Health Tips Blog

Protecting the Arms from Baseball-Related Injuries

Little League

With the start of another baseball season upon us, it is important for coaches, parents and athletes to be aware of some ways to protect their arms from injury. The American Sports Medicine Institute (ASMI), lead by noted orthopedic surgeon Dr. James Andrews, has outlined risk factors for injuries, as well as injury prevention recommendations. Risk factors for injury include overuse, poor pitching mechanics, poor physical fitness and throwing curveballs at too early an age.

ASMI recommendations for preventing injuries in adolescent baseball pitchers include:

● Watch and respond to signs of fatigue (decreased velocity, decreased accuracy, upright trunk during pitching, dropped elbow during pitching, increased time between pitches)

●No overhead throwing of any kind for at least 2 - 3 months per year. No competitive baseball pitching for at least 4 months per year

●Do not pitch more than 100 innings in games in any calendar year

● Follow pitch count limits and days of rest

● Avoid pitching on multiple teams with overlapping seasons

● Learn good throwing mechanics ASAP. The first steps to learn, in order: 1) basic throwing; 2) fastball pitching; 3) changeup pitching

●Avoid using radar guns

●A pitcher should not also be a catcher for his team. The pitcher/catcher combination results in many throws and may increase injury risk

●If a pitcher complains of elbow or shoulder pain, discontinue pitching until evaluated by a sports medicine physician

●Encourage athletes to have fun playing baseball and encourage participation and enjoyment of other sports and various physical activities

Little League Baseball has adopted pitching rules with pitch count limits and required days of rest for adolescent pitchers. These recommendations are as follows:





50 pitches per day


75 pitches per day


85 pitches per day


95 pitches per day


105 pitches per day






66 or more pitches in a day

Four (4)

51-65 pitches in a day

Three (3)

36-50 pitches in a day

Two (2)

21-35 pitches in a day

One (1)

1-20 pitches in a day

Zero (0)



76 or more pitches in a day

Four (4)

61-75 pitches in a day

Three (3)

46-60 pitches in a day

Two (2)

31-45 pitches in a day

One (1)

1-30 pitches in a day

Zero (0)

Additional rules of note established by Little League Baseball include the following:

●The league must designate the scorekeeper or another game official as the official pitch count recorder

●The pitch count recorder must provide the current pitch count for any pitcher when requested by either manager or umpire and must inform the umpire when a pitcher reaches their pitch limit

●The manager must remove the pitcher when they have reached their pitch limit. The pitcher may remain in the game at another position. However, a pitcher who delivers 41 or more pitches in a game cannot play the position of pitcher for the remainder of that day. Any player who played the position of catcher in four or more innings in a game is not eligible to pitch on that calendar day

Do you or your child have a throwing injury? Questions about injury prevention for the overhead athlete? The physical therapists at Western Reserve Hospital Rehab at the Natatorium have many years of experience treating throwing injuries. Contact us to find out how we can help!

Ankle Sprains

Iman Shumpert 2015

I was watching the Cavs game the other night. As I was watching, I noticed that Iman Shumpert started limping and then went out of the game. As I continued to watch, they mentioned that he had twisted his ankle. So today, I want to talk about an extremely common injury – the ankle sprain. 

Let’s first look at some of the anatomy in the ankle. The ankle is primarily composed of three bones and a variety of ligaments to provide stability. The tibia and fibula are the two bones that form the lower leg, and those connect to the talus bone in the foot. This connection is made stable by a variety of ligaments, which are on either side of the ankle joint. The three major ligaments in the ankle are the deltoid, talofibular and calcaneofibular. On the inside of the ankle, the deltoid ligament provides significant support and stability. Rarely is an ankle sprain on the inside of the ankle. The other two ligaments, especially the talofibular ligament, are where the ankle sprain normally takes place. The talofibular ligament is on the outside of the ankle and is divided into two sections, anterior and posterior.

The anterior talofibular ligament connects the talus (foot) to the fibula (outer lower leg). When you step on uneven ground or on the outside of your foot, the twisting pressure on the ankle will cause the anterior talofibular ligament to stretch more than the ligament is meant to, which causes injury to the ligament. This injury to the ligament will then cause the body to try to protect the ankle joint. The inflammation process is meant to heal the joint, but it will cause stiffness and discomfort. The ankle will swell with fluid as it tries to stabilize the joint and prevent it from moving any more. To treat an ankle sprain, you have to deal with the swelling and inflammation. You would need to rest, ice, compress and elevate the ankle. I have also been trained to perform facial-distortion (soft tissue) techniques that will get you on the road to recovery quickly.  

How Physical Therapy Can Help with Osteoarthritis Pain


Arthritis is the inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. There are several types of arthritis, and the most common type is osteoarthritis. Osteoarthritis is usually caused by normal wear and tear, or follows an injury to a joint. Risk factors for arthritis include gender, family history and previous joint injuries. Arthritis is the leading cause of disability in the U.S., with one in five adults being diagnosed with arthritis every year.

