Therapist is IN:


Welcome to the first edition of "The Therapist is IN".  It is my hope to create an open forum for all the players and coaches at Beekman Athletic Club to ask questions about prevention/treatment of injuries in young athletes.  So feel free to ask a question about injury prevention, strengthening and conditioning, stretching, treatment of common sports injuries, etc.  I'll do my best to answer your questions, and if I don't know the answers, I'll find someone who does.

Q&A ASK PHIL
Q:  How do I know if I have elbow tendonitis?
A:  Typically, baseball players will experience pain and tenderness over the middle aspect of the elbow.  This is known as Pitcher's Elbow.  You do not need to be a pitcher to develop Pitcher's Elbow.  Usually this is due to overuse, improper mechanics, poor warm-up, muscle weakness or trying to throw curveballs at too early an age.  Pain on the outer aspect of the elbow is commonly referred to as Tennis Elbow.  The itis is just a medical term for inflammation or swelling.  Ice should be applied for 20 minutes to the area, followed by an hour off.  This should be done for the first 48-72 hours.  If allowed take an anti-inflammatory medication (Advil, Motrin, Ibuprofen, etc) as described on the bottle.  Selective rest should be observed.  This means avoiding the activity that causes pain.  If pain persists for longer than 5-7 days, please see an Orthopedist or your Pediatrician.

Q: Why is it important to stretch before playing a game or practice?
 
A:  It is important to stretch before playing or practicing to prevent injuries.  Most injuries occur because of overuse or improper stretching and warming up.  Think of a car in the winter, you start the car and let it warm up before driving anywhere.  Why?  Because the oil (oil lubricates the engine and makes it run efficiently) is sitting in the oil pan, not in the engine where it's needed.  When we warm-up and stretch we're getting the blood pumping to our joints and muscles so that they work more efficiently.  If you start practice with light toss, a light jog, maybe some calisthenics you're getting the blood flowing, the joints lubricated and the muscles prepared to work.  If you stretch cold muscles you may strain or pull a muscle.  Typically, you want to warm-up for 10 minutes then strecth for 10 to 15 minutes.  Start with large muscle groups first: Hamstrings (back of the thigh), quadriceps (front of the thigh), deltoids (large shoulder pad muscles) down to the forearms and fingers.  Hold each stretch 10 to 15 seconds and repeat 10 times.  Never bounce!  Keep a steady HOLD for each stretch.  Stretching after you play is just as important.  This helps to rid the body of waste products and may prevent stiffening up.  Also, don't forget to ice down, especially after pitching.  Next column I'll try to include pictures of stretches. 


8 tips to keep healthy:
  1. Stretching the muscles related to the activity is very important. For example, if a child is pitching, he should concentrate on stretching his arm and back muscles. If a child is catching, the focus should be on the legs and back.
  2. A good warm-tip is just as important as stretching. A warm-up can involve light calisthenics or a short jog. This helps raise the core body temperature and prepares all the body's muscles for physical activity.
  3. Children should not be encouraged to "play through pain." Pain is a warning sign of injury. Ignoring it can lead to greater injury.
  4. Swelling with pain and limitation of motion are two signs that are especially significant in children -- don't ignore them. They may mean the child has a more serious injury than initially suspected.
  5. Rest is by far the most powerful therapy in youth sports injuries. Nothing helps an injury heal faster than rest.
  6. Children who play on more than one team are especially at risk for overuse injuries. Overuse injuries are caused by repetitive stress put on the same part of the body over and over again.
  7. Injuries that look like sprains in adults can be fractures in children. Children are more susceptible to fractures, because their bones are still growing.
  8. Children's growth spurts can make for increased risk of injury. A particularly sensitive area in a child's body during a growth spurt is the growth plate -- the area of growth in the bone. Growth plates are weak spots in a child's body and can be the source of injury if the child is pushed beyond his limit athletically.

Credentials:

Phil Toombs is a 12 year resident of Poughquag and he currently has three children involved in baseball/softball.  He has 20 years experience as a Physical Therapist specializing in Sports and Orthopedics for the last 19 years.  He is currently the Director of Rehabilitation at Putnam Hospital Center in Carmel, NY.  He can be reached at (845)279-1785.