Complete Game Physical Therapy: Patient of the Month, Fran


Complete Game Physical Therapy introduces our patient of the month, Fran.

Fran came to us following her hip replacement surgery. As you can imagine, recovery from this surgery is a process and patients gradually add more to their daily routines.

Fran worked very hard at her exercises in our clinic and she was sure to follow her prescribed home exercise program. She was focused on getting back to her favorite activities. “I wanted to get back to cooking, going out with my friends, and playing with my grandchildren,” she said. “When I came here, I couldn’t go up or down the stairs regularly or even make my famous meatloaf because bending to lift it out of the oven was too painful.”

Now she is back to 100% and doing everything that is important to her! And her family can enjoy her wonderful cooking again.

It was a pleasure to have you in our clinic, Fran, and we are so glad we were part of your recovery process.

WARM-UP Before the Chill by Dr. Andrew Levanti, DPT, ATC


The days are getting shorter and colder which can make sticking to your training program tough. Cold weather training can also lead to unwanted injuries, slowing down your progression and keeping you from participating in your favorite winter sports. A good dynamic warm up prior to activity is key to keeping your body healthy. Not warming up prior to your workout can leave your muscles feeling tighter throughout the workout and at an increased risk of injury. Below is a quick way to warm up and get keep you going through those chilly workouts.

Get the Blood Flowing:

Getting your heart rate up and the blood flowing to the muscles is the first step to a good warm up. A review of literature published in Sports Medicine concluded that increasing muscle temperature prior to activity can improve performance by decreasing the stiffness of muscles and joints, increase the transmission rate of nerve impulses, and producing a positive change of the force-velocity relationship (Bishop, 2003). Increasing blood flow and muscle temperature can be done in a few ways and really doesn’t require much space at all. If you have a stationary bike or elliptical at home you can hop on there for a quick 3-5 minutes at low intensity to get your heart rate up and blood flowing. If not, give these a try:

  1. Jumping Jacks:

    1. Start position: standing with your hands at your side.

    2. Movement: Start doing jumping jacks, raising your hands over head and jumping with your feet wide at the same time.

  2. Burpees:

    1. Start position: standing with your hands at your side

    2. Movement: Bring hands on the floor in front of you, then kick both of your legs backward, landing into a plank position. Perform a push up, then hop your legs back in toward your hands. Jump off the ground raising your arms overhead, then gently land, and repeat.

  3. Mountain climbers:

    1. Start position: Push-up position.

    2. Movement: Quickly alternate bringing your knees to your chest.

Dynamic Stretching:

The next step to a good warm is dynamic stretching to loosen up the muscles in preparation for the work out. A review of literature published in Current Sports Medicine Reports by the American College of Sports Medicine recommended dynamic stretching immediately prior to activity for a majority of athletes (Peck, 2016). Dynamic stretching consists of functional movements to bring the muscles into a lengthened position. They differ from static stretching in that the stretch is not held for prolonged amount of time. Once again, a ton of space is not needed to get this done in the house before heading out into the cold. It can be done in a hallway or even right in the living room. Here are a few dynamic stretches to try out.

  1. Walking Knee Hugs:

    1. Start position: Standing in a open and flat area.

    2. Movement: While walking lift one knee up to your chest and hug it with your arms. Hold 2-3 seconds, release, and take 2 steps, then repeat on the other side. Repeat 10-15 times of each side.

  2. Walking Quad Stretch:

    1. Start position: Standing in a open and flat area.

    2. Movement: While walking, bend one knee bringing your ankle to your bottom grabbing it with your hand. Hold 2-3 seconds, release, and take 2 steps, then repeat on the other side. Repeat 10-15 times of each side.

  3. Frankenstein's:

    1. Start position: Standing in a open and flat area.

    2. Movement: While walking kick one leg straight out in front of you hip high while reaching with your opposite arm to touch your toes on the leg you are kicking up. Take 2 steps, the repeat on other side. Repeat 10-15 times of each side.

  4. Walking Lunge Twist:

    1. Start position: Standing with your hands behind your head in a open and flat area.

    2. Movement: Take a large step forward, lowering into a lunge position with your knees bent to 90 degree angles. Keeping your chest up, twist your trunk to the left, then right, and back to center. Then raise yourself up and take a step forward with your other leg without letting your foot touch the ground in between and repeat motion. Repeat 10-15 times of each side.

