Femoral Acetabular Impingement: Kira

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Early in the year I had a hip injury and I couldn’t dance for a few months. Thanks to Chris and Catz I am back dancing with my team and am headed with them to compete at USA Nationals in a few weeks.

-Kira

Movement of the Week: Med Ball Pitching Step Up

Building strength in the stride leg of a pitcher is essential for developing a stable balanced support as the arm and body aggressively enter the acceleration and deceleration phases of throwing.  The arm reaches its highest velocity and greatest range of motion during these two phases, so it’s critical for the pitcher to land on a solid, stable base.  This is a task specific a drill that can be added to a traditional strength training routine for building stride leg strength while rotating and weight shifting  from back to front and right to left.

The Relationship Between Rotator Cuff Weakness & UCL Tears

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By Tom Sutton, DPT Student

The following is a study that was published in International Journal of Sports Medicine that researched the relationship between the strength of the rotator cuff and ulnar collateral ligament (UCL) tears. There are a variety of reasons why baseball players of all ages, from youth to the majors, injure their arms. The results of this study found that baseball players who had a torn UCL had deficits in strength of the rotator cuff vs. players with a healthy UCL.

This study shows that it is very important to make sure the baseball player, whether a position player or pitcher, has adequate strength of the rotator cuff musculature. Muscles can act as dynamic stabilizers and ligaments only prevent unwanted movement. With that, a strengthening program for the rotator cuff may play a role in preventing UCL tears in baseball players.

BASEBALL PLAYERS WITH ULNAR COLLATERAL LIGAMENT TEARS DEMONSTRATE DECREASED ROTATOR CUFF STRENGTH COMPARED TO HEALTHY CONTROLS   Garrison JC, Johnston C, Conway JEGarrison JC, Johnston C, Conway JE

In a study performed by Garrison et al, the investigators researched the possible relationship of ulnar collateral ligament (UCL) tears in baseball players with deficits in rotator cuff muscular strength. The study consisted of 33 players who had been diagnosed with a UCL tear and 33 players that were healthy and without UCL tears. All participants were not exclusively pitchers, as both groups were matched by position. All participants had baseball experience at the high school and/or collegiate level and volunteered for the study.ijspt

The hypothesis of the study stated that baseball players with a torn UCL would have decreased isometric strength in external rotation (ER) and internal rotation (IR) at 0 degrees glenohumeral (GH) abduction. All participants’ strength was evaluated on both throwing and non-throwing arms.

In closing, the study demonstrated that the group of players with a torn UCL showed a great decrease in strength on the throwing and non-throwing arm in both ER and IR when compared to the healthy control group.

img_7501  Blog Post written by Tom Sutton, DPT Student at the University of St. Augustine.  Tom is currently in his final Clinical Rotation with me at Catz Physical Therapy Institute.

Movement of the Week: Pitching Lateral Speed Lunge

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This movement is part of a pitching deceleration series. Pitchers need to be able to decelerate not only their arm but their entire body. I like to use this not only for deceleration but also for training: foot placement, coordination, hip/shoulder disassociation and agility.

How it’s done:

Hold a pair of lighter dumbbells at shoulder height in 90 degrees of external rotation.  Shuffle once to the side and open up towards the shuffle direction leading with the foot followed by the hip, trunk and finally allow the opposite arm to fall across the body in a pitching motion. The key is allowing the arm to fall, this should not be an active throw, it should be a faster but controlled fall. The trunk should hinge forward at the hip over a flexed knee and ankle. Keep the opposite arm up in an externally rotated position, reverse the motion and repeat in the opposite direction.

Standing Multi-Plane Core Stability

Dead Bugs, Bird Dogs, Bridges & Plank variations are a great place to start a core stability routine.  The problem is that we don’t live our lives on a table.  Once the core musculature is activated and we can move our limbs while stabilizing our spine in a safe gravity reduced position its time to get off the table and introduce gravity and resistance.  This routine is a nice place to start because the majority of these movements are isometric at the spine yet they are able to introduce stability in 3 stances and 3 planes.  This is the environment that most of us live and play in.  The upper extremities do the majority of the movement while the spine and core musculature need to respond the increasing demands created by the changing lever arms of the band resistance.  This routine works well as a second step to traditional core stability movements because it complies with post-op restrictions and provides a more challenging environment where safety is still a priority.

Movement of the Week: Band Resisted Lunge + Reach

This is a more advanced version of a standing core stability series I take many of my lumbar patients through. I like this for clients with hip & pelvic stability issues as well as for athletes having difficulty controlling frontal plane knee forces during lunge tasks. The purpose of these movements is to maintain posture through the ankles, knees, hips, trunk and shoulders while performing a single plane movement and resisting isometric multi-plane forces applied by the horizontal pull of the band as the lever arm.

How it’s done:

Start with the hands against the body and take a fencing lunge forward, once the lunge posture is stable reach the hands forward or overhead. Make sure the hands go straight forward or straight upwards and there is no deviation towards or away from the pull of the band, then reverse the sequence back to the starting position. After the desired number of reps turn and face the opposite direction and repeat.

Movement flaws can easily be observed from side and front views, look for over compensation strategies as well. Modifications can be made by changing the band resistance or shortening the lever arm by remaining in the starting position with the hands close to the body during the entire task.

Below are a few additional variations:

1. Overhead Stick Reach: This makes it easier to get overhead, sometimes clients have difficulty getting overhead witch the narrow grip.

2. Long Arm Rotational Lunge +  Reach:  This is a more advanced version of the rotational lunge + reach movement. The longer lever arm intensifies the rotational core demand.

There are many other variations, feel free to share some of yours with me in the comments.