Health Tips Blog

Preventing Injuries in Adolescent Baseball Pitchers

Baseball _pitcher 

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 age¹.

ASMI recommendations for preventing injuries in adolescent baseball pitchers include¹:

● 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) change up 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 follows¹̛  ²:




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 following²:

●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!


Mike Flaherty, PT, MSPT, CSCS
Western Reserve Hospital Rehab at the Natatorium
2345 4th Street
Cuyahoga Falls, OH 44221
(330) 926-0384


  1.  American Sports Medicine Institute.   Position Statement for Adolescent Baseball Pitchers.  Updated April 2013.
  2. Little League Baseball.  Regular Season Pitching Rules – Baseball and Softball.  2017.

Snow Shoveling

Shoveling snow is a repetitive activity that can cause muscle strain to the lower back and shoulders. Back injuries due to snow shoveling are more likely to happen to people who may not know they are out of condition. Following these tips may help you avoid injuries:

  • Life smaller loads of snow, rather than heavy shovelfuls. BE sure to bend your knees and lift with your legs, not your back

  • Use a shovel with a shaft that lets you keep your back straight while lifting. A short shaft will make you bend more to lift the load. A shaft that is too long makes the weight of the snow heavier

  • Prevent “next-day back fatigue” by stepping in the direction in which you are throwing snow to prevent the low back from twisting

  • Avoid excessive twisting because the spine cannot tolerate twisting as well as it can tolerate other movements. Bend your knees and keep your back as straight as possible to lift with your legs

  • Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back

  • Stretch your back by bending backwards while standing to help reverse the excessive forward bending of shoveling: stand straight and tall, place your hands on the back of your hips and bend back slightly for several seconds

10 Healthy Tips for Flu Season

1. Wash your hands often.
Scrub with soap and warm water for at least 15-20 seconds

2. Know the symptoms of a flu.
Watch for fever, headache, cough and nausea. Educate yourself on seasonal illnesses and cold and flu strains that are affecting your area

Vaccination is an easy and affordable way to protect yourself against the flu AND avoid spreading it

4. Cover it up.
Use tissues or your shirt sleeve (NOT your hands) to cover your cough/sneeze

5. Schedule wellness visits.
Regular visits to your doctor can help catch potential illnesses or conditions before they start or get worse

6. Avoid touching your eyes, nose or mouth.
Germs spread easiest when these areas of the face are touched by contaminated hands or other surfaces

7. Keep your distance.
Stay away from others who are sick. If you are sick, stay away from those who are not

8. Keep it clean.
Catch the cleaning bug and sanitize your doorknobs or light switches daily to kill lingering germs in high- traffic “touch areas” of your home or office

9. Get enough sleep.
Your immune system is at its best when it has rest. Get at least seven hours a night to keep your immune system at peak performance

10. Exercise. Regular exercise is a proven immune system booster and stress reducer. Aim for 30-45 minutes of exercise a day, five days a week. Be mindful of unsanitary areas at the gym - clean shared equipment before and after use

Raking Leaves 101

It's that time of year when the leaves start to fall. Here is a list of safety tips to follow when raking leaves:

• Use a rake which is the right size for you. The handle should be chin height and hands should be able to hold the rake 18″ to 24″ apart. A rake that is too short can hurt the back; one that is too heavy can strain shoulders and neck

• Wear appropriate layers of lightweight clothing

• Wear gloves to prevent blisters

• Wear skid resistant shoes – leaves can be wet and cause a fall

• Warm up muscles with light stretches of the arms, back and legs, take a 5 minute walk before starting

• Alternate hands with raking, and stagger feet to help shift weight

• Make short strokes, so you don’t overextend muscles

• Rake to the side, keeping the back straight

• Bend at the knees, instead of at the back

• Don’t twist. It’s better to move the legs and pivot the body to shift your weight

• Be careful not to overstuff the bags. Remember that wet leaves weigh more, so pack less leaves in the bags when they’re wet

• When moving the bags, make sure to lift with the legs – bend the knees and keep your back straight and stomach tight. If a bag is large and awkward to lift, walk backwards pulling the bag, or use a handcart or dolly to move it

