Physical Therapy, Baseball, Pitching
Joe Midgett
Early Sports Specialization

Early Sport Specialization (ESS)

Before I explain why, lets briefly get on the same page with a definition for Early Sport Specialization (ESS). Typically ESS refers to year-round (for at least 8 months) intensive training or competition in an organized sport by young athletes (<12 years of age) while excluding all other sports.

Injury Risk

One of the most studied problems with early specialization is increased injury risk compared to peers. The biggest factor contributing to this increased risk was participation in any individual sport for greater than 8 months of the year3. This is especially true in baseball pitchers where pitching for more than 8 months per year was correlated with a 500% increase in risk for Tommy John surgery. (I discuss this and other risk factors for UCL injury in my blog “Minimizing the Risk for UCL Injuries in Throwers” *hyperlink). Across all sports there is an increased injury risk of 1.81 times in highly specialized athletes compared to their multi-sport peers5.



Early Sports Specialization
weight lifting, Crossfit, Fitness
Jordan Bork, PT, DPT, CSCS, CFSC
Little League Shoulder

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

Little League Shoulder
Physical Therapy, Fitness, hiking, Knee
Mark Bouma, PT, DPT, OCS, COMT, FAAOMPT, CFI
Raking Leaves

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

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

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

  • Squatting

  • Climbing Stairs

  • Eccentric Step-Down Test

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

Raking Leaves
Physical Therapy, Fitness, Knee, Football, Hip, Neck pain, Running
Victor Kolar, PT, DPT, CSCS, TPIc
Turkey Bowl 2023

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

Turkey Bowl 2023
Running, Cross-Fit, Crossfit
Liam Main, PT, DPT, CSCS
CrossFit

In the ever-evolving world of fitness, CrossFit has emerged as a dynamic and intense workout regimen that captivates enthusiasts seeking a combination of strength, endurance, and functional workout. While it has gained popularity rapidly over the last decade, there is a large amount of misinformation and preconceptions regarding it as a means of physical activity.  As a physical therapist, my aim is to provide you with a holistic view of CrossFit—highlighting its benefits, potential drawbacks, and the role of physical therapy in your health journey.


CrossFit

Fitness

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March for Larch

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March for Larch

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

Precautions for Hiking

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Sacroiliac Joint Pain

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Sacroiliac Joint Pain

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

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Ankle Sprains

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Ankle Sprains

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

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SpikeBall

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SpikeBall


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

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Heat or Ice?

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Heat or Ice?

Ice or Heat: Body Pain’s Greatest Question

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

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Little League Elbow

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Little League Elbow

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

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

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

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

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

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

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Moving Day

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Moving Day


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

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Scoliosis Treatment

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Scoliosis Treatment

Adolescent Scoliosis

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

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What is a Squat?

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What is a Squat?

What Is a Squat? A Physical Therapist’s Perspective

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

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ACL Series Part 3: Rehab

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ACL Series Part 3: Rehab

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



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Reducing Fall Risk

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Reducing Fall Risk


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




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ACL Series Part 2: Surgery

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ACL Series Part 2: Surgery

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



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Hip Osteoarthritis

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Hip Osteoarthritis

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



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Exercise After COVID

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Exercise After COVID

What to know about getting back into activity following a diagnosis of COVID

With the most recent spread of Covid across the country, The Journal of the American Medical Association has recently released guidelines on the safest way to return to exercise following all levels of Covid infection. As physical therapists, we are responsible to help our patients return to safe exercise, and should be taking responsibility for returning our patients safely to exercise following Covid. Here are some things to consider for best practice when returning to activity following a COVID diagnosis depending on severity of symptoms.



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ACL Series Part 1: Pre-Surgery

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ACL Series Part 1: Pre-Surgery

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



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Raking Leaves

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Raking Leaves

The annual prevalence of patellofemoral pain in the general population has been found to be over 22%! Anterior knee pain is not just a problem for young adults and adolescents. In this article, I’d like to provide you with several key tests you can use to help determine if you may have patellofemoral pain and then outline how a physical therapist can successfully help you recover.

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

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

  • Squatting

  • Climbing Stairs

  • Eccentric Step-Down Test

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

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Patellofemoral Joint

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Patellofemoral Joint

The annual prevalence of patellofemoral pain in the general population has been found to be over 22%! Anterior knee pain is not just a problem for young adults and adolescents. In this article, I’d like to provide you with several key tests you can use to help determine if you may have patellofemoral pain and then outline how a physical therapist can successfully help you recover.

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

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

  • Squatting

  • Climbing Stairs

  • Eccentric Step-Down Test

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

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Medial Tibial Stress Syndrome

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Medial Tibial Stress Syndrome

What is Medial Tibial Stress Syndrome?

Medial tibial stress syndrome (MTSS), also known as “shin splints”,

is an overuse injury that causes pain at the front of the shin with exercise. MTSS is an early stress injury along a spectrum that includes tibial stress fractures. It is most common in runners, jumping athletes, and military personnel-- individuals which undergo recurrent impact exercise.

Differential diagnosis of MTSS requires clinicians to distinguish MTSS from tibial stress fractures, exertional compartment syndrome, peripheral vascular disease or popliteal artery entrapment, and other less common causes of exertional pain in the lower extremities, including muscle or fascia involvement or nerve entrapment syndromes.

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Iliotibial Band Syndrome

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Iliotibial Band Syndrome

IT Band Syndrome

What is it?

Iliotibial band syndrome (ITBS) is a common overuse injury characterized by pain at the outside of the knee. It’s particularly prevalent in endurance athletes such as runners and cyclists-- those who undergo repetitive back-and-forth knee movements. In fact, ITBS is the leading cause of lateral knee pain and the second leading cause of overall knee pain in this population.