Want to Improve Health and Performance? Just Breathe!

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What if I told you that you may be doing something 20,000 times a day that is compromising your sleep, recovery, performance and health?  In fact, if you are breathing improperly, that is exactly what you are doing. Breathing pattern disorders are common, but also relatively easy to fix.  Let’s review proper and improper breathing mechanics and give you some strategies to improve your breathing pattern.

Caution: If you are experiencing chest pains, breathlessness or dizziness, you should contact your doctor to rule out more serious causes of your breathing dysfunction.

Proper Breathing

In proper, or diaphragmatic, breathing, inhalation is initiated by the downward movement of the diaphragm and the outward movement of the abdomen and lower ribs.  The rib cage should expand in a 3D pattern top to bottom, back to front and side to side. Expiration should be effortless as the abdomen and lower ribs descend and the diaphragm moves back to its original domed position.

Chest and Neck Breathing

The most common breathing pattern disorder we see in the physical therapy clinic is neck or upper chest breathing.  This occurs when you use the accessory muscles of the neck and upper chest, rather than the diaphragm, to draw in air.  These muscles are not designed for a highly repetitive task and this pattern can lead not only to difficulty pulling in enough air for proper recovery or athletic performance, but also to problems such as neck pain, arm pain, back pain or headaches.  

Breathing Pattern Assessment

To assess your breathing pattern, lay on your back with one hand over your belly button and the other over your upper chest.  Take a deep breath in and see where you feel movement under your hands. You should feel your belly move into your bottom hand and very little movement in your top hand.  If you feel most of the movement in your top hand, then you are using a neck/upper chest breathing pattern. If you feel the muscles of your neck and jaw tighten during inhalation, this indicates that these accessory muscles are kicking in.

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Retrain Your Breathing

Retraining your breathing pattern is pretty straight forward. Return to the same position you were in to test your breathing pattern.  Fully exhale and, once all the air is out of your lungs, slowly count to four. As you draw your breath back in, you should feel your abdomen and lower ribs expand.  If this movement is difficult and you feel your neck and upper chest muscles kicking in, you can bend your knees up and place your hands behind your head. Next, practice this exercise while sitting or standing.  Hands can be placed behind your back to relax the neck and upper chest.

Try to take “breathing breaks” throughout the day and consciously work on your breathing pattern.  You will be amazed at how much better you feel physically and mentally when you breathe properly. Though breathing is something we often take for granted, improving this movement pattern can dramatically improve both your health and performance.

If you have any questions or would like more information contact Greg at Complete Game Physical Therapy, 978-710-7204 or gcrossman@completegamept.com.



Complete Game Physical Therapy Patient of the Month: Pete

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

Pete came to us following a hip injury that had been giving him issues since the fall. Pete is a Andover High School graduate in his first year at University of New Hampshire where he is a member of the varsity lacrosse team. He had been rehabbing and resting is hip for much of the fall lacrosse season but it continued to limit his performance on the field. Upon returning home at the end of the semester Pete came to Complete Game Physical Therapy to focus on getting back to 100% before having to return to UNH for what will be is first season with the team.

Pete’s hard work both in the clinic with his exercises and compliance to his prescribed home exercise program allowed him to steadily progress back to game speed. As a freshman varsity athlete at UNH Pete continually said that he wanted to be able to complete all activities from day one of practice in order to try and compete for some playing time as a freshman.

Now he is able to sprint, cut, and all complete sport related activities at 100% effort. With Pete heading back up to school with would like to honor him as our patient of the month. It was a pleasure working with an athlete with such strong determination and we are glad we were part of your rehab process.
Good luck this season Pete and the UNH Wildcats!

New Year… New (Injury-Free) You!

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Five tips to avoid overdoing it with New Year’s fitness resolutions

Every year we see patients come into the clinic who had the best intentions with New Year’s resolutions to get in shape, but who, instead, end up injured.  We’ve seen muscle strains, tendonitis, back injuries, and even tendon and muscle tears in people who overdo it with their fitness resolutions.  So whether your plan is to run more, lift more, or do more yoga, here are some tips to reduce the likelihood that you will suffer a setback due to injury.

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  1. Make stretching part of your routine.  Often, especially with running and weight lifting, people don’t plan an appropriate amount of time for stretching.  You should allow enough time for a short, light stretch before exercise, and 5-10 minutes for more thorough stretching after your workout.

  2. Ease into it. Trying to jump back into the same kind of workouts you did 10 years ago is a sure way to get hurt.  Take it slow and gradually build up your workouts.  This will give your body time to adjust to your new program.

  3. Build a well rounded routine.  Running, lifting weights or even yoga every day is not good for your body.  If you tend to be a tighter, less flexible person, look to incorporate stretching into your regular routine.  If you tend be more flexible, add some strength training.  Building balance between strength and flexibility will help your body be more resilient and reduce your likelihood of injury.

  4. Careful with group classes. Though group classes are a great way to work out because they are fun, motivating and reasonably priced, be careful when working out in the group setting.  Especially around the new year, there tends to be a big influx in people signing up for these classes.  If the trainer hasn’t assessed you, they may not know what exercises your body can and can’t do.  Also, be careful if you have a competitive nature. The person next to you may be lifting a 60 pound dumbbell overhead, but that doesn’t mean you should too!

