis, a condition associated with overuse and degeneration. Achilles Tendinitis causes pain along the back of the leg near the heel. If you suffer from Achilles Tendinitis – try these pain relief methods.

REST: Cut back your training by decreasing your mileage and intensity. Also avoid hills and speedwork. You may substitute running with swimming, running in water and biking to reduce the irritation.

ICE: Apply ice to the affected area for 10 to 20 minutes with at least one hour between applications. Do not apply ice directly to your skin – a pillowcase or dish towel works well as a protective barrier. Frozen peas or reusable gel packs are flexible and conform well to the injured area.

PROPER FOOTWEAR/ORTHOTICS: This situation can be corrected with arch supports or custom orthotics. Orthotics allow your foot to maintain correct position throughout the gait. Avoid walking barefoot and wearing flat shoes. If your pain is severe, your doctor may recommend a walking boot or to cast you for a short time. This gives the tendon a chance to rest before any therapy is begun.

NON-STEROIDAL ANTI-INFLAMMATORY MEDICATION: Drugs such as ibuprofen and naproxen reduce pain and swelling. They do not, however, reduce thickening.

PHYSICAL THERAPY: Achilles tendinitis can be painful, chronic condition if left untreated. Consult your physician to discuss physical therapy options. Licensed physical therapists coordinate with your physician to provide individualized care and treatment options for your specific needs.

CORTISONE INJECTIONS: Cortisone, a type of steroid, is a powerful anti-inflammatory medication. Cortisone injections into the Achilles tendon are rarely recommended because they can cause the tendon to rupture (tear).

Athletic Injuries PTandMe

3 Types of Athletic Injuries

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3TypesAthleticInjuries_FBsize

Did you know that most athletic injuries can be boiled down into three main categories?  Acute, Overuse and Chronic.  Physical therapists that specialize in sports medicine, help athletes experiencing pain get back in their sport.  From the time of the injury through recovery and performance, the licensed physical therapists that partner with PTandMe have the know-how and experience to get rid of your pain.

1.) ACUTE: Usually a result of a single traumatic event within the last five days. Examples: fractures, sprains, dislocations, muscle strains.

2.) OVERUSE: Subtle and occur over time, making them challenging to diagnose and treat. Examples: swimmer’s shoulder, runner/jumpers knee, Achilles tendonitis, shin splints.

3.) CHRONIC: Usually has lasted at least three months or more.

COMMON CAUSES OF INJURIES:

  • Improper training and technique
  • Incorrect equipment fitting and support
  • Anatomic or biomechanical issues of athlete
  • Catastrophic event on or off the field

football injury

OVERUSE INJURIES AND BURNOUT
Overuse/overtraining injuries and burnout are a major problem for adolescent athletes. Both can occur when students participate in sports year-round with no “off season”, or have insufficient recovery time between practices and games.

WATCH for typical burnout signs:

  • Pain during or after activity, or while at rest
  • Lack of enthusiasm for practices or games
  • Dip in grades

PREVENT overuse injuries and burnout with these simple tips:

  • Allow enough time for proper warm-up and cool down routines
  • Rest 1-2 days per week or engage in another activity
  • Focus on strength, conditioning or cross training during the “off season”

Did you know that 50% of all sports injuries to student athletes are a result of overuse?

SPRAIN
Sprains result from overstretching or tearing of the joint capsule or ligament which attaches a bone to another bone.

STRAIN
Strains, also referred to as pulls, result from over-stretching or tearing a muscle or tendon, which attaches a muscle region to a bone.

CONTUSIONS
Contusions or bruises are an injury to tissue or bone in which the capillaries are broken and local bleeding occurs.

TEARS
Tears are a complete separation of the tissue fibers.

Physical therapy and athletics go hand in hand. In many cases, your PT may be a former athlete that experienced an injury in their youth, and as a result found a passion for rehabilitating others. If you are experiencing pain, or have already had an injury, don’t wait to talk to your physical therapist. The faster you ask for help the faster you can get back into your sport.

