Mike Reinold
@mikereinold
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DPT, ATC, CSCS, C-PS. Award winning clinician, researcher, author. Owner @championptp | Advisor @whitesox | President @aaspt_apta | Past @redsox Head ATC/PT
Boston, MA
Joined November 2008
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Note to parents: When we said youth athletes should play multiple sports and not specialize too early, we didn’t mean play all these sports simultaneously all year long.
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Nice review of biceps femoris EMG during a variety of exercises. I like graphs that show the EMG across a variety of exercises. Great info to help us with our HS strain rehab, Nordics are still impressive but this can give us a way to gradually build.
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Orthopedic surgeons know as much about physical therapy as physical therapist know about surgery.
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Had an urgent care doctor tell a high school athlete who fractured his radius skiing that he shouldn't exercise at all, including lower body, for 2 weeks to "take it easy."
Docs... why do you say stuff like this? So disappointing and a disservice to the patient.
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Nonspecific pain is common. People are often surprised that I don't stress out when I don't have a clear diagnosis.
The body is complex, sometimes all we need to do is rule out the bad stuff, then work on a checklist of what's suboptimal and symptoms resolve.
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I just sent this pic to
@APTAtweets
, it's an application for physical therapy CEU approval for 1 state, it's a 1/2 ream of paper & requires a $900 payment. And, each state is different, imagine doing this for every state? Makes no sense, we need to fix this broken CEU system.🤦♂️
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I'm excited to officially announce that I have been nominated to run for president of the
@aaspt_apta
!
The election starts in April. I'll have a ton to share but I look forward to bringing my clinical perspective as a true "sports physical therapist" to the Academy. 🙏🙏🙏
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I just spent the last 2 weeks at spring training educating players. Not evaluating, treating, or training. Sure, those happened, but when you start to see your job as empower players to optimize themselves to maximize their career, it’s amazingly more impactful.
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Here's what I think PT Students should bring to their clinical each day:
1. A positive attitude
2. Your "A" game
3. Your hustle & energy
3. A willingness to learn & be open-minded about getting every ounce of experience as you can
Other than that, maybe your lunch & a snack 😂
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A tip for new grads: Not everything new is good, and not everything good is new.
Shiny new objects are cool sometimes but don't chase them.
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Here's a little light reading for your Sunday, our phase 1 research on a 6-week weighted ball program has been published! Yup, it takes this long to conduct & publish real peer-reviewed science. Phase 2 and 3 done, coming soon!
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Some unpublished data I have worth sharing:
It takes >15% deficit in strength to detect a 4/5 on MMT for the rotator cuff. Essentially, you can have a 15% deficit in strength and still be a 5/5 on MMT which is unacceptable to me.
You need to measure with a HHD to be effective.
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New
@JSESMedia
study looked at posture & rotator cuff tears: prevalence = 2.9% w/ ideal alignment, 65.8% w/ kyphotic posture. Posture was predictor of symptomatic & asymptomatic cuff tears. How does this study fit into the pain science vs biomech debate?
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With the amount of student debt that DPT students are facing, I wish I could film their reaction when they get that first letter from their schools in the mail asking alumni for donations.
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I pride myself in making the complex simple. I feel that most people on social media try to make the simple complex.
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If I had to pick, my best advice is to always know the "why" behind everything you do. Why did you pick that special test? That exercise? That set/rep scheme?
If you don't know the answer, research it. It will challenge you to keep learning w/ an open mind.
#solvept
#dptstudent
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Just IMHO, I’m not using BFR in my baseball pitchers’ throwing arms. I’m seeing a lot of silly applications w/o considering the impact of neurovascular compression in the upper arm.
It’s great to try new things, but let’s not all blindly apply things without using our heads.
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The Difference Between Experts and Beginners. Rather that self proclaim expertise, embrace the fact that you are learning and share your journey.
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"I'm listening and learning." - Dr. James Andrews. This was probably the most impactful slide I saw at APTA CSM from my long time friend and mentor, and probably most renowned person in sports medicine history. Wish everyone on Twitter felt this way.
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Are we really returning patients back to sport too early, or are we just doing a poor job preparing them?
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Biceps Load Test - SLAP Special Test - Shoulder Clinical Examination
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The Nordic hamstring exercise < hamstring strains by > 50% in a past AJSM article. I think it really shows the importance of eccentric training in hamstring strain prevention and rehabilitation programs. What other eccentric hamstring exercises do you use?
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Wow, MLB teams still doing the sleeper stretch?