• Pace yourself and take breaks every 15 minutes

• Remember to stretch after you finish. A few standing back bends and another short walk may help prevent muscle soreness

If you are in need of Physical Therapy for your pain, please call one of our physical therapy clinics:

Rehab at the Natatorium
2345 4th Street
Cuyahoga Falls, OH
Phone: (330) 926-0384

Easy Street Therapy at Western Reserve Hospital
1900 23rd Street
Cuyahoga Falls, OH
Phone: (330) 971-7445

Main Street Therapy
999 N Main Street
Akron, OH
Phone: (330) 940-5708

Sitting All Day Seriously Hurts Your Health


The human body, especially the cardiovascular and digestive system, is set up to operate most effectively while standing upright. However, the average person remains sedentary for over half of the hours they are awake throughout the day due to desk work and evening television programs.

Sitting for an extended period of time, or over 6 hours, increases your risk of several serious health problems including heart disease, cancer, diabetes, depression, obesity and shorter life spans, even for those who exercise regularly. Researchers at the University of Toronto found that due to excessive sitting, people have an 18 percent increased risk of dying from cardiovascular disease, a 17 percent increased risk of dying from cancer and a 91 percent increased risk of being diagnosed with Type 2 Diabetes.

As you sit throughout the day, your body experiences many negative physical changes. The longer you sit, the weaker your large leg and gluteal muscles become due to lack of usage, according to WebMD. These muscles stabilize your body while walking and standing and cause you to become more susceptible to injury when they are weak. Your hips and back are also impacted while remaining sedentary. The hip flexors become shortened, which may cause problems with the hip joints in the future. The back is affected negatively especially while sitting with poor posture, which can lead to premature degeneration of the spine due to the compression of spinal discs.

As far as mental health goes, more research is being done to find out the link to risks of sitting often. What we do know is anxiety and depression are higher in those leading sedentary lifestyles, likely because they are not experiencing the positive effects generated by physical activity and exercise.

Any prolonged sitting at a desk, in the car or in front of a screen is harmful because significantly less energy is used compared to when you stand and move. Exercising daily does not completely counteract the effects of sitting for hours on end as researchers once thought. Instead of exercising more, the key to maintaining good health is taking frequent breaks from sitting. Incorporate physical activity into your work life as often as possible. Do this by following these tips:

  • Take the stairs instead of the elevator
  • Stand up every 30 minutes
  • Host walking or standing meetings with colleagues
  • Stand while answering phone calls
  • Position your computer on a standing desk or over a treadmill
  • Place your trashcan across the room to force yourself to walk to dispose trash

Pitcher's Elbow

Medial apophysitis, or pitcher’s elbow, is a condition that occurs as a result of an injury or irritation to the inside of the elbow, commonly affecting young athletes. It is often classified as an “overuse syndrome” in baseball or softball players in the developmental stages of rapid growth (approximately 11 to 15 years of age).


Forceful and repetitive actions, such as overhand throwing in baseball players, and lack of recovery (not enough time between periods of activity), can cause inflammation of the growth plate inside the throwing elbow. This occurs in adolescents because their elbow structure (bones, growth plate and ligaments) is not fully mature or developed.

With pitcher’s elbow, you may experience:

Gradually worsening pain at the inside of your elbow when throwing a ball.

• Lingering soreness at the inside of your elbow following throwing activities.

Swelling and tenderness around the inside area of the elbow area.

Inability to throw the ball at your normal speed.

• Loss of grip strength.

Loss of accuracy or distance when throwing.

Muscle cramping in your forearm.

Loss of motion of your elbow.

Discomfort with daily activities that use your forearm muscles, like turning a doorknob or carrying a heavy object in front of you.