Physical therapy can help to decrease arthritic pain. The main goal of treatment is to reduce symptoms and improve quality of life. People with arthritis often have stiff joints largely because they avoid movements that can increase pain. However, by not moving arthritic joints, the stiffness and pain only get worse. Therefore, people with arthritis often benefit from physical therapy with instructions on how to correctly and effectively perform strength-conditioning exercises that target specific muscle groups. Strong muscles help keep weak joints stable and more comfortable and protect against further damage. Land therapy can help improve joint flexibility and strength, and aquatic therapy may also be a good choice because the buoyancy of the water reduces stress on the joints. With arthritis, you will have good days and bad days, but the most important thing is to keep moving and to keep strong.

Appropriate management can help people with arthritis live healthy and independent lives. Speak to your doctor first. It is important for patients to learn about their disease and to take part in their own care. A physical therapist will help you come up with an effective plan and workout regimen to help manage your pain and symptoms. For more information about arthritis, visit

Snow Shoveling Safety


It’s winter here in Northeast Ohio, which means a variety of things. But for most of us, snow comes with an all-too-common chore: shoveling driveways and sidewalks. Although it may look pretty and fluffy, snow can be remarkably – and deceivingly – heavy. That’s why I wanted to talk about a big health risk for that big snow storm. 

Shoveling snow can cause a variety of injuries, but I want to focus on the possible lower-back implications. It is not possible to keep the snow from falling onto our driveways and sidewalks, so how can you protect your back while shoveling? 

Let’s look quickly at the lower back. We have discussed the lower back previously when we talked about disc herniations, but I want to hit some of the highlights here, as well. The lower back is a combination of vertebra and soft tissue providing support and structure. Previously, we focused on the vertebra and discs. Now, I want to focus on the muscles and ligaments surrounding the spine and how they can help with the problem of shoveling snow.

The lumbar spine has a number of supporting muscles that help to take the pressure off the vertebra and discs. The lumbar paraspinal, core/abs (abdominal and oblique muscles) and leg muscles all work together to lift, push, pull and provide movement. The best way to protect your back is to decrease the pressure on the spine. Proper lifting technique says, “Bend at the knees, not at the waist.” Bending at the knees puts much more stress and strain on the muscles in the legs rather than on the vertebra. Conversely, when you bend at the waist, most if not all the strain moves directly to the discs, creating increased strain.

So, as you see the snow fall, be mindful of how you are lifting and moving as you go outside. Try as much as you can to push the snow rather than lift it. Pushing the shovel allows you to keep the proper posture and will also allow you to use your legs more than your back. Not only does lifting increase the weight your back is supporting, but while shoveling, you also must bend forward to hold the shovel. This significantly increases the pressure on the lower back. Also, when you do have to lift, do not throw the snow to the side or behind you. Twisting is the biggest stressor, and it’s very hard on the lower back.  Sometimes, the snow will get the better of you. In situations like that, chiropractic can help to get you (and your back) back on track.    

Aquatic Physical Therapy


Did you know that Western Reserve Hospital offers aquatic physical therapy at the Natatorium? Our expert aquatic therapy team treats a variety of diagnoses, including joint replacements, arthritis, neck and back pain, tendon/ligament repairs and sports injuries, to name a few. Because the buoyancy of water decreases joint compression and can support and assist in movement, aquatic therapy allows patients to start therapy sooner and exercise with less pain and discomfort. Aquatic therapy is also beneficial when weight-bearing is limited after fractures or surgical procedures.

Our therapy pool is one of the largest in the region at 1,600 square feet with a warm-water temperature of 90 degrees. You do NOT have to be able to swim to do aquatic therapy, as the deep end is only 4 feet 6 inches and the therapist can get in with you for your personalized therapy session. If you feel you could benefit from aquatic therapy, call us at (330) 926-0384 to schedule an aquatic therapy evaluation. A physician order for aquatic therapy will be necessary prior to scheduling. 

The Physics of Proper Posture

Posture Pic

Do you ever wonder why your back hurts after sitting for a prolonged period of time? It could be that you don’t practice proper postural awareness while sitting. Poor posture can be an underlying issue regarding not only neck/back/shoulder aches, but also digestive health, poor breathing and tension headaches.

So what is posture and why is it important? Posture is the position in which you hold your body upright against gravity. Proper posture requires good muscle flexibility, normal range of motion in the joints, strong postural muscles, a balance of muscles on both sides of the spine and an awareness of proper posture which leads to conscious correction when needed. With practice, correct posture can gradually replace your old posture. This is important because it:

  • Helps to avoid abnormal wearing of joint surfaces that could result in arthritis
  • Decreases the stress on the ligaments holding the joints of the spine together
  • Prevents the spine from becoming fixed in abnormal positions
  • Prevents fatigue because muscles are being used more efficiently, allowing the body to use less energy
  • Prevents strain or overuse injuries
  • Prevents backache and muscular pain
  • Contributes to good appearance

Someone who sits with proper posture maintains the following positions:

  • Hips pushed to the very back of the chair with weight evenly distributed
  • A lumbar roll is used to maintain the normal lumbar curve of the spine
  • Both feet are supported flat on the floor or on a foot stool
  • Knees are at hip level or slightly lower; legs should not be crossed
  • Shoulders are relaxed and forearms are parallel to the floor

***Try to avoid sitting in the same position for more than one hour***

How can a physical therapist help?