  5. Walking Hamstring/Calf Stretch:

    1. Start position: Standing in a open, and flat area.

    2. Movement: Take a step forward placing your heel on the ground in front of you with your leg straight. Slowly bend forward at your hips with your back flat reaching your hands toward your toes until you feel a gentle stretch in the back of your thigh and calf. Then keeping your back flat return to as standing position as you reach your hands over your head before bringing them back to your side. Take 2 steps and repeat motion on other side. Repeat 10-15 times of each side.

At Complete Game Physical Therapy injury prevention is one of our primary goals. We provide wellness movement screens to ensure that your body is moving properly and efficiently. With the results of the screen we are able to provide you with a set of corrective exercises to improve your mobility and keep your body moving the way it should. If you are are interested in a wellness movement screen or have any questions please contact us at 978-710-7204 or via email at

*Bishop, D. (2003). Warm Up II. Sports Medicine, 33(7), pp.483-498.

*Peck, E., Chomko, G., Gaz, D. and Farrell, A. (2014). The Effects of Stretching on Performance. Current Sports Medicine Reports, 13(3), pp.179-185.

Complete Game Physical Therapy: Patient of the Month, Kimberly Herbert


Complete Game Physical Therapy welcomes our Patient of the Month, Kimberly Herbert.

Kimberly is quite an athlete! While training for her Ironman Competition, she tore her hamstring.

“I was devastated, and unsure if I was going to be able to make it to the starting line, let alone cross the finish line!” Kim says about her feelings after her injury. There was a silver-ling, though. “Due the expert knowledge and compassion of Complete Game Physical Therapy,  I was not only able to compete, but also crush my goals!”

We focused on a personalized treatment plan for Kim and that seems to make all the difference in her recovery. “Being a multi sport athlete, it was important that my therapist understood the need for personalized treatment plans.  They were able to help me focus on what I could do, not what I couldn't do. I am extremely thankful to them and will without a doubt go to them again!”


Thank you, Kim! We are so proud of what you accomplished and wish you many more competitions in the future.

Hitting for Power and Pitching Velocity… It’s All in the Hips!

“It’s all in the hips.”  Not just a great line from the movie Happy Gilmore but also a great way to create more power hitting a baseball and increase pitching velocity in a safe manner.  I had the great pleasure of taking the Titleist Performance Institute (@mytpi) certification course over the last few days and they spend a lot of time talking about how pelvic tilt relates to power in the golf swing.  I of course immediately think of how it relates to baseball and with golf and baseball both being rotational sports they relate pretty closely. There must be something to this if TPI is currently training the top 60 golfers in the world!

Pelvic Tilt

Pelvic tilt is simply the position of the pelvis or hip bones in relation to the ground when standing.  An anterior tilt can be pictured as simply an increased arch in the lower back. A posterior tilt is the opposite and decreased arch in lower back or flattening of the spine.  A neutral spine is the spot right in between the two.


How Pelvic Tilt Occurs in Throwing and Hitting

When our front leg lands as we throw or our back hip rotates around as we hit our pelvis is in an anterior tilt.  Doing this allow our hips and shoulders to rotate separately from each other to help create power. This leaves us in a position of lower back extension or increased arch.  As we come to release point in throwing or contact point in hitting we need to get out of that arch of the lower back and move into a more neutral or even slightly posterior pelvic tilt.  This allows us to use the power we generated with our lower half effectively and deliver it to the ball. Eric Cressey (@ericCressey) and Matt Blake do a great job of giving a detailed explanation of this in a blog post here:

What We See in the Clinic

At Complete Game PT we have started off season screenings for area youth baseball players and we are seeing a lot of trouble with control of pelvic tilt.  Whether it’s due to poor anterior core strength, poor glute strength, tight hip flexors or just poor motor control kids have a really hard time moving from an anterior pelvic tilt to posterior.  This can lead to poor performance due to lack of power hitting or throwing or even worse injury to the back or hips. Problems with core control have also been related to shoulder and elbow injuries in throwers.

