News & Events

Concussion Focus, What Is It? 

Over my five years as a physical therapist, I have been a part of many teams and have taken on many different roles, each of which has grown me as a professional and as a person.  One of my favorite roles is serving with the Concussion Focus team. Today I want to tell you a little about the team and what we do!  

Concussion Focus was originally started in the midst of a rising awareness of concussions. At that time, there were few multidisciplinary options for concussion treatment. Concussion Focus brought together physicians, physical therapists, psychiatrists, athletic trainers, and people passionate about and well trained in concussion management.

The Concussion Focus team continues to meet every other month.  The team is unique as we each represent separate organizations, but when we gather to meet we all take off those hats and come together to do our best to impact concussion treatment. In our meetings, we discuss ways to support each person’s individual efforts in regard to concussions, share current research and swap case studies. We also set a goal each year as a group to get the word out about advancement in concussion treatment.

This year we will be writing a series of blogs as a team with the intent of helping to provide resources to people dealing with concussions.

If you would like to learn more about concussions or Concussion Focus, please go to concussionfocus.org. Be on the lookout for more blogs to come from my colleagues on the Concussion Focus team!

Written By: Josiah Parker, PT, DPT


What can a physical therapist do for a concussion?

If you are suffering from post-concussion symptoms, you may feel helpless and think there is no way to help speed up the process of recovery. But there is a way! 3 Unexpected Treatments for Concussions – That Work!

The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)

pt_concussion

Concussions are now more widely recognized in the world of sports, in work safety and in the medical world than ever before. According to the CDC, a concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head that can change the way your brain normally works.

 

1 out of every 5 people who sustain a concussion WILL NOT recover in the normal 2-3 week time frame.

Though they may appear to be functioning just fine, people suffering from a concussion may be dealing with an array of symptoms. These symptoms include time lost from school/work, time out of sports, headaches, dizziness, nausea, balance problems, fatigue, and the list could go on.

If you have had a concussion and are struggling with fully recovering, don’t wait any longer. Click the button below to schedule a consultation.

Schedule a Consultation

3 Ways We are Hurting our Backs

Lower Back Pain? Don’t Drag Your Feet!

Okay, that sounds more like the start of the motivational speech my parents used to give me when I was younger. Many of you may be asking yourself what does shuffling my feet on the ground have to do with low back pain? Well, a lot more than you might think. 

When referencing lower back pain, this is the speech I find myself giving to more and more of my patients.

When we look down at the ground, we tend to bring our body into a position of trunk flexion. By this, I mean that your chest is coming forward over your toes. When this occurs, our center of mass starts to move forward and we create an anterior tilt through our pelvis.

When our center of mass comes forward we adjust our body position to maintain our balance by extending through our lower back and, on occasion, by going up onto our toes. The body corrects its position to maintain balance with changes being processed by the change in our visual field by looking down.

When we shuffle our feet, we typically create the habit of making our initial foot contact with the toes pointed down and then sliding the foot forward instead of actually rolling across the foot as one would walk with a normal gait.

A normal gait is to make initial contact with the heel and push off the toes. When I see people shuffle their feet, there is also a tendency toward reducing the amount of contact the heel makes with the ground. We refer to this as an ‘early heel rise gait’ and will often see this gait pattern in toe walkers. These individuals will hardly make contact with the ground through their heels. When we ambulate with this gait pattern, much like when we look down, we translate our center of mass forward. Again, to correct we typically go into back extension. 

These tendencies toward back extension are what lead to the long-term potential problems.

First, there are the anatomical stresses that long-term extension can create. These conditions are often seen in increased arthritic changes in the lower back due to the increased stress through the facet joints in the spine.

Next, there is the tendency toward using you back extensors to perform lifting activities. Since these muscles are already being engaged to help you maintain your balance they will often fire more when you are lifting something leading to the increased likelihood of a potential muscle strain.

The next time you are out for a run or a walk my advice is to look up and enjoy the scenery and think about that nice heel to toe gait pattern. Your back and the rest of your body will appreciate you for it in the long run!

Written By: Nick Wegener, Director of Physical Therapy – PT, ATC, OCS, CSCS

How to: Improve Your Health Through Breathing

Is your breathing helping or hurting your daily performance?

The average person will take more than 8 million breaths per year! Yet, chances are you may not be taking the proper steps for your breath to properly serve you in day-to-day activities and workouts. Today, I will go over three simple tests you can use to improve your workout, mood and manage stress levels. 

Breathing Test:

  • Start by lying on your back.
  • Place your right hand with the thumb below the ribs and the center of the palm on the abs (as if you had a tummy ache).
  • Take the left hand and place it on the chest, centered on the ribs.
  • Finally, inhale through your nose and out through your mouth.

What did you feel?

Ideally, you should feel your stomach begin to expand before your chest and shoulders move. There should have been minimal movement in your upper hand. This means your extremely strong breathing muscle, called the diaphragm, is doing its job!

The diaphragm pulls the lungs down during proper breathing, expanding the lungs in a 3-D like a pattern, top to bottom, front to back, and to the sides

Breathing is an involuntary muscular action, meaning we don’t have to think about it. Because of this, many people are not able to fill their lungs to full volume. When this occurs, it is called a “chest breath”.

