Spring into Action!


With warmer days approaching, our activity also increases.  For some, this may include beginning a running program.  While running is not for everyone, it does provide a great workout and is easily tailored to each individual.  If you are like most people, the winter is reserved for inactivity and rest. Beginning a program after a period of inactivity can be energizing and satisfying.  The goal is to get to the finish line without injuring yourself before you make it.  Take these easy steps to ensure yourself of reaching you goal.

1)      Gear Up

Believe it or not, having the right outfit is an important step in beginning your program.  Dri-fit technology will absorb perspiration making it more bearable for you (and your training partner).  Buy some cool comfortable clothes for the warmer months.

Visit a shoe store where you can be fitted properly with the type of shoe that is designed for your foot.  Be sure to break them in gradually.

2)      Commit

Even if you are not a runner, sign up for a 5K.  Many 5K races are set up for run/walk.  This will give you a goal to work towards.  Start early, the more time you have to train, the better.  Ideally plan on 8 weeks.

3)      Plan

Make a plan.  If possible, find a buddy.  It is always easier to stick to a plan when you have someone to do it with.  Start small and work your way up increasing no more than 10% each week.  Your schedule should include a steady increase in both distance and speed.   This is the best way to avoid injury.  There are many programs available now on the internet or on smart phones that will walk you through the process.

4)      Interval Training

Do not be afraid to alternate between running and walking.  Walking will continue to strengthen your muscles.  So, if you find yourself out of breath, slow to a steady walk until your recover, and then try another burst of running.  The further into your program, the less walking you will need to do.

5)      Stretching

Always stretch before and after your workout.  Focus on the quadriceps, hamstrings, calf muscles and lateral thigh or IT band.  Don’t forget your upper body!  Whether you realize it or not, you are using these muscles as well.

6)      Rest and Hydrate

Most importantly, take days off.  Running everyday does not allow your body time to recover.  This can result in injuries.

Always remember to drink water or a sports drink.  The more your exercise, the more fluids our body loses.  It is crucial to replenish our body’s lost fluid and electrolytes.


Just remember, exercise isn’t easy.  It takes time and dedication.  Always keep your goal in mind.  You will be surprised at what your body can do when you just set your mind to it!

Emily Young, PA-C


Get Ready for Golf!

golfWhen the cold and snowy weather breaks, and you want to be ready for a new golf season, here are some tips to keep you healthy and enjoy your time on the course:

Flexibility is an important part of golf, and performing regular stretching year round can help your swing and your game.   Stretch the large muscles in your legs – hamstrings, quadriceps, and calves, holding each for 20-30 seconds. Don’t forget the back, neck and shoulders as well.   Stretching is best done when muscles are warm, like after a walk or other workout, or after a shower.   If right before your round of golf, stretching should consist of more dynamic movements, like light swinging of clubs or 5-10 second stretches.

Strength of core muscles is another very important part of the golf game. Sit ups are no fun, but stomach muscles are a key contributor to power in your game.   Sit ups can be done on the floor or on an exercise ball, and core can also be worked with medicine balls and resistance bands.   The gluteus muscles (in your buttocks) and leg muscles are also important muscles to keep strong for good performance on the golf course.   Squats and wallslides will help to increase lower body power with your swing.

Another important part of the game that you can train year round is balance. The golf swing requires good balance.   Take time to stand on one leg, 15-30 seconds. Try at first with eyes open, then progress to eyes closed. This is easy to do while standing and doing dishes or brushing your teeth.

Improving flexibility, strength, and balance will not only help your overall performance with golf, but hopefully prevent injury as well.   So get yourself ready so you can go out and hit ‘em long and straight!

Laura Blair is a physical therapist at Center for Joint Surgery and Sports Medicine.   She is also certified level II by Titleist Performance Institute to perform golf fitness evaluations.   Call her for all your golf fitness questions, and also check out www.mytpi.com for additional golf fitness information.