Pelvic Tilt Test

A simple test you can do to see if you or your athlete has trouble with controlling pelvic tilt is to stand in your hitting stride or pitching stride position and simply see if you can tilt your pelvis by arching your low back, then flattening your low back, then try to find the neutral position right in between.  If you have trouble doing this stand with your back against a wall with your feet about 18 inches from the wall and try to flatten your back against the wall. If you have trouble with that next step is to try doing the same thing laying flat on your back with your knees bend and feet flat on the floor. You should be able to move from anterior tilt to posterior and back to neutral easily and smoothly.

This test turns into a great exercise to work on if you have difficulty with the pelvic tilt in any of the positions mentioned above.  It is also a great example of how problems further down the chain like hip and core control can relate to poor performance or even injury further up the chain in the shoulder or elbow.  If you have any questions or would like to get you or your athlete assessed give us a call at Complete Game PT 978-710-7204 or email me at

Complete Game Physical Therapy Patient of the Month Allie


Complete Game Physical Therapy introduces our September Patient of the Month, Allie Indingaro. Allie came to Complete Game after she had ACL Reconstruction. After working very hard on her recovery after this surgery, she was able to return to playing soccer this Fall.

We worked with her to not only get her knee better but also to stay positive and focus on her goals of returning to sports. She had plenty of inspiration from all of the athletes and active individuals that we have in our facility. She was motivated by all of the positivity throughout her recovery!

Allie’s mom was there throughout the recovery process. “At first it is hard to see your child in pain and struggling but that quickly changes to happiness and pride when you see them growing stronger and stronger. Greg is so focused on the patient he is with and my daughter felt he was focused solely on her and her recovery."

It was so great to work with you, Allie! We can’t wait to see on the soccer field this season.

Tips to Help Prevent Injury for the Ex Ballplayer Returning to the Field


After a few years away from playing baseball, I’ve decided to join a men’s adult baseball fall league or, as my kids affectionately call it, the “old man baseball league.”  Having seen many former players who have returned to baseball or softball in the PT clinic over the years, I thought I would put together some tips to help reduce the likelihood of injury.  Here are a few things to keep in mind if you plan to return to the field.

  1. Warm up.  We may remember the days where we could just show up to the field and get right out there and play.  Unfortunately, as we age, those days are over. Having some form of warm up is key to preventing injuries such as muscle strains and tears.  Do some light jogging and follow with gentle stretching or a dynamic warm up such as body weight squats and lunges to get the blood flowing and loosen up your muscles before you play.

  2. Be careful with sprinting.  As we age, we lose muscle mass, particularly the fast twitch muscle fibers that are used with sprinting type activities.  Combine that with tight hamstrings due to sitting at a desk all day and you have the perfect situation for hamstring tears.  Don’t let your first sprint be when you are trying to leg out a double. Practice some sprints before you play by slowly progressing your sprinting.  Start at 50% speed, increase to 75%, and then build to full speed.

  3. Build up throwing slowly.  Just as you should increase your sprint gradually, you should build your throwing slowly as well.  Overhead throwing is not a natural motion for the body and, again, if you sit at a desk for much of the day or just generally have bad posture, the throwing motion is even less natural.  When you return to throwing, slowly build the number and distance of throws you make. If you start to feel pain in your shoulder or elbow, stop, get some ice on it and rest. If the pain doesn’t go away, see a medical professional.  I’ve seen many people who returned to throwing after a long lay off, tried to throw through pain and ended up with shoulder impingement or rotator cuff tears.

These tips are not only helpful for baseball but also soccer, basketball or even playing back yard touch football.  Follow these tips to help stay injury free and on the field!

 At Complete Game Physical Therapy we help athletes and active individuals of all ages get back to the sports and activities they love without missing valuable playing time or losing their competitive advantage.  For more information or to make an appointment call 978-710-7204 or email Greg at

Complete Game Physical Therapy Welcomes Dr. Andrew Levanti


Complete Game Physical Therapy welcomes our new Physical Therapist, Dr. Andrew Levanti. Dr. Levanti will be starting to see patients in September and we are taking appointments now.