A chest breath is a type of breathing when the diaphragm is not involved, and we are not using our lungs to their full capacity. This type of breathing causes the body to enter a response state called “Fight or Flight”. This type of body response is what we feel when we encounter a bear and must make the choice to defend ourselves or run. When our bodies are in this type of response, it causes a release of stress hormones to the body. These stress hormones are highly inflammatory and negative to the brain and body’s performance over a long period. 

3 Breathing Exercises:

To help eliminate the release of stress hormones throughout the day, try this exercise.

  • Inhale for 6 seconds
  • Hold that breath for 4 seconds
  • Exhale for 10 seconds

If you feel groggy or tired, try this exercise. 

  • Inhale for 6 seconds
  • Hold for 2 seconds
  • Exhale forcefully

Finally, to prepare your body for a workout, try this breathing exercise. 

  • Inhale for 4 seconds
  • Hold briefly
  • Exhale forcefully

As we breathe all day without much thought, it is important we become aware of how we are breathing. Being able to control breathing will help you become more mindful and feel better throughout the day!

Try these three exercises out and see a difference in your mood and activity.

Happy breathing,

Parker Victor, MA, CSCS, USAW-1, Head Performance Coach

3 On-The-Go Vacation Exercise Circuits

No Gym, No Weights, No Problem!

As we begin setting up our summer vacation travel plans, it is also important to plan ahead for making sure we keep our strength training and exercise plan in action during our trip. Today, I will outline simple steps needed in order to plan your vacation exercise routine and I will cover a 30-minute vacation exercise circuit. 

Before you take off on your travels, be sure to let your coach or trainer know at least two weeks in advance you will be out of town. Why is this important?

Two reasons. The first is so they aren’t wondering where you are or if you are skipping out on your sessions. The second reason is so they can provide you with a training routine to complete during your vacation.

Once you have let your coach or trainer know you will be out of town, the second step is to research if there are any gyms in the area you will be traveling. Is there a gym in the hotel you are staying? If there is not, you may have to plan for implementing body weight exercises inside your hotel room.

No matter what amenities you have available, it’s all about utilizing what you have to continue toward your exercise goals. Your coach or trainer will then give you the routine with enough time in advance, in case you may have questions before leaving on vacation.

I have put together a body weight exercise plan you can complete anywhere. Remember, vacation is a time to relax.  But, with a little effort each day you can also continue working towards your exercise goals. Even if it comes down to a few 30-minute routines during a week-long trip, you will not regret the effort once you get back to your everyday routine. 

Warm-up:

  • 30 sec. Imaginary Jump Rope
  • 10 Body weight Squats
  • 10 Arm Hugs
  • 30 sec. Imaginary Jump Rope
  • 5 each Leg Split Squats
  • 20 sec. Front Plank
  • 20 sec. Each Side Plank
  • 30 sec. Imaginary Jump Rope

Body Weight Strength Training:

Circuit 1:

  • 10 Squats with three sec. isometric hold
  • 8 each High Plank Shoulder Tap
  • 20 sec. Bottom Push-up Hold
    *Repeat circuit three more times

Circuit 2: 

  • 8 each Single Leg RDL
  • 8 each Side Plank Top Leg Lifts
  • 8 each High Plank Renegade Row
    *Repeat circuit three more times

Circuit 3:

  • 5 each Split Squats with three sec. isometric hold
  • 10 Straight Leg Sit-Ups
  • 5 each Quadruped Thoracic Rotations
    *Repeat circuit three more times

Finisher: Energy System Development

This is a perfect exercise finisher if you feel like adding another element to your routine.

  • 15 each Mountain Climber
  • 15 each Seated Twist
    Rest 30-40 seconds after those exercises and complete 5 times through

Written By: Trenton Clausen – MA, CSCS, USAW-L2SP, Director of Sports Performance

How to Self-Diagnose Your Athlete’s Arm Pain

Late spring into early summer is one of the most common times we see shoulder and elbow injuries.  A lot of parents often ask me what “warning signs” they should be looking for with their son or daughter’s arm pain. Most importantly they want to know if the pain is serious or not. 

To a certain extent, we come from a place where we believe the motto “no pain, no gain”, and in some cases, I fully agree with that mindset. But at other times, this mindset can be very detrimental. How do you determine which pain is okay to play through and which pain is not? Here are four common arm pain areas to evaluate and guidelines to help you decide if your athlete should get the area checked out.

Pain Area #1:
Front or the back of the shoulder

Back of Shoulder Pain 

Pain and soreness in the shoulder are not uncommon with athletes, but the key is where the pain is located. Pain and soreness in the back of the shoulder usually occur when athletes use their arm to throw or serve. The muscles in the back of the shoulder often get strained.  They are small muscles and take on a lot of force when the arm is stopping after a throw or a swing.  Typically, this soreness gets better by the next day and eventually the muscles get stronger so the pain does not return.  