Avoid Sore Arms This Baseball Season

It’s that time of year when the weather is starting to warm up and baseball players are beginning to throw.  It’s also that time of year when we start seeing a lot of sore arms come through our physical therapy clinic.  In most cases the issue is just muscle strain when a ball player was trying to throw too hard, too far, too soon.  In other cases the injury may be a bit more serious such as suffering from tendonitis or bursitis at the shoulder or elbow.  And in extreme cases severe injury can occur such as torn ligaments at the elbow or torn muscle/tendon involving the rotator cuff.  Most of these injuries could have been avoided just by performing a proper warm-up and stretching routine.  Having good throwing mechanics is also vital but that is a whole different story (blog).

First thing to do in your warm-up is to take a light job around the field or jog from foul pole to foul pole along the outfield fence and back.    The warmed muscles will be more pliable which will facilitate stretching.  This is a good time to stretch the major muscle groups of the lower extremities to include quads, hamstrings, calf and groin.

To address the arms, you can first start by doing arm circles out to the side to get the blood flowing.  This can be followed by doing the Clemson drill or versions there of which would entail moving your arm up and down.  Starting with your throwing arm down at your side, lift it over head keeping elbow straight in a direction in front of body. May do 5-10 reps.  Then do 5-10 reps lifting throwing arm overhead with elbow straight moving in direction out to the side.  Finally, do 5-10 reps in a diagonal motion starting with throwing hand up overhead and moving arm down and across body to opposite hip, again keeping elbow straight.  Next, the posterior shoulder capsule stretch can be done.  To do so, bring your throwing arm across your chest.  Then use your non-throwing arm to hook the throwing arm at the elbow and pull throwing arm further across the body/chest.  Hold for good10 seconds.  Another good stretch is the tricep stretch.  Bring throwing arm up overhead, then bend elbow and try to touch your upper back or shoulder blade.  Use non-throwing arm to push elbow further back.  After doing tricep stretch you can do biceps stretch.  This stretch is best done with a team mate.  First, lift both arms backward with palms facing down.  Now have a team mate gently lift your arms higher and bend wrists back until comfortable stretch is felt.  Hold 10 seconds.  Repeat 2-3 times.  Now stretch the forearm muscles by holding your throwing arm straight out in front of you, keeping elbow straight bend your wrist back using your other hand and then you can bend wrist down holding 10 seconds each way.

Finally, this may be the most important stretch of all, especially for the older baseball player (high school/college), particularly pitchers.  It is called the Sleeper Stretch.  The easiest way to do this stretch is to lie on your side.  If you’re a right handed thrower, lay on your right side and vice versa if you’re a lefty.  Then bring your throwing arm out so that it is perpendicular to your body.  Bend your elbow to 90 degrees so the forearm/hand is pointing straight up to the sky.  From here, use your other arm to bring forearm/hand of throwing arm down towards ground in direction of waist, as if arm wrestling yourself.  Make sure to keep elbow bent at 90 degrees.  You should feel a good stretch but also should be a comfortable stretch.  This stretch will create more internal rotation motion allowing more range for the arm to decelerate once the ball is released, thus reducing stresses on ligaments and muscle/tendon at the elbow and shoulder.

By following a good warm-up and stretching routine, sore arm syndrome and more importantly, serious injuries can be avoided.

Have a great season and play ball! – Charles “Pete” Rinehart, MPT

sleeper stretch standingsleeper stretch lying down

DVT Prophylaxis

One of the most common concerns that patients have after surgery, is whether their swelling is normal and if they could have a DVT.  This blog article will education patients on DVT, or Deep vein thrombosis, and how to prevent it post-operatively:

What is a DVT?


A DVT, deep vein thrombosis, is the formation of a blood clot in a deep vein.   The most common location is in the legs.  This is concerning because the clot can break off and move through the bloodstream.  This is called an embolism.  This embolism can settle in the lungs, causing a Pulmonary embolism, which is life-threatening.

Who is at risk for a DVT?

Those at risk for a DVT are the following:

Those people who are on bedrest or are immobile.

Family history of blood clots

Fractures in the pelvis or legs


Recent Surgery

Cigarette smokers

Taking birth control pills

Sitting for long periods of time during traveling

What are the symptoms of a DVT?

The main symptoms of a DVT are redness, leg or calf pain, significant calf swelling, and warm skin to touch.  After the total joint surgeries, it is normal to have some swelling in the leg, with warmth at the incision site, mild redness around the incision site, and some bruising that can even show up in the foot.