Dr. Andrew Levanti, DPT, ATC has practiced physical therapy for the past year and has been a certified athletic trainer for the past 4 years. He completed his undergraduate in Athletic Training at Stony Brook University in New York prior to continuing his education at UMass Lowell graduating with his Doctor of Physical Therapy degree in 2017. During his time at UMass Lowell he served as the Head Athletic Trainer for Club Sports. For the past year he has been working as a physical therapist in a sports orthopedic clinic in New Jersey. Andy’s passion is in sports medicine with special interest in shoulder and knee injuries. When not in the clinic he enjoys mountain biking, skiing, and enjoying the outdoors. Andy is very excited to continue to grow his career at Complete Game Physical Therapy!

5 Signs Your Back Pain May Be More Than An Ache


We’ve all done it, you wake up with a sore back after doing some yard work or being out playing with the kids and figure it’s just an ache and will go away.  This may be the case but what if it’s not? Today I wanted to give some examples of instances where that ache in the back could be something more significant.

  1. Pain radiating down the leg- if you have pain coming down your leg which seems to start in your low back there is likely some nerve involvement.  The nerve can be irritated at the nerve root near your spine or more distally, either way this is more than just a sore back.

  2. Severe pain- any time you have pain that is severe in nature it is likely more than just some normal post activity soreness.

  3. Numbness, tingling or legs “giving out”- these are signs of more significant nerve damage.

  4. Pain that seems to be getting worse- a normal back ache should resolve within a few days of relative rest.  If not you may have something more going on.

  5. Recurring episodes of back pain- if your back ache keeps recurring there is likely something more going on.

For the symptoms above your back problems probably aren’t going to go away on their own and you should see a medical professional.  Keep in mind though that this is not an all inclusive list and there are other instances (like recent unexplained weight loss or unremitting night pain) that you should contact your doctor.

Back pain is not unusual.  As a matter of fact 8 out of 10 Americans will experience back pain in their lifetime.  Seeing a physical therapist can be one of the best ways to help with that back ache and make sure it doesn’t turn into something more significant.  A PT will sit down with you, get your history and figure out the best plan to not only reduce your pain but also keep it from coming back in the future.

At Complete Game Physical Therapy we specialize in the treatment of back pain and can help you take control of your back problems today. Visit our website or call our Lowell office at 978-710-7204 to make an appointment.

Yearly Physical Therapy Visits are Just as Important as Annual Cholesterol Tests


You know the drill: During your annual visit, your primary care physician will order a cholesterol test. Combined with an assessment of health measures such as diet and exercise, the results of the cholesterol test will provide your physician with the information she needs to make a recommendation. If the results are positive, you might hear: “You’re doing great, keep doing what you’ve been doing!” If the results are unfavorable, then you’re more likely to be told: “I’d like you to walk for 20 additional minutes each day and eat cholesterol-lowering foods like oatmeal.”

Over time, high cholesterol can cause fatty deposits to form in your arteries, putting you in a high-risk category for heart disease and stroke. Similarly, the cumulative effects of poor posture or a muscular imbalance, for example, can take a toll on your body and inhibit your ability to move properly. That’s where a physical therapist comes in: Annual PT “checkups” can catch the musculoskeletal problems that put you at risk for injury or limit your ability to function down the line.

Of course, it’s best to schedule your checkup before you’re experiencing a problem. That way, your physical therapist can establish a baseline based on your functional level at that time and use it to identify changes during subsequent annual visits. The effects of poor posture or a muscular imbalance may not be immediately apparent to you, but they will be to your PT.

An annual “checkup” gives your PT an inside look at your musculoskeletal system, which is comprised of your muscles, bones, cartilage, tendons, ligaments, joints and other connective tissues. It’s important that these essential internal structures are working together to support, stabilize and move your body.

Just as taking an annual trek to the primary care physician helps to monitor your cholesterol levels—and prevent heart disease—yearly physical therapy appointments allow your PT to identify and address any changes in the way you move before they become something more.

One of the best tools in a PT’s prevention arsenal is the movement screen. By analyzing your fundamental movements with a movement screen developed for their own practice or one that requires certification such as the Functional Movement Screen (FMSTM), PTs can get a clear picture of what the future will bring for you. Based on the information gathered, a physical therapist can help you safely reach your fitness goals and teach preventive strategies that can be incorporated into your daily life.

