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Arm Care in Baseball is More Than Pitch Counts

The number of shoulder and elbow injuries in youth baseball pitchers is on the rise and we consistently see these injuries for performance physical therapy. In response, consistent efforts have been made to better monitor the amount of stress taken by pitchers after each visit to the mound.

For many years, this was done by simply limiting the number of innings an athlete could pitch and setting a specific number of rest days between outings. More recently, pitch counts have become the standard for tracking a pitcher’s workload. However, while this change is an improvement, pitch counts do not tell the entire story.

What pitch count fails to account for is the varying intensities between throws. For example, a throw at 100% effort has a very different intensity than a throw at 50%. This is why efforts have been made in recent years to more accurately track the intensity, or workload, of a pitcher while on the mound.

A Better Method to Track Stress: Workload

According to athletic physical therapy, a more reliable measure of stress is the acute to chronic workload ratio (ACWR). Acute workload refers to the average workload of a single day over the past 9 days, whereas chronic workload refers to the average one-day workload over the past 28 days.

Research by sports scientist Tim Gabbett has shown that spikes in acute workloads, such as quickly increasing pitch count to more than the body is used to, can increase the risk of injury.

Calculating Your ACWR

There are two main ways to calculate the acute to chronic workload ratio.

The first is to use a series of formulas using pitch count and a subjective rating of perceived exertion (RPE), ranging on a scale of 1–10.

  1. Calculate acute workload by multiplying the number of high-intensity throws (around 70% of full effort or more) by the athlete’s RPE.
  2. Calculate chronic workload by calculating the weekly acute workload average of the past four weeks.

Once you have the acute and chronic workload, divide the acute workload by the chronic workload to get the ACWR.

The second and perhaps much simpler method is to use wearable technology. For example, in recent years, technology has become available to track the stress on a pitcher more accurately after an outing.

Sensors such as the MotusTHROW can accurately measure the amount of force placed on an athlete’s elbow during each throw. This data can be applied to calculate the ACWR to safely and effectively determine when a pitcher needs rest or is ready for their next high-intensity outing.

If you’d like to learn more about keeping your son or daughter safe on the mound, our experienced athletic physical therapy and injury rehabilitation team in Bethesda can help!

Debunking the Bone on Bone Myth

“Best Walking Shoes for Knee Pain for Women” by gm.esthermax is licensed under CC BY 2.0

I’m sure you’ve heard someone say it before:

“My knees are in such bad shape. It’s pretty much just bone on bone down there.”

Although this is a commonly held belief, athletic physical therapy speaks to the truth: “bone-on-bone is largely a myth.

Many patients complain of knee pain because they are “bone-on-bone” assuming there is nothing they can do but get surgery.

Fortunately, this common misconception just isn’t true. If a person is experiencing joint pain, one of the first treatment measures is X-rays or another imaging study of the joint. If the joint damage on the X-ray is severe, you may be told you are “bone-on-bone.” However, all that term means is that there is some amount of cartilage loss in the joint.

As the cartilage deteriorates, there is less cushioning between the ends of the bone that form the joint. This “rubbing” of bones against each other with less cushioning causes pain and discomfort. However, rarely, if ever, is the cartilage of the joint completely destroyed.

A doctor at the Core Medical Center in Blue Springs, MO, conducted more than 1,000 knee X-rays and discovered only one case where the cartilage of the knee joint was completely destroyed. The other 999 cases were simply deterioration of the cartilage, but it remained intact and functioning.

The truth is that “bone-on-bone” is just a fancy way of saying the cartilage is slowly deteriorating. Very seldom does it ever completely disappear. This term is used by doctors and physical therapists to better describe the situation to patients and the severity of their pain points.

If you’re experiencing joint pain or discomfort, our injury rehabilitation clinic in Bethesda/Chevy Chase can help! Whether you’re looking to overcome a recent injury or sick of joint pain preventing you from enjoying an active lifestyle, our team of physical therapists can help!

How Professional Athletes Are Addressing Their Mental Health

“File:20140101 Kevin Love (cropped).JPG” by TonyTheTiger is licensed under CC BY-SA 3.0

Health is a word that has a variety of meanings. Although physical health often comes to mind, mental health is equally important. Quality performance training and injury rehabilitation includes activities that improve both your physical and mental health to improve performance in sport.

What is Mental Health?

According to The Center for Disease Control, “Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices.”

Mental health is important at every stage of life, from childhood through adulthood. Positive mental health allows people to better cope with stress, work productively, realize their full potential, and make more meaningful human connections.

Mental illness, such as depression, increases the risk for many physical health problems, particularly long-lasting conditions like diabetes, stroke, and heart disease. Furthermore, the presence of chronic conditions can increase the risk for mental illness.

Put simply — mental health is an aspect of overall health and well-being that cannot be overlooked.

The Impact of Mental Health On Performance

Mental health not only improves your quality of life, but it also improves performance — both in sport and in the workplace.

According to the CDC, poor mental health can negatively affect job performance, productivity, communication, physical capability, and job function. For example, someone could be in elite physical shape, but if their mental health is lagging, their performance will ultimately suffer.

Psychologists and mental health experts aren’t the only ones preaching the importance of mental health. Kevin Love, a professional basketball player for the Cleveland Cavaliers, has been very public with the mental health issues he’s dealt with throughout his career.

To help people strengthen their mental health, Love founded Koa, an online learning experience with therapist-led emotional fitness classes and 1:1 therapy. This growing community is helping people taking on real-life challenges and better prepare for the stresses of life.