Front of Shoulder Pain

Front shoulder pain is a whole different issue.  We consider this pain to be concerning, and it should be closely monitored. Structures like the front ligaments of the shoulder, the labrum (cartilage in the shoulder), and parts of the rotator cuff are all stressed during overhead movements.  If your athletes are complaining of pain here, this is NOT the pain they should try to play through.  The pain can go away on its own; however, if the pain persists for more than three days or if it occurs every time they try to play their sport, go have it furthered examined by a physical therapist or a licensed health care professional. 

Pain Area #2:
Outside of the upper arm

Pain and soreness aren’t commonly experienced on the outside of the upper arm as the deltiod muscle is just about the only muscle in that area. Pain here, especially in adolescent athletes, is usually a sign of an injury to the growth plate of the upper arm.  Have you ever heard the term “little leaguer’s shoulder”?

Little leaguer’s shoulder can have delayed healing and significant downtime if left unaddressed.  Again, like in the shoulder, this pain can go away fairly quickly.  However, if it becomes persistent or happens every time the athlete tries to use their arm for activity, it is time to have it checked out.

Pain Area #3:
Inner or outer elbow  

Inner elbow pain

Pain and soreness in the elbow are not as common as the shoulder and tends not to be bothersome – unless the athlete is throwing or serving. This infrequency is why I think people don’t have this area looked at as much or soon enough.  The inner elbow is home to some key structures that are stressed during overhead movements.  The ulnar collateral ligament (Tommy John ligament) and the inner elbow growth plate (little leaguer’s elbow) are the most significant.  Once these areas start developing pain, they are usually past the mild stage and are typically in the damage stage.  

Outer elbow pain

The outer elbow rarely develops pain and usually does not develop pain without previously having inner elbow pain.  Pain in the outer elbow can be significant such as a cartilage lesion on one of the forearm bones.  This damage happens from over-compression in the joint, commonly due to a loose ulnar collateral ligament.  Like the inner elbow, by the time this area becomes painful, the damage has already set in.  

Pain localized to the inner or outer elbow should not be dismissed as the consequences can be detrimental to the longer term health of the elbow.

Pain Area #4:
Biceps or triceps muscles

Pain and soreness in muscle tissue is rarely a “red flag” for us.  Injuries to muscles can definitely be painful but more times than not, they will resolve on their own in a reasonable amount of time.  The biceps and triceps are the muscles most susceptible to getting strained in sports like baseball, softball, and tennis.

 

A lot of the time the pain is located in the middle of the muscle or, for tricep pain, down by the elbow joint. Again, these pains usually go away quickly and usually respond well to light to medium massage.  If for some reason, the pain is not fully gone in a couple weeks, then I would recommend getting it checked out.


Conclusion:

As your athlete participates in the common summer sports, pain and soreness can and will happen.  The key as parents is to continuously monitor the symptoms and use the guidelines above to help determine severity.  If the pain falls into one of the key areas, don’t be that parent that finally takes their kid in only to find out they fractured their growth plate.  On the flip side, if the pain isn’t too bad, “go rub some dirt on it” is sound advice!

When in doubt give us a call 402.932.7111 if you have any questions about your athletes’ arm pain.  We’d be happy to answer any questions you may have! 

Written By: Travis Manners, PT, SCS, CSCS

Concussions and the Classroom: Bridging the Gap

Concussion Focus & Athletes’ Training Center
Guest Blog Author: Becky Docter, MA, ATC, Sports Medicine Athletic Trainer Children’s Hospital & Medical Center

Becky Docter is an Athletic Trainer who joined Children’s Hospital & Medical Center in 2016.  Previously, she spent a decade working as an Athletic Trainer in the secondary school setting in Omaha. She continues to advocate for education in youth concussion across the state of Nebraska.  She Co-Chairs the Metro Brain Injury Regional School Support Team (BIRSST) and serves on multiple concussion education groups including Concussion Focus.org and Concussion Coalition.  Becky received her Bachelor’s degree from Doane College and her Master’s degree from the University of Nebraska at Omaha.  She is very involved in professional service on the state level serving on the education committee for Nebraska State Athletic Trainer’s Association, (NSATA) serving on the Department of Health and Human Services (DHHS) Athletic Training Board, and working with the Board of Certification (BOC) to create standards for professional education in athletic training.  Becky and her husband just welcomed their first baby boy to their family this May.

Return to Learn

What is it?

Return to Learn is an amendment to the Concussion Awareness Act that was passed in July 2012.  The Return to Learn Amendment was added in July 2014, stating that a return to learn protocol be established for students that have sustained a concussion.  The protocol shall recognize that students who have sustained a concussion and returned to school may need informal or formal accommodations, modifications of curriculum, and monitoring by medical or academic staff until the student has fully recovered.

Download Full .pdf Blog: Concussion and the Classroom Bridging the Gap


The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)


Our Collaboration with Concussion Focus

What is ConcussionFocus? Concussion Focus is a collaborative group of healthcare professionals in the Omaha and surrounding area that decided to come together to provide a team approach to concussion management. 

Representing the areas of family medicine, pediatrics, neurology, athletic training, physical therapy, and other disciplines allow each professional to offer expertise in their field while communications with each other to best serve the patient’s needs.