For more information scheduling your annual PT checkup give us a call at Complete Game Physical Therapy 978-710-7204 or email at

Complete Game Patient of the Month: Connor Donovan

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Introducing Complete Game’s Patient of the Month, Connor Donovan.

Connor came to Complete Game with a very bad elbow injury. “Doctors told me that I would probably never throw again.” Naturally Connor was disappointed with this prognosis.

Connor did what he thought was best. “I went to Dr. Oh at Massachusetts General Hospital for a second opinion. He told me that knew the best guy North of Boston that could help me. He recommended that I see Greg Crossman.”

Greg worked with Connor after his surgery. “I worked with Greg for a grueling eleven months and I am happy to report that I am back on the field and am back on the golf course! I never thought I would be back where I am today and I can’t thank Greg and Complete Game Physical Therapy for getting me there!”

Connor, we are so glad that you are back to doing what you love.

Preventing Injury May Be As Easy As Touching Your Toes

Touching your toes without bending your knees is a fundamental movement pattern.  When I ask patients and athletes to do this at our PT clinic I often hear “I haven’t been able to do that in years!” or “I’ve never been able to touch my toes!”  Though this may be true it may not be for the reasons you think.


Most people think that not being able to touch their toes means they have tight hamstrings or a stiff low back and though this may be the case, these problems may be more a symptom than a cause.  What we are looking for with a toe touch is a posterior weight shift in the hips. That means your hips need to shift backward as you bend forward. If you can’t do this your body recognizes the fact that if you bend forward you will fall over so it sends a message to the muscles in the hamstrings and lower back to “put on the brakes” and tighten up preventing you from bending all the way forward.

You can picture how big a problem this can be if you’re in the backyard gardening, bending forward, and your back and hamstrings are constantly trying to pull you out of that forward bend position.  In athletics that posterior weight shift is critical for proper form and to generate power for maximal performance.

A simple exercise to work on this is a wall sit back.  Stand about 6 inches from a wall facing away from it. Bend forward to touch your toes and as you do sit back until your rear end just touches the wall.  As you get better at the posterior weight shift you will be able to move out further from the wall.

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At Complete Game we use the toe touch as part of our screening assessment with patients and it is also part of our wellness screens for those who come to us to avoid injury in the first place. Here is our demonstration of the toe touch screen.

We are here to help! For more info on our wellness screens or other services contact us at 978-710-7204 or email


Complete Game Patient of the Month: Riley Magee

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Complete Game is happy to introduce our May Patient of the Month, Riley Magee.

Riley came to us following "Tommy John" surgery on his elbow over a year ago.  Through a lot of hard work Riley has returned to baseball at Northern Essex Community College.  Riley has helped lead NECC to the National Junior College World Series in Tennessee.  He won first team all region, regional gold glove at catcher, triple crown of region and regional player of the year this season.  At Complete Game we were able to coordinate Riley's recovery with his coaches, instructors and trainers to help get him back safely and stronger than before. We are all proud of the coordinated team effort to get him back to peak condition.

“Greg has since become a close friend to me since seeing him because of his kindness and interest for every patient,” said Riley. “With passion for their profession, the physical therapists at Complete Game helped me back into baseball stronger and in a quicker time frame than expected and made a big contribution to my success this year after my surgery. The level for expertise and drive for higher knowledge makes Complete Game far superior than anyone else in the area also combined with extremely kind and generous staff makes this a must go place to anyone that is need of therapy.”

We can’t thank Riley enough for his kind words and the for the opportunity to work with him.


A Parent’s Guide to Pitch Counts in Youth Baseball

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With baseball season in full swing, I have heard a lot of talk recently about pitch counts, both in my clinic and at my son’s games.  Most youth leagues at this point have adopted some form of pitch count parameters for players, but there is generally little explanation as to why it is important to follow them.  It is important for parents to understand this issue, and essential if kids play on multiple teams as it will fall to the parent to watch the overall number of pitches a player is throwing and communicate clearly with coaches.