A physical therapist can first and foremost identify that there's a problem with your posture. They, along with their team of assistants, can then help you with correcting your posture by recommending exercises to strengthen your core postural muscles. He or she can also assist you with choosing proper postures during your daily activities, helping to reduce your risk of injury.

Posturegraphic Ptblog

5 Tips for a Healthy, Happy Thanksgiving


To help you make the most of your 2016 Thanksgiving, here are some helpful tips to make your turkey day a little healthier.

  1. Try using healthy, lower-fat ingredients. For example, use fat-free chicken broth to make gravy and baste the turkey, reduce oil and butter wherever possible and swap desserts for fresh fruit and appetizers for fresh veggies with hummus
  2. Practice “mindful eating” – don’t starve yourself for the big meal, start with small portions, focus on the dishes you really want to enjoy and save the breads and stuffing for last
  3. Not everyone has plenty on Thanksgiving – consider donating or volunteering at a local charity, like the Haven of Rest, to help provide for people and families who are in need this holiday season
  4. Exercise will help you work off the extra calories – whether it’s a football game with the family or just a brisk walk around the neighborhood, be sure to spend some time exercising on this calorie-rich holiday
  5. Avoid the turkey hangover – stave off your post-dinner lethargy by staying hydrated throughout the day and getting some mild exercise immediately after dinner

The Graston Technique


The Graston Technique is a unique manual therapy treatment that helps relieve the pain associated with injuries to muscles, tendons, bones and joints. This technique involves the use of specially designed stainless steel instruments that help release restricted tissue.

  • The goal is to smooth out the tissue to restore normal tissue integrity and movement.
  • Treatments include the surrounding area as well as the painful area. Treatments gradually get more aggressive to reach the deeper tissues.
  • The Graston Technique is followed by gentle stretching, and may include strengthening exercises.
  • Treatment sessions take about 15 minutes, and the patient is seen for 6 – 8 Graston treatments.
  • Only licensed clinicians certified/trained in the Graston Technique should be performing this technique.
  • More information, plus a video, can be found on the Graston website at
  • You can find certified/trained Graston therapists at two of our outpatient therapy locations: Rehab at the Nat, located inside the Cuyahoga Falls Natatorium; and Easy Street Therapy, located inside Western Reserve Hospital.

Concussion Prevention

Concussions Bable

Sports related concussions continue to be a topic of discussion in the media these days. As a parent, it’s important to have a good understanding of what a concussion is and how you can keep your child safe.

A concussion is a mild brain injury and should be recognized as such. There are many symptoms of a concussion, and no two concussions are the same. They can cause headaches, vision changes, pain, anxiety, dizziness and can make it difficult for a child to concentrate during school.

The first step to concussion management is preventing it. According to the CDC, prevention starts with creating a safe sports culture. Children should feel comfortable reporting symptoms of a concussion to their coach. Enforce the rules of the game. Proper tackling or contact should be enforced as well as proper helmet wear. If a concussion is suspected, the athlete should be removed from the game immediately. New research has shown that a player who stays in may take twice as long to recover from the concussion as one who leaves the game.

If a concussion is diagnosed, the child should not return to the field or practice until cleared by a physician. Usually, symptoms clear on their own within a couple of weeks. However, if symptoms persist, concussion therapy may be recommended. Concussion therapy may include physical therapy, occupational therapy and/or speech therapy, depending on symptoms. For more information on concussion treatment and prevention, visit the CDC website or talk with your physician or physical therapist. If you need treatment, Western Reserve Hospital Easy Street Therapy offers a program to evaluate and treat post-concussion symptoms. 

Physical Therapy - Integrative Dry Needling


Do you suffer from pain following an athletic event, after running, or due to a car accident? Back pain after periods of sitting? Dry Needling may help you!

- A fine filament needle is used to reach the trigger points in the tissue that cause pain
- Treatment is virtually painless, but sometime creates a twitch of the muscle
- Performed by a licensed Physical Therapist with special training in the technique
- Helps conditions such as: tendonitis, headaches, sciatica, plantar fascitis
- Reduces inflammation and pain
- Helps with range of motion
- Different from acupuncture
- Covered by health insurance
- All you need is a physical therapy prescription 

Western Reserve Hospital’s Rehab at the Nat and Easy Street Therapy locations offer Physical Therapists who are trained in Integrative Dry Needling. Call (330) 926-0384 (Rehab at the Nat) or (330) 971-7445 (Easy Street Therapy) for questions or to schedule an appointment.