Continue reading


Shin Splits, How to Reduce Your Risk – 3 Strategies

I have two words for you.  Two words which give runners everywhere nightmares.  “Shin splints”. Most people are familiar with this diagnosis; and if you have had them before, you know that they are highly irritating!

In this blog, I want to talk about three strategies you can use to help reduce your risk of developing shin splints symptoms. 

1st: Buy a Good Pair of Running Shoes

Just like anything else shoes break down and need to be replaced. How often they need to be replaced depends on how far you are running in a week.

As a general rule of thumb, running shoes should be replaced every 300 to 500 miles, which means you can’t simply replace them once a year (if you are averaging 50 miles a week).

2nd: Slowly Ramp up Your Running Distance

Have a plan for building up your running distance. If you want to run a half-marathon this summer, but have not been putting in any miles during the winter, you should not start off running 30 miles a week.  You should instead begin by building up your walking tolerance, move to walk/run intervals, then build your running distance from there.

Going from spending most of your time sitting on the couch and binge-watching Netflix straight into hardcore run training is a sure fire way to end up with a case of shin splints.

3rd: Stretch Your Calf Muscles 

Finally, make sure you stretch out your calf muscles before and after your run. When stretching out your calves, it is important to ensure you stretch out both of the major muscles which reside there, your gastrocnemius and soleus muscles.

The gastrocnemius is stretched when your toes are pulled toward your head with your knee straight as this muscle spans across the knee. In order to stretch the soleus, you must have your knee bent as this muscle stops short of the knee.

soleus stretch

gastrocnemius stretch

 

Each of these three strategies can play an important roll in helping you to avoid shin splints and helping runners everywhere to get a better night’s sleep!

 

 

If you or someone you know is already dealing with this condition, then set up an appointment today to be seen by one of our physical therapists.  There are many strategies to help speed up recovery!

Written By: Josiah Parker, PT, DPT

Concussion Return to Work: Plan of Action

Guest Blog Author: Rebecca Lancaster, MD

Returning to work after a head injury poses unique challenges. It may seem unclear what steps to take or how far you should push yourself as you return to work. A good place to start would be discussing the situation with your employer and physician.

A sudden noise, bright lights, a computer screen, physical exertion or mental activity may not be well tolerated by the recovering brain. It is most helpful to me when patients bring a list of job expectations to their office visit so we can develop a reasonable plan for modifying their work and predict which aspects may cause problems.

Job Details: Driving expectations, screen time, noise levels, physical activity and levels of responsibility/decision making are very important to know when formulating a reasonable return to work plan.

You may need to start with a few days off from work (or longer) to start your recovery. When you are ready to start back to work, sometimes working a few hours at a time or half days are more appropriate. It is common to experience fatigue and mental exhaustion at the end of the day or the end of a week. Making adjustments such as doing more challenging work at the start of the day might help.

Even though you are able to return to work, you may find frequent breaks to be helpful, even necessary.

Back to Work Tips:

  • Changing the settings on screens to include larger text and lower brightness. 
  • Adjust lighting in the workspace.
  • Try using noise canceling earphones/earbuds. 

These changes may help provide fewer stimuli and relief to a brain while it is still recovering.

Once you are back to work, try to avoid situations where you have to learn new skills if possible. Training and testing are generally less successful while you are healing.

Use extra caution in high-risk jobs, especially those with little margin for error. Try to get a good night sleep between work shifts. Worsening concussion symptoms or fatigue might be a sign that you are doing too much too fast. If you can identify triggers that make your symptoms worse, be sure to bring these up so efforts can be made to avoid or minimize these triggers. For example, multitasking may be more difficult than working on one task at a time.

Above all patience can be your best friend. Focus on what you are able to do and take one day at a time. Pushing through does not lend itself to a faster recovery.

If you have any further questions or concerns feel free to email any one of us at the concussion focus team. 

Guest Blog Author: Rebecca Lancaster, MD


The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)


Our Collaboration with Concussion Focus

What is ConcussionFocus? Concussion Focus is a collaborative group of healthcare professionals in the Omaha and surrounding area that decided to come together to provide a team approach to concussion management. 

Representing the areas of family medicine, pediatrics, neurology, athletic training, physical therapy, and other disciplines allow each professional to offer expertise in their field while communications with each other to best serve the patient’s needs.

Continue reading


Debunking 7 Common Concussion Myths

Hello, my name is Josiah Parker, PT, DPT, I am a physical therapist at Athletes’ Training Center. Although I treat a wide array of patients, concussions are one of my favorite areas to treat. I’ve attended courses at the University of Pittsburg and the American Academy of Neurology for specialized training in this area. 

We have learned so much about concussions over the last 10 years but there is so much left to be learned. This influx of information has been great for the rehabilitation of patients with concussions however, there is still a ton of misinformation out in the public. My goal with today’s blog is to shed some light on some of these common concussion myths.

Myth 1. Concussions only affect athletes and only on the field

False, I see many patients who get concussions from everyday activities such as work, driving, etc.