Pitch Counts In Youth Baseball

Parents love to see their child out on the mound, having fun and being successful.  And coaches love to see a pitcher throw strikes and get batters out. Unfortunately, this can lead to pitchers being overused.  Research is showing us that overuse is a key factor in pitching injuries:

  • Pitching more than 100 innings per calendar year has shown to leave players three times more likely to be injured.

  • Averaging more than 80 pitches per game leaves players four times more likely to be injured.  

  • Pitching more than eight months out of the year leave players five times more likely to be injured.

  • Pitching while fatigued has shown to increase risk for injury by 36 times!

To help prevent overuse injuries, USA Baseball, along with MLB and the American Sports Medicine Institute, have come together to develop pitch count guidelines for youth baseball that recommend pitch count limits and how many days rest a pitcher should have before he pitches again.  

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Many youth baseball leagues around the country have instituted these guidelines as rules on how many pitches can be thrown, but parents still need to pay attention.  A recent survey asking about compliance with pitch count parameters in youth baseball showed that as many as 25% of coaches are not compliant with pitch count guidelines.  Even when coaches are compliant with pitch counts for their league, they may not know if the pitcher has thrown in another league recently. Therefore, it’s important for parents to be aware of the pitch count guidelines, keep track of pitches for their player, and communicate clearly with coaches.

Other Factors that Relate to Youth Pitching Injury

Some other factors that should be considered along with the number of pitches thrown include

  • Player size and how hard they throw.  Generally speaking, the bigger the pitcher is and the harder he throws, the more stress is placed on the arm.  It’s a good idea to keep these pitchers on the lower end of the pitch range.

  • High stress innings.  Not all pitches can be considered equal.  Long innings where a lot of pitches are thrown are much more taxing on pitchers.  If a pitcher starts the game off with a few very long innings, you may want to keep him on the low side of the suggested number of pitches.

  • Other positions they move to after pitching.  The overall volume of throws should be considered not just from the mound, but also in the field.  Moving from pitching to positions where there are a lot of throws made, such as shortstop or especially catcher, increases injury risk.  

I hope these thoughts help parents understand why pitch counts have been established, the importance of following pitch counts for the youth pitcher, and some other factors that should be considered along with pitch counts.  Managing youth pitching is certainly a challenge and, unfortunately, one that often falls into the hands of the parent. If we can work together as parents, coaches and medical professionals, however, we can help reduce injuries in young players and keep our kids healthy, having fun and on the field!

Complete Game Physical Therapy is here to help. For more information or to make an appointment call us at 978-710-7204.

Complete Game Patient of the Month: Mackenzie


Complete Game Physical Therapy is pleased to introduce our Patient of the Month, Mackenzie.

Mackenzie is a high school freshman athlete who is both a softball and volleyball player and had labrum surgery . She saw Greg at the Nor'Easters facility for 2-3 months prior to the surgery when she had trouble throwing and came back again about 2 months after surgery. Now after four months, she is almost back to normal. 

Mackenzie, we are so glad you are pleased with your experience here at Complete Game. We loved working with you. 

Arm Care Routine for Youth Baseball/Softball


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

What is an arm care program?

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

Preseason program

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

Pregame and practice warm up

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

In-game arm care tips

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

Postgame arm care for pitchers and position players

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

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

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

What To Do When Your Arm Hurts After Baseball or Softball


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

Soreness vs. Pain in Baseball and Softball

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

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

  • Muscles feeling tired or tight.

  • Soreness that loosens up with light stretching or activity.

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

Signs that the soreness may be something more serious include:

  • Pain that is sharp in nature.

  • Pain that worsens with activity.

  • Symptoms that do not resolve after warming up.

Do Not Play Through Pain

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

Soreness Rules

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

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

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

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


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

Complete Game Patient of The Month: Bill Elwell


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

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

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

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

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

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

What is an Overhead Athlete?

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

Definition of the Overhead Athlete:

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


The Overhead Athlete and the Shoulder:

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

Considerations for the Overhead Athlete:

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

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

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

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

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

How to Avoid Having Chronic Ankle Sprains

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

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


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

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


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

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



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

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


Patient of the Month: Connor


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

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

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

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