For more information about physical therapy and sports medicine – try the links below:


       

This article about athletic injuries was provided by PTandMe physical therapy partner: The Center for Physical Rehabilitation. More information about the Center and their locations throughout Grand Rapids, MI can be found on their website at www.pt-cpr.com

throwing injuries PTandMe

Guidelines to Prevent Throwing Injuries

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In this monthly series, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


WRIST EXTENSION
Start with the arm supported on a table and your wrist facing toward the ground. Hold the weight off the edge of the table and bring the back of your hand toward the ceiling.


WRIST FLEXION
Start with the arm supported on a table and your wrist facing toward the ceiling. Hold the weight off the edge of the table and bring your palm toward the ceiling.

ASMI GUIDELINES TO HELP PROTECT PITCHERS FROM SHOULDER & ELBOW THROWING INJURIES:

Don’t throw too much:
Daily, weekly and annual overuse is the greatest risk to a pitcher’s arm health. Numerous studies have shown that pitchers who throw more pitches per game and those who do not adequately rest between appearances are at an elevated risk of injury. While medical research does not identify optimal pitch counts, pitch count programs have been shown to reduce the risk of shoulder and elbow injury in Little League Baseball by as much as 50% (Little League, 2011). The most important thing is to set limits for a pitcher and stick with them throughout the season.

Don’t pitch through arm fatigue:
Individuals are 36 times more likely to develop shoulder and elbow injuries when routinely pitching with arm fatigue.

Don’t pitch more than 100 innings per year:
If an athlete throws over 100 innings they are 3.5 times more likely to be injured than those who did not exceed 100 innings pitched.

Don’t throw more than 8 months per year:
Athletes who throw > 8 months per year are 5 times as likely to suffer an injury requiring surgery of the elbow or shoulder. Pitchers should refrain from throwing for at least 2-3 months per year and avoid competitive pitching for at least 4 months per year.

Don’t pitch on consecutive days:
Pitchers who pitch on consecutive days have more than 2.5 times greater risk of experiencing arm pain.

Don’t play catcher following pitching:
If the player catches following pitching they are 2.7 times more likely to suffer a major arm injury.

Don’t play on multiple teams at the same time:
There is increased risk of injury due to the difficulty in monitoring pitch limits and rest time. If the player is on multiple teams, make meticulous efforts to keep track of the amount of pitches thrown to allow adequate rest.

Don’t forget the shoulder in strength and conditioning programs:
Numerous studies have shown that deficits in upper extremity strength and mobility are strongly correlated to serious arm injuries. Shoulder and forearm strengthening exercises can build strength, endurance and motor control which can prevent injury.

Be cautious with throwing curve balls and sliders:
While existing research has not consistently shown a strong connection between the curveball and injuries, Yang et al., found that amateur pitchers who threw curveballs were 1.6 times more likely to experience arm pain while pitching and Lyman et al, found that youth pitchers who throw sliders are 86% more likely to experience elbow pain.

Be cautious with the radar gun:
Radar guns do not directly cause harm to a pitcher, however, the gun may cause the pitcher to over throw beyond their normal comfort level. This could possibly create arm strain.

Following these guidelines may keep the throwing athlete safe from the debilitating shoulder and elbow throwing injuries seen on a regular basis in physical therapy clinics.

Pitching Guidelines Chart

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. They specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Their staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

prevent throwing injuries

Guidelines to Prevent Throwing Injuries

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In this monthly series about how to prevent throwing injuries, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


PRONE ROW
Lay on your stomach with your arm hanging off the edge toward the ground. Squeeze your shoulder blade and bring your elbow toward the ceiling while keeping your forearm perpendicular to the ground.


PRONE ROW WITH EXTERNAL ROTATION
Lay on your stomach with your arm hanging off the edge toward the ground. Turn your wrist so your palm is toward your feet. Squeeze your shoulder blade and bring your elbow toward the ceiling while keeping your forearm perpendicular to the ground. Once your arm is parallel with the ground rotate the back of your hand toward the ceiling while keeping the elbow bent.


PRONE T (HORIZONTAL ABDUCTION)
Lay on your stomach with your arm hanging off the edge toward the ground. Lift your arm straight out to your side and squeeze your shoulder blade with the palm continuing to face toward the ground.


PRONE Y (SCAPTION)
Lay on your stomach with your arm hanging off the edge toward the ground. Lift your arm at a 45 degree angle over your head with your thumb facing toward the ceiling. Squeeze your shoulder blade down and toward your spine.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. They specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Their staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

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