Myth 2. Concussions always come with a loss of consciousness

False, I would say from my experience less than 20 percent of the concussions I see experience a loss of consciousness. The biggest predictor of a longer recovery after a concussion is actually feeling dizzy after sustaining a concussion.

Myth 3. The person needs to just rest until all concussion symptoms are gone

False, rest is very important after a concussion but simply cocooning yourself after a concussion is detrimental if done for longer than 48 hours. After that 48 hours sleep continues to be very important and should be prioritized but along with this, a slow progression back into activities is very important for full recovery.

Myth 4. If I wear the right type of helmet, I will not get a concussion

False, helmets are very effective at preventing injuries such as skull fractures but concussions can be caused by the brain-twisting inside the skull or hitting the front and back of the skull. Both of these mechanisms of injury are not prevented through helmet use. Don’t get me wrong helmets are a good thing to wear but they are not a foolproof way to prevent a concussion.

Myth 5. My MRI/CT scan was clear so I don’t have a concussion

False, neither one of these scans are able to detect a concussion. They are able to rule out more serious conditions such as a brain bleed but concussion damage is on a more microscopic level which is not picked up on these scans.

Myth 6. People with concussions should wake up every 2-3 hours after a concussion

False, uninterrupted sleep is very important after a concussion, especially in that initial 48-hour window. There is not any research showing interrupting sleep is helpful even on the first night after a concussion.

Myth 7. Concussions are a minor injury

False, many concussions resolve quickly with little to no long-term effects. However, the more concussions someone gets the longer symptoms last and the more intense they are. There are some people who have lasting symptoms for months or even years after a concussion. Therefore though most concussions are not life-threatening, may be life-altering.

The effects of these concussions cause interruption in daily activities, making the return to work/school challenging and can be very frustrating. This is not an all-inclusive list but as you can see there are many wrong ideas about concussions.

If you or someone you know are suffering from post-concussion symptoms, know there is help available and many times rehabilitation can help to speed up the recovery process. Use the information below to get in contact with someone who can help guide this process for you!

Call us at 402.932.7111. or visit concussionfocus.org

Written By: Josiah Parker, DPT, PT


The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)


Our Collaboration with Concussion Focus

What is ConcussionFocus? Concussion Focus is a collaborative group of healthcare professionals in the Omaha and surrounding area that decided to come together to provide a team approach to concussion management. 

Representing the areas of family medicine, pediatrics, neurology, athletic training, physical therapy, and other disciplines allow each professional to offer expertise in their field while communications with each other to best serve the patient’s needs.

Continue reading


5 Common Pitching Mistakes & How to Avoid Them

I hate seeing young athletes hurt.  There may not be a worse feeling than telling a young, energetic, baseball loving athlete they need stop playing for a while so we can get them through an injury.  Now, I appreciate there are some injuries that are completely unavoidable and these injuries are the nature of playing sports. 

On the other hand, some of the injuries I see in the clinic have the potential to be avoided with a little extra knowledge and a keen eye.  

In this post I will cover some of the common mistakes to look for in your young throwers.  I will also share how these mistakes can lead to less than optimal performance and how they create the potential for injury.pitcher

Mistake #1 – Getting out of the glove late

 

This error is one that can have a detrimental effect on the rest of the throwing cycle because if the hand break is delayed it forces the thrower to have to catch up in the sequence of the throwing motion.  As the pitcher begins to come out of his balance position and his front knee begins to lower, his hands should begin to separate from the glove.  In doing so, he will not be rushed to get the arm into the proper position or slot when he starts delivering the ball.

 

Mistake #2 – Faulty arm path
 

Faulty Arm Path

We were all taught as kids when you bring the ball out of the glove the arm should follow a “C” path or “down, back, and up”.  The reason we were taught this was because it gets the arm in the right position for effective delivery. The common faulty arm path I see is the ball coming down and behind the pitcher after it exits the glove.  Now the pitcher has to hurry up to get his arm in the proper position for delivery.  If his timing is not just right, it leads to the next mistake.
 
Mistake #3 – Lagging coming through the slot

Pitcher dragging

Once a thrower starts turning his chest toward the target, the throwing arm should be in sync with the torso, or in other words, they should move together at the same time. Have you ever seen a young pitcher make a throw and it looked like his hand was still pointing at the short stop when his chest was facing the catcher?  That is lagging.  The arm is trailing behind the body’s movement toward the plate.  In my opinion, this mistake is the NUMBER #1 cause of shoulder and elbow injuries in young throwers.
 
Mistake #4 – Glove side arm flying open

Glove side openRight up there with “down, back, and up”, “tuck your front side elbow” was probably the next thing I remember all my coaches preaching – and rightfully so.  When a thrower is delivering the ball to the catcher, all his momentum should be driven forward toward the catcher.  If the front side arm is away from the body, it creates a spinning effect drifting the pitcher off to the side and not toward the catcher.  

This error has two consequences.  First, the pitcher has a harder time locating his pitches because it is hard to time a spinning motion.  Second, now the pitcher lands unbalanced and often is not ready to field a ball or protect himself if the ball is hit back toward him.

