Kinesio Tape

Kinesio tape  has been around for a while now and is getting more popular these days as  it is getting more exposure on TV and social media etc. I have ignored it for a while because there is no scientific explanation to why and how it works. However, there have been a lot of research studies that support that it works and getting more difficult to ignore. According to the past studies, it may reduce pain, increase range of motion, increase strength, reduce swelling and ecchymosis (bruise), etc. What we do not know yet is its physiological effects on the body (if there is any...). Could it just be psychological?! Possibly.. But let's say you get injured or aggravated your old injury in the middle of tournament or competition and need to get through it.... if using kinesio tape helps with pain etc, why not use it. But at the same time, you do not want to keep masking the symptom using kinesio tape or NSAIDs instead of taking care of what caused the pain or injury. Kinesio taping could be useful in certain cases. Here is an example of kineio tape applied for wrist flexor tendonitis at medial elbow. 

Movement Impairment (1)

Have you had any pain and saw the doctor but were told that there was anything wrong?! Have you had pain that gets better with rest but comes back as soon as you start using the body part?! There is probably nothing more frustrating as an athlete than having pain that keeps you from training and competing but no one can figure out what is really going on. It is a lot easier to understand why you are having pain when you see what is damaged on a film such whether it is broken bone or torn ligament. However, there may be a lot more to "pain" than pain caused by injuries diagnosed by the doctor. Let's say there is a female figure skater with chronic lower pack pain. Her back is fine as long as she keeps her training  short, however, her pain increases as her training intensity and length increase. Her doctor took an x-ray and MRI of her back but did not see anything wrong with her back structurally. So she was told that she was fine and keep training as pain permits. So in her case, is she really fine?! Or is there something wrong that did not show up on the films?! The fact that she has pain that keeps her from training is not "fine". There must be something wrong. But what is wrong with her that even her doctor could not find?! First of all, lower back is where she is having pain and may not necessarily be where a cause of pain is. Then, where is her pain coming from?! This is something we, rehabilitation specialists, can or should be able to find and fix so she will be pain free. We examine things such as flexibility, muscle strength, range of motion, core stability, feet, posture, etc etc etc to name a few. One of the things we look at is how  her body is moving or the way  she moves her body. And what movement(s) she is having trouble with, having pain with, is not doing right, etc. And what movements she has no pain with. Having strong muscles and strength and good range of motion is one thing. But how she is using  those in a system during movements is another story. Every body movement happens in a system, which means that each part of the body/segments have to work in sync to optimize the movement and to prevent stress from being placed on the body. The human body is very well balanced withing asymmetries that we have. Our body is not completely symmetrical but well balanced. So, if a part of the balance system fails, this can be a problem. Doing a certain movement wrong a few times are not likely to cause pain right away, but if that happens over a long period of time, this can be a problem. There are a lot of things that may have caused her lower back pain. But just because the pain is not diagnosed or there is no structural damage, this does not mean there is nothing wrong. Bottom line is... pain is a sign that there is something wrong and it is very important to figure out what is really causing the pain and fix the contributing factors. Otherwise, it will keep coming back. 

Speed Isn't Everything: Tennis Serve

In sports such as baseball and tennis, athletes tend to improve on pitch speed and serve speed. And it is important to have enough speed, however, it may not be everything you need to have when it comes to professional sports. We analyzed more than 200 match stats from this year's Grand Slam (Australian, French, Wimbledon, and US opens). We have found that the winners' average 1st serve speed was about 183km/hr and also that the losers served about 183km/hr on average. The 2nd serve speed was 149km/hr for the winners and 148km/hr for the losers. What was different between winners and losers were that the winners won about 77% of their 1st serve and the losers won only 65%. Also the winners won 56% of their 2nd sere points and the losers won only 45% of them. This tells us that serve speed was not everything in those Grand Slam matches. There has to be something else that matters other than the speed. Ball location, serving strategy, and ground stroke, etc etc. This just tells us that serve speed isn't everything in tennis and probably the same for sports such as baseball at least in a professional level.

