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Archive: June, 2013

POSTED: Friday, June 28, 2013, 9:01 AM
Nerlens Noel waits for the first round of the NBA basketball draft, Thursday, June 27, 2013, in New York. (Kathy Willens/AP)

“It’s happening again!”

That was the initial reaction of many 76ers fans, as news broke that the team was trading All-Star point guard Jrue Holiday to the New Orleans Pelicans as part of a package that would bring back much-heralded draft pick Nerlens Noel from the University of Kentucky.

Why the concerns? Well, Noel is currently recovering from an ACL tear that is expected to keep him out until December. After the previous year’s drama with Andrew Bynum, how could the Sixers deal their potential franchise player for another injured big man?

POSTED: Thursday, June 27, 2013, 5:50 AM
(iStockphoto)

As a Physical Therapist, I work with injured athletes on a daily basis. One particular professional athlete I was working with recently validated a trend I have been noticing for years. He was recovering from a knee surgery and, from looking at the size of his muscles and extra large stature, I assumed his strength would be off the charts or at least stronger than most average-sized patients.  

While his quadriceps and hamstrings tested strong, his gluteal, hip and trunk muscles were extremely weak. He had difficulty holding some basic exercise positions on my treatment table, yet he was one of the fastest players on the field. But, he was recovering from a non-impact injury and it became clear to me that this pattern of weakness was the main reason for his injury.

The body was designed to be balanced in strength in all planes. However, due to current trends in weight lifting, poor body mechanics habits and inefficient use of all of our muscles, most people have developed a quadriceps dominant pattern of movement. This means over-utilizing the muscles in the front of the thighs and generating power from smaller, less efficient muscles. This faulty pattern leads to common athletic injuries involving the knees, foot/ankle, hip and low back.

By size, the gluteus maximus is a massive muscle designed to be the primary extender of the hip, especially during running. Most people do not even know how to activate this muscle and they tend to rely on the next accessible hip extending muscle group, the hamstrings. This explains the common "hamstring pull" injuries that afflict athletes of all levels. If the body was functioning in perfect balance, the posterior gluteus maximus and the anterior quadriceps would be working in a 1:1 ratio; this is something I rarely see in my patients.

The quadriceps dominant pattern is an epidemic. I see this displayed in most of the athletes I treat. From a 7-year old multi-sport athlete to the older weekend warriors to the elite runners, gymnasts, cyclists, ball players and professional level athletes, I see remarkable similarities in poor use of the posterior and lateral hip muscles in addition to the trunk stabilizers. It is easier to substitute the long strap muscles for the smaller stabilizing muscles, but at the risk of major injuries that can take these amazing athletes out of their sports altogether.

Retraining the hip and trunk muscles requires careful progression from the most basic non-weight bearing activation to more static and dynamic weight bearing conditions and finally to sport simulation movements. More coaches, trainers and physical therapists need to begin incorporating hip and trunk focused work-outs from the elementary aged athletes on up. This would prevent many unnecessary non-impact injuries and keep athletes excelling in their sports.

Read more Sports Doc for Sports Medicine and Fitness.

POSTED: Wednesday, June 26, 2013, 6:00 AM

The 2013 FIFA Confederations Cup is underway. Group play is over and the semifinals are set: Brazil vs. Uruguay; Spain vs Italy. It’s a tune-up, a full dress rehearsal for the biggest event on the soccer world stage—the FIFA World Cup. Confederations Cup competition consists of eight teams: the champions of each of the six FIFA confederation championships (UEFA, CONMEBOL, CONCACAF, CAF, AFC, OFC), along with the FIFA World Cup winner and the host nation. 

The teams play in the exact same venues where World Cup play will take place. The dry run gives teams a chance to make sure everything is ready and allows the host nation time to make adjustments when they are not. Players get a chance to check out the pitch and the volume of the crowds. Coaches get a sense of how the field will play and plan accordingly. Also, players get an idea of weather conditions, sun positioning, and altitude. All of these factors will play a major role next summer.

Also, this dry run allows a team’s staff members to get a chance to assess the amenities so they can bring what they need for the World Cup. In the United States, each professional sports league has specific rules and regulations regarding the locker rooms and athletic training rooms, supplies that the host team provides, and assistance for away teams. That’s not the case in international play.

POSTED: Tuesday, June 25, 2013, 5:25 AM
(via Reebok CrossFit Games)

“So what's your secret sauce?” 

Medals have been distributed, the podiums have been cleared, and equipment is being hauled away as I hear a spectator pose this question to Lauren Krygowski, a coach and competitive athlete representing CrossFit Explode, the number one team in the Mid-Atlantic.

"Train heavy, fight light," Lauren responds, repeating the mantra screen-printed on t-shirts bearing the CrossFit Explode logo and echoed on the gym's website.

POSTED: Friday, June 21, 2013, 6:00 AM
(iStockphoto)

Previously we discussed how muscle imbalance leads to movement dysfunction in athletes. When athletes move poorly, either during games or training, they increase their injury risk and decrease performance. There are various systems to assess and correct movement dysfunction: Postural Restoration Institute, Functional Movement Screen, National Academy of Sports Medicine’s (NASM) Corrective Exercise Program, and Vladimir Janda’s systems to name a few.  Although these systems have differences, they all target imbalances, not pain.