“Mental health is an invisible thing, but it touches all of us at some point or another. It’s a part of life,” said Kevin Love of his struggle with mental health. Mental and physical health are equally important components of overall well-being. Love understands that to perform at the highest level, both his physical and mental health must be properly trained.

Surprising Benefits of Walking for Mental and Physical Health

“Morning Walk” by /\ltus is licensed under CC BY-NC-ND 2.0

One important but often overlooked aspect of a healthy lifestyle and even injury rehabilitation is walking. Walking is a simple way to improve physical fitness and health while reducing the risk of various diseases.

The Benefits of Walking

Physical activity doesn’t need to be complicated. Although walking is often overlooked, science shows that putting one foot in front of the other can have some impressive mental and physical benefits.

  • It helps to maintain a healthy weight and trim body fat.
  • Increases energy levels and improves mood, memory, and sleep.
  • Reduces stress and tension in the body.
  • It eases joint pain and boosts immune system function.
  • Improves cardiovascular health and muscle endurance.
  • Reduced risk of common health problems such as heart disease, obesity, diabetes, and high blood pressure.

You may be asking yourself, “That sounds great, but how much should I be walking to reap all these benefits?”

How Many Steps Should You Get Per Day?

Walking is one of the best low-impact forms of exercise that can be done on a lunch break, while talking on the phone, or to get to your favorite coffee shop down the street.

Although the exact number of steps per day can vary based on age, health, and fitness goals, most experts recommend at least 10,000 steps per day. As a general rule of thumb, the faster, farther, and more frequently you walk, the greater the benefit you’ll experience.

By completing 10,000 steps per day, most adults can burn an extra 2,000–3,500 calories while also reaping the incredible benefits of additional cardiovascular exercise.

Not only is walking a great time to disconnect and unwind, but it will also improve your mental and physical health. 10,000 steps per day is a great goal for anyone looking to jumpstart a healthy lifestyle. However, if you want a more personalized approach, a physical therapist from our clinic in Bethesda can help!

What Is Blood Flow Restriction Training? Can It Help You Overcome Your Injuries?

“Running by Coolidge Corner” by jpo.ct is licensed under CC BY-NC-ND 2.0

Since the beginning of performance training, athletes have searched for the most effective training methods out there. Although there are countless strategies available, blood flow restriction training, or BFR for short, has been used for more than 20 years in physical therapy and performance training.

What Is Blood Flow Restriction Training?

Blood flow restriction is a training technique that involves performing exercises with a reduced amount of blood flow to the arm or leg. Using a cuff or strap placed tightly around the limb, blood flow is reduced to that specific area. BFR training combines low-intensity exercise with blood flow restriction to produce similar results to high-intensity training.

In recent years, blood flow restriction training has become popular for both athletes and patients recovering from injuries. Mike Reinhold, a leading physical therapist, describes the various benefits as:

  • Provides a great workout with smaller weights and fewer reps or time
  • Can help with rehab from injuries
  • Improve strength for clients with physical limitations
  • Pain reduction after ACL surgery or knee osteoarthritis
  • Relieve pain and treat functional scores for older patients

Is BFR Training Right For You?

Much like anything, it’s important to educate yourself before trying any new training method. For example, blood flow restriction training is commonly used in performance training and physical therapy because it allows patients to develop strength and stability without requiring a lot of weight. 

Although it is within the scope of practice for physical therapists and athletic trainers, our PTs at CHP are certified specifically in blood flow restriction training. If you’re returning from a recent injury or want to learn more, contact us to set up an initial consultation

Get The Most Out of Your Runs!

Whether you’re an elite runner or weekend warrior, rest days are equally important. In our years as a physical therapy clinic in Bethesda, we’ve taught our patients that the rest days are a crucial component of any good running program.

Resting is necessary to recover appropriately, avoid burnout, and develop as a runner. On days off, your body repairs and rebuilds broken-down muscle tissue from strenuous runs and training sessions. Without proper rest, you may end up needing a physical therapist in Chevy Chase or Bethesda.

Here are three simple things you can do to optimize your days off.

Catch Up On Sleep

Sleep is one of the most important aspects of recovery. During sleep, your muscles relax, and hormones that promote tissue recovery are produced. 

Without sufficient sleep, your muscles might remain tense and sore, which can even lead to chronic pain. On your days off, try getting to bed an hour earlier to catch up on this vital muscle recovery component.

Perform Light Movement

One of the most important things you can do on a rest day is perform a relaxing home exercise routine to address any inflammation or muscle tightness. Examples include light mobility work, yoga, or whatever else you may enjoy. This will help reduce muscle soreness and improve your range of motion. They’ll help your legs feel fresh and get you ready to run hard the following day.

Fuel Your Body

Another important aspect of rest and recovery is nutrition and hydration. Just because you aren’t running on a rest day doesn’t mean you should deviate from your normal nutrition strategy.

On rest days, it’s essential to fuel your body with foods that support muscle recovery and growth. This means prioritizing protein-rich foods, complex carbs, healthy fats, and plenty of fruits and vegetables. Focus on healthy, nutrient-dense foods to help improve muscle recovery. 

Final Thoughts

Just as your training runs are vital to your running performance, so are your rest days. Without taking the proper time to rest and recover, you’re putting your body at greater risk for injury or burnout. These three simple techniques can help optimize your rest day and improve your recovery. If you want a customized approach to optimizing your rest days, our sports physical therapy clinic in Chevy Chase can help!