Gravity in Sports

Most people do not like physics and chemistry and math and.... all those things we all learn in school. Most of us wondered why we had to learn all that. Sometimes knowing a little about physics won't hurt us..... Yes! Even in sports! We all know what the gravity is and all know that it exists every where we go on Earth. And it's constant everywhere. And it is FREE to use!! The gravity can be your best friend or your enemy. It depends on how you use it. When we do rehabilitation and exercise, we think about the gravity all the time to effectively and efficiently use it or to eliminate it. Let's say you are being measured for a max vertical jump. When you are standing straight on the ground, you are experiencing something called ground reaction force (GRF) which is the same as your body weight. Your weight pushes down on the ground and the ground pushes you back up. That's why you are not sinking into the ground or you are not being pushed up in the air. How high you can jump depends on how well you can use GRF. How well you can maximize it and how efficiently you can use it. Athletes with more weight potentially have more GRF they can use because GRF varies with body weight. However, they have to be stronger to be able to jump because they are heavier. So how can we maximize it? Stand on a scale and see how much you weigh...staining straight...and then try moving your arms up and down or bend your knees. You should see the number of the scale go up for a moment. That's one way to jump higher. Use your legs and arms. Another way to do that is to do a little hop before you jump up (this is usually not allowed when you are being measured though). Any object in the air has something called potential energy and it depends on its mass and its height. When you hop straight up before you jump, you are creating an extra energy that you can use because when you land from the hop, GRF is higher. Try hopping on a scale (without breaking it) to see what happens when you land on it. However, a flip side of this is that when you jump you have to land too. The higher you jump, the bigger the force your body feels and needs to absorb is. A good thing is that you have shock absorbers in your own body...muscles. Muscles are like springs. They can create a force for you to use and can dissipate it. A lot injuries happen during landing and its cause is multi-factorial. A failure to absorb a force when you land will put stress in your body (joints, muscles, bones, etc) If you do not land in a right way, your body will feel extra stress that you may not feel when you land correctly. Over time, it could lead to an injury. You also have to have enough muscle strength to do it. You need to have right muscles working at the right time too. Bad mechanics will interfere with it. Especially in sports where jumping is a major part of, it becomes even more important to be able to utilize the gravity and also able to protect your body from it. Gymnastics, volleyball, figure skating, basketball, etc etc etc. Hope this makes a little sense. The gravity can be your best friend or can be your worst enemy. But it is up to you to make it your BFF!!!

Stress Fracture in Figure Skaters

This figure skating season is nearing an end as only a few more international and national level competitions are left. Also, this is about time of the season when athletes get injured as an intensity of competitions increases. Those skaters who qualified for the nationals are probably training harder to do well in the competition. Some may be trying to secure a spot at the Worlds. Or some may already been training for the next season. Training hard is necessary to be successful. However, training too hard can be potentially damaging to the body. One of the common injuries suffered by figure skaters is stress fracture. The common injury sites are foot, lower leg, hip, and lower back. Stress fractures are categorized into 2 categories. One is a high risk fracture and the other is a low risk fracture, depending on where the fracture is located. High risk fractures are treated more aggressively because of their higher chance of non-union fracture. Many cases may require a surgical fixation of the fracture. Low risk fractures are usually treated with relative rest, partial or non weight bearing, activity modification, and rehabilitation. In case those do not work, then, it may be treated more aggressively. One of the reasons why it makes it challenging is that a lot of skaters will ignore a pain and keep training until it gets to the point that they cannot. By the time it becomes that painful, it may be too late. Once diagnosed with a stress fracture, a skater will be off the ice for a long time, probably around 6 weeks to a few months. Good news is that it is preventable. Causes of stress fractures include sudden increase in training intensity and time, a change of skates, nutritional factors, over training, not having proper mechanics, etc to list a few. Female skaters are more prone to stress fracture than male skaters. A study done at BYU showed that figure skaters sustain about 8 times of their body weight when they land on ice from a jump. That means that they have to be able to sustain that much force only using knee and hip muscles (and core muscles play an important role as well). When we jump and land on the ground, we can use ankles, knees, and hips and muscles around them to absorb the force. However, when skaters jump on ice, they are forced to use only knee and hip because of rigid type skates they wear. It becomes very important that they have enough muscle strength in their knees and hips to sustain that much force. By being evaluated for any risk factors they may have and by eliminating those factors when they are healthy, injuries such as stress fracture can be prevented.

Pitch Count in Professional Baseball Pitchers: USA vs Japan

There have been so many injuries in MLB about a half way through the season especially UCL tears, the most recently a NY Yankee pitcher, Tanaka. A lot of people in baseball world including coaches, media, and medical staff are discussing that pitchers in Japan pitch too much and they will get hurt. A pitch count is strongly reinforced in the US including little league baseball and professional baseball. However, it is not in Japan. Especially high school baseball in Japan is so popular and it is not rare that a single pitcher pitches a complete game in 6 straight games in a week long period tournament. However, if we look at how much Japanese professional pitchers pitch and compare it to American pitchers, it may be a bit surprising. In Japanese professional baseball league, they play 144 games with 6 men rotation. A typical healthy starting pitcher will be pitching in about 24 games a season. Let's say he pitches 125 pitches a game, he would be throwing 3000 pitches a season. In comparison, in MLB, 162 games are played a season with 5 men rotation. A pitcher will be pitching in 32 -33 games on average with average of about 100 pitches per outing. He would end up throwing 3200-3300 pitches a season. More games played, more pitches thrown, less time to recover... this may be something we should be looking at when it comes to Japanese pitchers getting hurt after coming to play in MLB. Ohh and these pitch count numbers do not include pitches thrown in each bullpen session and side session between starts. 

Knee Balance Exercise

We all know that balance is an important factor for athletic performance and injury prevention. Balance exercises are done usually on a foot on the ground or uneven surface to make it harder. Or you can add a ball toss to make it more challenging. Also, you can do a balance exercise on your knee instead of your foot. It is hard to put your knee down on a hard surface so try doing it on a balance pad or BOSU ball, etc. It challenges more of your hip muscles and postural stability than regular balance exercise on a foot. Pictures below show the knee balance exercise. This is another way to train your hip and core stability and proprioception. Again, balance is an important factor when it comes to performance enhancement and injury prevention!

Left knee balance with his left foot and right leg in the air.

Knee balance with ball toss.