  5. Get a movement assessment.  Starting up a new fitness routine without a clear understanding of your specific deficits in strength, flexibility and balance will make your workouts less efficient and can lead to injury.  Many personal trainers and all physical therapists are trained to assess your fundamental functional movements.  Find a trainer or PT near you who offers movement screens. The small price in time and money you spend will pay off in the long run.

Happy New Year and good luck with your fitness goals!


If you have any questions or would like more information on setting up a movement screen please contact Greg at Complete Game Physical Therapy, 978-710-7204 or gcrossman@completegamept.com.

Complete Game Physical Therapy: 2018 In Review

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2018 was a great year here at Complete Game Physical Therapy! We completed the move from our Tewksbury, MA location to our new location here in Lowell. As we settled in, we were able to concentrate on expanding and continuing to provide the best physical therapy services to all patients. Here are just some of the highlights from our year!

We have two new full-time staff members. Bonnie is our receptionist and admin and is the first face that most people see when they come through the door. Dr. Andrew Levanti, DPT, ATC joined us in August and sees patients along with Greg. The additions of Bonnie and Andy have contributed to our success this year!

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We have cultivated exciting partnerships with the Lowell Jr Spinners Baseball, Mill City Volleyball, Boston Jr Rangers Hockey, Dracut High School Baseball, Northern Essex Community College Baseball organizations. In addition, we made some great connections with local fitness centers and gyms including New England Strength Performance, Choice Fitness, J&K Custom Fitness and Zone Fitness.

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Greg and Andy currently write columns for the Tewksbury and Wilmington Town Crier to give readers a better understanding of physical therapy and treatments.

We continue to focus on and expand our youth sports injury prevention services with screenings for area youth sports organizations and to speak to youth sports organizations about youth sports injury and injury prevention.

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As 2018 comes to a close, we are excited about the upcoming year! We hope that you all enjoyed a very Happy Holiday! Be sure to follow us in 2019 as Greg, Bonnie and Andy share news about Complete Game!

Keeping Healthy in the Baseball/Softball Off Season

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Though the winter is in full swing and it may seem way too early to be thinking about the baseball or softball season, many players and teams will have started their offseason training.  Here in the northeast, indoor training facilities are filling up fast with players getting ready for next season. Check out these tips if you or your child is starting offseason training.

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Training Considerations for Youth Baseball and Softball

Ages 12 and Under

A research review published in the American Journal of Sports Medicine in 2017, entitled “Sport Specialization at an Early Age Can Increase Injury Risk”, not only found a higher rate of injury in those that specialize early, but also found that those who waited to specialize tended to reach higher levels of athletic achievement.  Playing multiple sports, especially at younger ages, has clear benefits.

Be careful though.  Playing 3-4 sports in the same season is not necessarily beneficial and can, in fact, lead to overuse injuries or burnout.  We often see kids (and their well intended parents who let them play 3-4 sports in the same season) in the PT clinic with overuse type injuries (tendonitis, muscle strains, etc.).  Pick and choose what you play so as not to over do it.

Strength and conditioning training at this age is helpful, but should be done only under observation with a trainer who is used to working with children.  Training at these ages should not focus on traditional “weight lifting” and instead should focus more on the A, B, Cs (Agility, Balance and Coordination).

Ages 13-14

This age group is a challenge.  We see more injuries in the clinic in this age group than any other group of athletes.  For baseball players, this is the age when they move to the big diamond. The longer throws in particular can be very taxing on their arms.  It is important at this age that athletes get in the gym and start some sort of strength training to help withstand the longer throws. They should also consider working with a coach on throwing mechanics.  We often see kids whose poor throwing mechanics become problematic when they move from small diamond to big diamond and have to make longer throws.

Softball field dimensions do not change as much, but this is the age where the female body begins to change and girls are at a higher risk for ACL injury.  The hips tend to widen, leaving the knees at an angle that is more susceptible to injury. Strength training programs or even ACL injury prevention programs can help reduce the risk of injury.

Ages 15+

This older age group should be involved in a more traditional strength and conditioning program.  Be sure, however, that your athlete is working with someone who has experience training “overhead athletes” like baseball or softball players.  There are many considerations that should be taken into account with this group. For example, because of the high level of stress that is placed on the front of the shoulder, care should be taken not to overstress the front of the shoulder in the weight room as well.

Another consideration with this group of athletes is that though it is still beneficial to play multiple sports, these athletes should be getting themselves ready for baseball or softball prior to the start of the season.  In the northeast, high school tryouts are typically in March and games often begin a week or two later. This is not enough time to prepare the body for high demand activities such as pitching. Athletes should be doing some throwing such as an interval throwing program to prepare themselves along with a strength and conditioning program.

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 gcrossman@completegamept.com.





Complete Game Physical Therapy: Patient of the Month, Fran

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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

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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 alevanti@completegamept.com

*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

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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!”


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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.


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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: https://ericcressey.com/pitching-performance-trunk-position-foot-strike-1.

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 gcrossman@completegampt.com.




Complete Game Physical Therapy Patient of the Month Allie

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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

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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 gcrossman@completegamept.com.

Complete Game Physical Therapy Welcomes Dr. Andrew Levanti

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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

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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

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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 gcrossman@completegamept.com.

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.

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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 gcrossman@complategamept.com.

 

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

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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

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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 gcrossman@completegamept.com