Karel Lewitonce said, “He who treats the site of pain is often lost.” Although some situations do require treating the site of pain… this statement emphasizes the need to address movement dysfunction and not only focus on painful areas when rehabilitating or preventing injuries.

Evaluating movement dysfunction can be very complex; however, here are some simpler assessments and corrective exercises that can be performed. A common evaluative technique in movement dysfunctionis squatting because it is extremely functional. Ideally, with hands folded to the chest an athlete should be able to squat so they are almost to the floor while keeping their heels on the ground (similar to the way a toddler squats.) Many athletes are unable to squat correctly due to muscle imbalances.

POSTED: Thursday, June 20, 2013, 5:30 AM

If you saw John “Jed” Carman running up the soccer field coaching his son’s team, you would never know that he is newly recovered from a spinal cord injury. His success story is one of the best that I have witnessed as a physical therapist at Magee.

Prior to his injury, Jedwas an avid triathlete and long distance runner who juggled two-hour workouts each day while maintaining a busy home and work life. His life changed forever early Sunday morning on September 23, 2012 when he had a severe accident while mountain biking. He is not sure if it was a tree root or rock that sent his bike for a tumble, but remembers waking just beside a creek unable to move his legs or left arm.

An hour later, a man walking his dog discovered him and immediately called 911 and Jed’s wife, Julie. It took a biker friend that knew the trails to help the paramedics find him in the woods. The rescue team carried him 1/2 mile out of the woods and then to Crozier Chester to be stabilized. He was then taken to University of Pennsylvania where Dr. Neil Malhotra performed a cervical fusion for a C6-7 spinal cord injury.

POSTED: Tuesday, June 18, 2013, 10:02 AM

Foam rolling has gained a lot of notoriety in the last few years but the big question is always: Is this a fad that I really should partake in? The simple answer is yes, you should.

Whether you are a professional athlete, an amateur athlete, a weekend warrior or just sit at your desk all day, foam rolling should be part of your daily routine. The truth is they can save you from pain that can take you out of everyday life.

What exactly is foam rolling? Foam rolling is massaging different parts of your body while lying on a foam roll. This is extremely beneficial for anyone to perform. It is safe and effective and can be done on any part of the body. During our daily routine muscles are stretched and shortened, sometimes for very long periods of time, like sitting at a computer or running a long distance and sometimes very forcefully like running down the steps or lifting a heavy weight. The actions performed by our muscles everyday takes a toll on them. Using our bodies every day, whether it be to exercise, carry kids around or do our jobs, takes a toll and muscles become tired and injured.


POSTED: Sunday, June 16, 2013, 4:00 AM
Andy North chips out of the sand to reach the 11th green during the opening round of the Senior PGA Championship golf tournament in Parker, Colo., on Thursday, May 27, 2010. (AP Photo/David Zalubowski)

Golfing can be a great and relaxing sport for many to enjoy, but there are common injuries that can occur in the weekend warrior golfer.

Golf is a full body sport—your swing and stroke involves your entire body. Injuries can occur in many different places, the most common occurring in the low back, elbows and shoulders.

Low back or lumbar injuries can occur during the coordinated movement of the golf swing. This area of your body is subjected to several forces: lateral bending, shearing, compression and rotation. Amateurs often swing harder, instead of more skillfully, to hit the ball farther. This increase of force puts stress on your body and tends to lead to low back injuries. As you get older, you also have an increased opportunity for arthritis as your spine will become less flexible. Good body and swing mechanics is essential for the prevention of low back injuries.

About this blog

Whether you are a weekend warrior, an aging baby boomer, a student athlete or just someone who wants to stay active, this blog is for you. Read about our growing list of expert contributors here.

Robert Senior Sports Doc blog Editor
Alfred Atanda, Jr., M.D. Nemours/Alfred I. duPont Hospital for Children.
Robert Cabry, M.D. Drexel Sports Medicine, Team physician - U.S. Figure Skating, Assoc. Team Physician - Drexel
Brian Cammarota, MEd, ATC, CSCS, CES Symetrix Sports Performance, athletic trainer at OAA Orthopaedics
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Rothman Institute, Head Team Physician for the Phillies & St. Joe's
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Rothman Institute, Head Team Physician - Eagles, Head Orthopedic Surgeon - Flyers
Joel H. Fish, Ph.D. Director - The Center For Sport Psychology, Sports Psychology Consultant - 76ers & Flyers
R. Robert Franks, D.O. Rothman Institute, Team Physician - USA Wrestling, Consultant - Philadelphia Phillies
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer at The Sporting Club at The Bellevue
Cassie Haynes, JD, MPH Co-Founder, Trap Door Athletics, CrossFit LI Certified
Eugene Hong, MD, CAQSM, FAAFP Team Physician - Drexel, Philadelphia University, Saint Joe’s, & U.S. National Women’s Lacrosse
Jim McCrossin, ATC Flyers and Phantoms
Kevin Miller Fitness Coach, Philadelphia Union
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales, Pa.
David Rubenstein, M.D. Main Line Health Lankenau Medical Center, Team Orthopedist - Philadelphia 76ers
Justin Shaginaw, MPT, ATC Aria 3B Orthopaedic Institute, Athletic Trainer - US Soccer Federation
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