 

Mistake #5 – Breaking Lead Leg

Now this on2Breaking kneee sounds bad.  I do not mean the pitcher actually “breaks” his lead leg.  I mean the pitcher is applying the brakes through his lead leg.  When a pitcher is delivering a ball, his momentum shifts his weight from his back leg to his lead leg.  When this happens the lead leg’s knee is supposed to be athletically bent.  Breaking the lead leg is when the pitcher rapidly and often violently snaps his knee straight as he is shifting weight onto it.  This error stops all forward momentum and energy thus forcing the arm to make up the difference in order to attain to the desired velocity. This mistake is the NUMBER #2 cause of shoulder and elbow injuries I see.
 

Coaches have an incredibly tough job when it comes to developing young pitchers.  I have discovered in my time of working with young baseball players there are a lot of kids ‘throwing’ off the mound and very few ‘pitching’ off the mound.  Having a keen eye and keeping these mistakes in mind will help your young pitcher stay healthy and develop a great foundation for pitching!

 
Written By: Travis Manners, PT, SCS, CSCS

 

Question: How are your young thrower’s mechanics?  Have you noticed any other common mistakes? You can leave a comment below.
 

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Tips for Managing Sleeping After A Concussion

Guest Blogger Introduction: Rebecca Lancaster, MD – Methodist Physicians Clinic

Rebecca is a graduate of Creighton University Medical School and Clarkson Family Medicine Residency.  She is a board certified Family Medicine Physician.  Rebecca began managing athlete concussions in 2010 when she became one of the first ImPACT certified physicians in Nebraska. 

She has continued to assist concussion patients in private practice and more recently at Methodist Physicians Clinic in Omaha, Nebraska. 

Her concussion patients now extend beyond athletes to include all age groups, as is consistent with family medicine, and varying degrees of head injury from acute concussions to post-concussion syndrome. Rebecca continues to be active in Concussion Focus and concussion education in the Omaha community.  Her goal in treating concussion patients is to understand where they are in their recovery,  help them through with the resources we have available and return them to their fullest quality of life after these most unfortunate head bumps.

Ah, sleep!  It is oh so important when you are recovering from a concussion, but what do you do when the injured brain does not want to sleep? 

Sleep habits become more essential post-concussion.  Scheduling regular sleep, wake times, and sticking to them helps. Here are a few tips you can implement to help manage sleep after a concussion. 

Managing a Concussion: Sleeping Tips

Aim for 7-9 hours of sleep per night. Minimize screen usage such as phones, computers, TVs, and reducing exposure to brighter lights before bed will help.

Try relaxing activities, meditation, stretching or reading if tolerated can be helpful before bed.  A short nap can be okay during the day, but if it starts to impair your ability to fall asleep, you may want to limit the duration of the daytime resting or eliminate it all together.  Physical activity is helpful during the day if you can tolerate some, but physical activity just before bedtime can make you more alert.  Decreasing or eliminating caffeine helps as well. 

And what if these tactics still do not work?

Sometimes an over the counter sleep aid like melatonin starting at a dose of 1 mg – 3 mg can be helpful to drift off to sleep easier. If headaches are a bother as well, Tylenol or Ibuprofen, at an appropriate dose for your age, prior to sleep may help.  You may also want to talk with your physician about medications that can diminish headaches as well as assist in sleep. 

Overall it is perfectly reasonable to start examining and modifying sleep habits. It may take some discipline and patience as you try a few nights with your new sleep routine. This course has no side effects and could lead to fewer concussion symptoms. If the concussion, however, has caused more difficult to manage sleep cycles, do not hesitate to seek help.

Sweet dreams!

Guest Blog Author: Rebecca Lancaster, MD


The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)


Our Collaboration with Concussion Focus

What is ConcussionFocus? Concussion Focus is a collaborative group of healthcare professionals in the Omaha and surrounding area that decided to come together to provide a team approach to concussion management. 

Representing the areas of family medicine, pediatrics, neurology, athletic training, physical therapy, and other disciplines allow each professional to offer expertise in their field while communications with each other to best serve the patient’s needs.

Continue reading


Time to Start the Discussion: Concussion Management 

Guest Blog Author: Tom Buehler, ATC

Concussion. There it is. That word that everyone knows about but no one wants to talk about. The second I say the word “Concussion” I see the reaction on the face of the athlete, the parent and the coach: Fear, anger, confusion, disbelief, skepticism, disapproval, disappointment, concern, and even sometimes acceptance. Over the last several decades the way we understand and manage concussions has evolved immensely and if you ask any person trained in concussion management they will tell you we have just begun to scratch the surface.

As an athletic trainer, I have training and several years of experience in the acute management of sport-related concussions (SRC). Recognizing the signs and symptoms while on the sidelines is the first step in the proper management of an athlete who has suffered a concussion. 

Below is a list of common symptoms a concussed athlete can display:

• Headache
• Foggy Feeling
• Emotion
• Loss of Consciousness
• Amnesia
• Balance Impairment
• Irritability
• Slowed Reaction Time
• Lethargy
• Drowsiness
• Anger

If you or your child have been a part of athletics, then you undoubtedly have seen this list before or one like it. Concussion symptoms can be acute or have a delayed onset. It is imperative to take all symptom reporting seriously and not diminish the significance of a symptom that has been reported to you.