How can I prevent a DVT?

The main things that you can do to prevent a post-operative DVT is to cease smoking, if you are a smoker, wear your TEDs stockings for the full 4 weeks after surgery, participate in physical therapy to reduce inactivity, limit your travel the first 4-6 weeks after surgery, and take your blood thinner that is recommended on discharge.

For the hip arthroplasty, we recommend Coumadin or Lovenox, depending on the surgeon.

For the knee arthroplasty, we recommend Ecotrin 325mg (coated Aspirin).

What is the treatment?

If there is any question after examining  a patient for the symptoms listed above, we send the patient for an ultrasound to detect a blood clot.  If it is positive for a blood clot, the patient is referred to their primary care physician to manage blood thinning medications for a period of time.  If it is negative, you most likely are experiencing the normal post-operative swelling and will need to continue to ice the joint, elevate the leg above the heart, continue the TEDs stockings, and continue physical therapy.


If there are any questions regarding your symptoms, please do not hesitate to contact Sarah Yost PA-C at the office.

It’s snowing…..again…..time to shovel!

snow picOne of the wonderful things about winter, other than drinking tons of hot chocolate, is the snow that falls down! It is a beautiful sight to watch until you begin to remember the snow will require shoveling. Shoveling is done by most folks who have one task in mind. That is to get it done! Back pain unfortunately can be a downside to shoveling all that snow that falls down so easily. By using a few techniques while you shovel, you may prevent your back from saying “Hello” to you later.

It is important that as you shovel, you switch sides you are using to push the snow away. So, try taking 3-4 pushes with the shovel to your right then switch your hand placement and do 3-4 to the left.  This works especially well if you are clearing off a light snow. For heavier snow which will require some lifting of the snow out of the way, alternating sides still is appropriate.  However, remember to bend your knees while lifting the snow and not to twist your body to dispose of the snow in another area. The easiest way to accomplish this is by not loading up your shovel with lots of snow but take smaller scoops that are more manageable.

One final technique that may help prevent some uninvited back pain is to make multiple trips to shovel over the course of the snowfall versus waiting till the last snowflake hits the ground! Now, don your gloves, put on your boots, clear all the snow safely and keep thinking Spring is just around the corner!

For additional information or what to do if back pain does say “Hello” to you after shoveling, contact me, Kelly Slocum, MPT, or any of our physical therapy staff at The Center For Joint Surgery and Sports Medicine at (301) 665-4575.

Stretching in the New Year!

ImageAs we begin the New Year and look to restart or accelerate our exercise program, stretching and flexibility often take a back seat to our exercise routine. We look at stretching as something to be done if we have a few minutes before starting our weightlifting, walking or running but certainly not the main focus.

Studies looking at stretching as a means of improving athletic performance have mixed results, but I’m convinced based upon my 27 years of Orthopaedic experience that stretching does decrease the risk of athletic and work-related injury. By maintaining a full range of motion through our joints we allow our body parts to work smoothly, effortlessly and efficiently.

As we get older our flexibility decreases due to muscle and tissue aging. Along with that, our reaction time slows increasing our risk of injury and falls. Putting this all together we can see that flexibility programs become even more important as we age. Whether we perform specific stretches or become involved in programs like Yoga or Tai Chi, maintaining flexibility enables us to age gracefully. Although there are certain defined benefits of maintaining muscle strength through exercise, is my opinion that as we age, it is maintenance of flexibility that helps the most in preventing injury The additional benefit of flexibility programs is that they also provide the opportunity for mental focus.

A few minutes spent with a daily flexibility program can return years of improved health and mobility. Flexibility exercises don’t require expensive equipment, travel to a gym or fancy gym clothes. They can be done in the privacy of your own home in just a few minutes. Take charge of your life and get those joints moving!

If you’d like to have a copy of a recommended flexibility program, contact me at DrRalph@thedoctorsin.net


Do you have a sports injury? Would you like to be seen by one of our doctors? Call our office in Hagerstown, Maryland at 301-665-4575 or visit our website at hipknee.com to request an appointment!