Once other conditions have been ruled out and pitcher’s elbow is diagnosed, your

physical therapist will work with you to develop an individualized plan tailored to your

specific elbow condition, and your athletic goals. There are many physical therapy

treatments that have been shown to be effective in treating this condition. Your

physical therapist may focus on:

Range of motion

Strength training

Manual therapy

Pain management

Functional training


Gardening Tips


Common gardening activities, such as digging, planting, weeding, mulching and raking can cause stress and strain on muscles and joints. This is especially true for senior citizens and people who are normally sedentary. Different body areas such as the shoulders, neck, back and knees can be vulnerable to injury during gardening. The following tips can help minimize or prevent injuries:

• Warm up before you garden. A 10 minute brisk walk and stretches for the spine and limbs are good ways to warm up

• Change positions frequently to avoid stiffness or cramping

• Be aware of how your body feels as you work in your garden. If a part of your body starts to ache, take a break, stretch that body part in the opposite direction it was in or switch to a different gardening activity. For example, if you’ve been leaning forward for more than a few minutes and your back starts to ache, slowly stand up and gently lean backwards a few times

• Make use of a garden cart or wheelbarrow to move heavy planting materials or tools. Be sure to keep your back straight while using a wheelbarrow

• If kneeling on both knees causes discomfort in your back, try kneeling on one and keep the other foot on the ground. Use knee pads or a gardening pad when kneeling

• If kneeling or leaning down to the ground causes significant pain in your back or knees, consider using elevated planters to do your gardening

• Use good body mechanics when you pick something up or pull on something, such as a weed. Bend your knees, tighten your abdominals

and keep your back straight as you lift or pull things. Avoid twisting your spine or knees when moving things to the side; instead, move your feet or pivot on your toes to turn your full body as one unit

• Avoid bending your wrist upwards when pulling things or using gardening tools. Instead, keep your wrist straight and use your shoulder muscles to pull and lift

• End your gardening session with some gentle backward bending of your low back, a short walk and light stretching, similar to stretches done before starting

Video Running Analysis


Do you have difficulty running due to knee or calf pain?  Does your hip or back pain prevent you from training for your next race? If so, a video running analysis is perfect for you!  Running is an activity that requires repetitive use of many muscles and joints in your body. Asymmetries can cause abnormal stress and strain on your body and create pain which may prevent you from running or from meeting your potential as a runner.   Running is a single leg activity and therefore requires many different structures to be balanced and work together. If your muscles are tight, weak or even over stretched, you may develop abnormal running patterns which may create pain, decreased performance or injury over time.  Although it is likely that the therapist can see “something is not right” when watching you run, finding faults in someone’s running pattern is much more likely with a video that can be broken down and analyzed in slow motion.  Even if you are not currently injured, a running video analysis is a great way to help you become a more efficient runner.

A running gait analysis will consist of a brief warm up on a treadmill followed by a 1 minute video from the side, front, and back.  The video will be reviewed by a Licensed Physical Therapist to look for potential factors that might lead to or be causing your pain. Angles will be measured and compared to normative data from current research. Suggestions will be made for corrective or preventive exercises to help you run more efficiently and overall, become a better runner. You will get a copy of your video electronically.

If you think you will benefit from a running gait analysis or to make an appointment, please call our Physical Therapy Department at the Natatorium, Rehab at the Nat, at (330)926-0384. You will need a Physical Therapy prescription from your physician.

Holiday Health and Safety Tips

The holidays are a time to celebrate, give thanks and reflect. Give the gift of health and safety by following these holiday tips:

  • Never use lighted candles near trees, boughs, curtains or any flammable item. With a natural tree, cut about 2 inches off the trunk and place the tree in a waterproof sturdy stand. Keep the tree well-watered so it does not dry out quickly. Dry branches can catch fire from heat of lightbulbs. If you use an artificial tree, choose one that is tested and labeled fire resistant. Use no more than 3 light sets on one extension cord. Use a proper step stool or ladder for putting up decorations. Don’t stand on chairs or other furniture.
  • Wash your hands often. Keeping your hands clean is one of the most important steps to avoid illness and spreading germs to others. Wash your hands with soap and clean running water for at least 20 seconds. You may use an alcohol-based hand sanitizer and let the product dry on skin.
  • Travel safely. Don’t drink and drive or let someone else drink and drive. Wear your seat belt. Always buckle your child in approved safety seat according to height and weight. Get vaccinations if traveling out of the country.
  • Make sure you wear several layers of loose-fitting, tightly woven clothing for the cold weather. Cold temperatures can cause serious health issues for children, elderly and pets.
  • As you are preparing the holiday meals, make sure you wash your hands and counter tops frequently. Avoid cross contamination of surfaces with raw meat, poultry, seafood and eggs with ready-to-eat foods and eating surfaces. Do not leave perishable foods out longer than 2 hours.
  • Keep a watchful eye on young children with potentially dangerous toys, foods, drinks and choking hazards (like coins and hard candy). Remember, if the object can fit down the roll of a toilet paper holder, it can slide down a child’s airway.
  • Enjoy the holidays the healthy way. Choose more vegetables and fruits.  Find fun ways to stay active, such as dancing to your favorite holiday music. Be active at least 2 1/2 hours per week. Children and teens should be active for at least 1 hour per day.