Now that you have recognized you or your athlete is displaying one or more of the signs and symptoms of a concussion, what do you do now?

Removal of any player who is suspected of having a concussion is critical and is the state law in Nebraska. Before returning to activity after a suspected concussion, the athlete must be evaluated by a licensed health care professional who has training and experience in concussion management. If no health care provider is available, a coach or parent needs to arrange for urgent referral to a physician even if this means a trip to the emergency room.

There are several important variables in the acute management of a concussion. Number one, two and three are communication. Communication of information between coaches, players, parents, teammates and health care professionals is essential for player safety. In addition to communication, we need to start to understand how concussions present. It’s not always going to be black and white. Concussions live in the gray.

The biggest roadblock I encounter is the parent who “knows better.” Note to parents and coaches: Don’t mitigate concussion symptoms based on your own agenda, don’t overlook symptoms that don’t fit your understanding of concussions and don’t try to convince yourself that it’s no big deal. LOOK and LISTEN to what your athlete is telling you and “when in doubt sit ‘em out.”

It’s time to start the discussion. Concussion doesn’t have to be this ugly buzzword that no one talks about. The potential for permanent injury or death as it is related to concussions has been well established. A 15-year-old athlete only sees one step ahead. It’s our responsibility as the adults in his/her life to see past the next play, next series, or next possession and understand what is really at stake.

Guest Blog Author: Tom Buehler, ATC, Athletic Trainer CHI Health Millard West High School

 


The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)


Our Collaboration with Concussion Focus

What is ConcussionFocus? Concussion Focus is a collaborative group of healthcare professionals in the Omaha and surrounding area that decided to come together to provide a team approach to concussion management. 

Representing the areas of family medicine, pediatrics, neurology, athletic training, physical therapy, and other disciplines allow each professional to offer expertise in their field while communications with each other to best serve the patient’s needs.

Continue reading


What Everybody Ought to Know About: Concussion Protocol Evolution

Around 2004, while the head athletic trainer at a Class A high school in Lincoln, NE, I had the good fortune of being part of a research study that was looking at the use of a computerized tool for assessing concussion. The name of the program was ANAM and it assessed things similar to what we know today as ImPact.  In watching football players take this test after sustaining a concussion and comparing it to their baseline, I started to notice something that made me sick to my stomach.

Kids were not recovering in the 7 day window which we used at the time as the standard for clearing them to play again after concussion.

Especially freshmen and sophomores.

Concussions Early 2000’s.

Dr. Lori Terryberry-Spohr, a phenomenal practitioner and researcher at Madonna Rehabilitation Hospital, was instrumental in helping me understand what this program was finding and why it was starting to concern me.   I was noticing athletes were still symptomatic even after returning to play.  They were struggling with quick and accurate decisions – which is something essential to playing sports effectively and safely.  I was starting to question how I was handling concussions and wondered if we needed to start doing things a little differently.  The other athletic trainers in my school district were wondering the same thing. 

I was starting to question how I was handling concussions and wondered if we needed to start doing things a little differently.  The other athletic trainers in my school district were wondering the same thing. 

 

At the same time, the national landscape was changing drastically in regards to managing concussions and in a very short amount of time we are where we are today.  No longer do we rate concussions in severity and no longer do we use a variety of grading scales that vary from liberal to conservative. You either have one or not.  Terms like bell rung, dingers, and stuns are not used any longer.

Concussions Today

All sorts of technology exists to aid athletic trainers and other sports medicine practitioners with concussion management.  There are state laws in place with the hope of protecting young athletes from continuing play after sustaining a concussion Nebraska LB 923.  Most importantly, we have much better approaches to return to play and now return to learn.

The more interesting point is all of this new information has streamed, really flooded, into mainstream media and the households of America.  Yet I still have to endure the verbal lashing from a parent when I explain why their athlete can’t finish the game and will probably be out for a minimum of 2 weeks. I still have to drum like the Energizer bunny advocating on behalf of the kid whose parents refuse to associate the decline in school with the concussion their athlete sustained months earlier.  I still have to read doctor’s notes clearing kids a day later.  

Yes, I said doctor.

I still have to drum like the Energizer bunny advocating on behalf of the kid whose parents refuse to associate the decline in school with the concussion their athlete sustained months earlier.

 

The good news is the greater majority of athletes, parents, and practitioners get it now and this has led to some really great multidisciplinary approaches to helping athletes recover from concussion.  A great example is the team of providers in Omaha that participate in Concussion Focus.  My colleague Josiah Parker leads that team.  He has immersed himself in knowledge and practice techniques to provide post-concussion physical therapy and for the small percentage of cases that don’t resolve normally he can make all the difference in the world for their recovery.

Obviously I did the best I could back then based on the information we had at hand.  I also feel extremely grateful the kids I sent back out did okay.  Today, though, I know so much more and am appreciative for all of the resources that exist for kids in relation to concussions.