Manage stress by sticking to a financial and time budget. Limit overspending.  Balance work, home and play. Get enough sleep. Don’t overcommit to holiday gatherings. 

Age Related Physical Changes


The world is aging. The number of Americans aged 65 and older is projected to double  from 46 million to more than 98 million by 2060.It will be the first time in history than the number of older adults outnumbers children under age 5.

Normal age-related physical changes include the following:

BONES- once we reach the age of 30, bone marrow gradually starts to disappear from the bones in our arms and legs. There is also a reduction of calcium that leads to decreased bone mass. A fall can lead to serious injury and loss of independence. Talk to your provider about diet, exercise, vitamins and supplements to keep bones healthy and strong. Consider modifying your living environment to minimize the risk of falls. Remove hazards such as throw rugs and extension cords. Add grab bars in the bathroom and secure railings along stairs.

EYES- By age 40, almost everyone is reaching for reading glasses. Presbyopia occurs when the eye lens becomes stiff and won’t adjust to re focus from distance to near vision. Clouding of lens or cataracts may begin to affect your vision when you reach your 60’s. Long term exposure to sunlight increases risk of cataracts. Recommend sunglasses and adequate lighting in your home.

HEARING – Age related hearing loss (presbycusis) is the loss of hearing that gradually occurs in most of us as we grow older. About one in three people between the ages of 65-74 have hearing loss. Having trouble hearing can make it hard to understand and follow your provider’s advice, respond to warnings, hear phones, doorbells, and smoke alarms. Hearing loss can make it hard to enjoy talking to family and friends, leading to isolation.  Because the loss is gradual, you may not realize you have lost some of your ability to hear. Some medications can affect your hearing. If you think you have a hearing problem, seek advice from your health care provider.

HEIGHT – Beginning in our 40’s, we lose one to two inches in height. Most of the loss occurs in the spine as the disks between vertebrae shrink.

MUSCLES – We experience a steady reduction in physical strength due to loss of muscle tissue, with the most rapid decline occurring after age 50. Be careful not to overdo it. Weight bearing exercises such as walking, dancing, or lifting weights can help you maintain muscle mass, strength and balance.

SKIN- Age spots and wrinkles become noticeable around age 40-50 and overall skin is less elastic. Skin is less resistant to cuts and bruises, especially if you are taking any blood thinner medications such as aspirin. Make sure dry skin is hydrated to help prevent cuts with moisturizing lotion and increase water hydration. Many older people are more sensitive to air temperature and less insulated from the cold with lower body weight, inactivity, and reduced muscle mass.

TEETH – With proper dental care, teeth should last a lifetime. As you age, your teeth will become more sensitive to hot and cold temperatures. Tooth decay, gum disease and discoloration of teeth occur with age. Keep your scheduled dental appointments twice a year for assessment and cleaning. Limit caffeine and carbonated beverages that can decrease dental enamel.

Continue to engage in routine preventative health behaviors, such as annual physical exams, lab work and immunizations (such as flu, pneumonia, shingles). If you feel anxious or depressed or are using alcohol or drugs to manage your mood, seek assistance. Untreated mental health problems are associated with poor physical health outcomes including increased disability, loss of independence, and decreased quality of life. The staff at Western Reserve Hospital is here to help with your health care needs as you age.