Written By: Danielle Kleber, ATC Director of Marketing & Operations

Question:  Do you know which sport has the second highest incidence of concussion (next to football)?

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Our 5 “Most Popular” Fitness Q&A’s

Every day we receive countless questions from our athletes and adults pertaining to: nutrition, weight loss, cardio, aches and pains and whether or not they should be eating breakfast… just to name a few.

While sometimes it is hard for us to always know the answers, we always encourage them to ask questions! Because, answering these questions is one of the best ways for us to develop a custom program to fit their unique goals. Today, we have compiled 5 of our most popular questions.

Question 1: Certain exercises are causing nagging aches and pains, what should I do?

Communicate with your coach! Don’t try to be a hero. Usually your coach can fix the issue by correcting technique, simplifying the exercise or adjusting the load or volume being performed. If not, then it might be time to get looked at by one of our staff physical therapists.

Question 2. I’m just getting back into training, how many times should I train per week?

Unfortunately, there is no one right answer to this question. Multiple factors come into play when determining the best plan for you. A great time to discuss that is during an evaluation, which is included in our semi-private adult and athletic memberships. During this time we will discuss your goals and put a plan in place to help you accomplish those goals!

Question 3. What’s the best way I can see results from my training?

Consistency! Treat your training sessions like you would any other appointment on your schedule and make attending a priority. Getting into a new routine can be difficult, but it is a must if we want to accomplish our training goals.

Question 4. I’m not much of a morning person, do I really need to eat breakfast?

Yes! Think about it this way…

You are just waking up from a 6-8 hour time period where you have not had any food. If you proceed to wait until lunch time to eat your first meal of the day then you are already behind! In order to function at your best, you need to start the day with a quality breakfast. Here are some of my favorite ways to start the day. They all take less than 10 minutes to put together.

  • Eggs, Whole Grain Toast/English Muffin, Yogurt
  • Oatmeal with Walnuts, Fresh Fruit, Glass of Milk
  • Create your own breakfast smoothie or shake. Trent Claussen wrote a 5 step process on how to make the ultimate smoothie that meets your specific fitness goals. You can read that here –Top 5 Smoothie Recipes – Post- Workout Nutrition.

Question 5. Why do we conduct evaluations with members prior to training?

As I mentioned earlier, the evaluation is the perfect time for goal-setting. It is also the time where we take you through a movement screen, discuss injury history and perform baseline testing. All of these factors go into creating a fitness program that is just for you!

Looking to get started, but don’t know how? Call us to schedule a free trial session today! Or, do you have a question that I did not answer? Email me your question and maybe you will see it in our next Q&A!

Mike Servais CSCS, USAW-L1, Performance Coach

 

Your Most Popular Dry Needling Questions Answered

Dry needling is currently one of my favorite manual treatments and I am constantly discussing it in the clinic with my patients. Due to the mildly invasive nature of the treatment, and because many people have not heard of dry needling I end up fielding many questions.

I recently received an email from a patient with several good questions and decided it would make a good blog post! If you don’t know what dry needling is check out our past blog post, “Functional Dry Needling” before reading the rest of this article.

Question 1:
Why do you feel I would benefit from needling and how does it relate to the big picture?

Dry needling is only on piece of the puzzle but it is a powerful piece. I like to explain dry needling as the ability to press the reset button on a muscle. I give the muscle a stimulus through the needle and that stimulus can help to decease muscle tension, decrease pain, increase range of motion, improve muscle activation, and improve function.

Pressing that reset button provides a window that allows us to work on treating the root cause of the dysfunction. I may follow the needling with exercises, stretches, etc which will help to reinforce the treatment and allow those changes to become more permanent.

Dry needling is only one tool in the toolbox, but my experience so far says that it is a very strong tool and one that I will continue to use more and more.

Question 2:
Do you see this as a temporary solution?

No! Needling done only by itself would be a temporary solution, but as a physical therapist I always back up my needling with other treatment so that we address the root cause of the dysfunction and not just the symptoms. I feel like in many cases needling helps to deliver results faster but my goal is not a temporary solution.

Question 3:
I see a massage therapist to help with my tight muscles, would I get the same result from just getting a deep tissue massage?

Massage is another tool in the toolbox and one that I often use, sometimes even in conjunction with the dry needling. However, needling provides a different stimulus and sometimes people respond better and faster to needling than they would to deep tissue massage. I have seen patients who responded terribly to massage respond very well to needling and vice versa. Needling is not the answer for everyone but when it works well the results are undeniable.

Hopefully this answers some of your questions on dry needling! If this has sparked more questions for you then feel free to contact us or post them in the comments section below.

Likewise if you are interested in treatment call our office today 402.932.7111 and schedule an evaluation, we would love to see you! We offer cash based options for Functional Dry Needling, and the treatment may also be covered by your insurance. 

Written by, Josiah Parker – PT, DPT

Jennie A., Collegiate Track & Field Athlete

Athletes’ Training Center has worked to specialize workouts to fit my athletic needs. The strength coaches have a one on one personal connection to fix minor details that have had a major impact on my athletic performance.