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New systematic review shows kinesiology tape does not improve sports performance:
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Here's a great tip for testing the elbow for a UCL or Tommy John injury. Try performing valgus stress testing in the prone position.
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The IR Press with Rhythmic Stabilization exercise is a great drill for people returning from shoulder instability. Here's a college baseball first baseman in the advanced phases of rehab following a labral repair.
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People are putting a lot of weight into systematic reviews because they are "level 1 evidence." There's one important thing to remember. If you put a bunch of crappy studies together, it's just one big level 1 crappy study.
#dptstudent
#solvept
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Femoroacetabular Impingement – Etiology, Diagnosis, and Treatment of FAI -
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Can You Have a Rotator Cuff Tear and No Symptoms? Sure, just build a bridge...
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The Difference Between Experts and Beginners. Rather that self proclaim expertise, embrace the fact that you are learning and share your journey.
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MAJOR ANNOUNCEMENT: Increasing fastball velocity in a pitcher leads to increased stress on their elbow. Shocker. It's amazing people are still in denial (or just avoiding the truth). Great stuff as always from
@ASMI_INFO
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Anyone criticizing the use of cupping, k-tape, ice etc in the
#Olympics
doesn't understand sports medicine.
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Really cool to be involved in the very first MLB Draft Combine. It's great to see MLB taking a page from other sports and putting on an event like this for hundreds of prospects.
Big 🙌 to MLB, USA Baseball, and all the volunteers that helped organize this event!
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Big congrats to all the
#dptstudent
passing their boards. For those that didn’t, hang in there. It’s a hard test and in no way means your a bad PT or won’t be successful. I failed my ATC boards the first time, it happens. You’ll be more prepared next time and crush it. 👊👊👊
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McMurray Special Test for Meniscus Tear - Knee Clinical Examination
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What You Need to Know About GIRD: What It Is and What it Isn’t -
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I’m not going to lie. I want to get back on Twitter more to discuss and interact with smart people. I hated all the negativity and arguing and have been using it less, but maybe I can just ignore better. What Physical Therapy hashtags are cool nowadays?
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A good tip for
#DPTstudents
: Never not know the answer to the same question twice.
It's OK to not have all the answers. But it's not OK to not seek them out.
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Wow, did you see the amazing performance by
@MileyCyrus
with
@templeofthedog
last night for
#chriscornelltribute
???
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Don’t give opinions if you aren’t BEING the example. This was a great post from
@lewishowes
. I've been seeing this a lot on social media lately. Lead by example.
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As baseball pitchers focus more on velocity over anything else, shoulder IR strength becomes important. Not only to produce velo, but also to eccentrically control layback. Here's a manual resistance drill I've been doing to work on both IR concentric and eccentric strengthening.
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Not sure if I'm more looking forward to the sun in Arizona or spending some time in our lab with
@BenHansen9
! Big year coming for the
@whitesox
👀👀👀
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The debate that "there are no bad movements" is too simplistic.
Some movements are less energy-efficient and some are more stressful. That may not be "bad" but also may not be "optimal."
The key to optimizing performance is to find that sweet spot to maximize output.
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One of the hardest things we need to do as physical therapists is to know when to push and when to back off when restoring motion after surgery.
3 things I put together to determine:
1. Tissue healing time frames
2. End feel
3. Patient guarding
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A lot of people don't focus on developing their soft skills of coaching.
For all the time we spend talking about exercise variations and periodization schemes, I sometimes wonder if developing your ability to connect with people is more valuable.
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Here's a great variation for an advanced scapula T exercise. Try the quadruped position with manual resistance and rhythmic stabilizations.
The quadruped position requires the athlete to stabilize the core and the thorax with his uninvolved arm pushing into the table.
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Coaching isn’t about just telling our athletes “what” to do, but also the “why.” The more we educate our athletes, the more they’ll improve and be an active part of the process. Do that and you’ll impact an athlete for their career, not just that day’s training session.
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Don’t give opinions if you aren’t BEING the example. This was a great post from
@lewishowes
. I've been seeing this a lot on social media lately. Lead by example.
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See many college coaches bragging about their weighted ball programs this time of year alarms me, we are in trouble.
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Want to get better in 2023?
Here are my recommendations for a simple professional development plan this year.
🧵👇
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So my kids set up a chalk dance floor on the sidewalk and put up a sign to have a doorbell camera dance off! Winner gets a roll of TP 🧻🧻🧻. We got a bunch of people doing it but this may be the best!!! 😂😂😂
#StayAtHome
#SocialDistancing
@johnkrasinski
@somegoodnews
Who says lineworkers can't dance?! When Belmont Light 1st Class Lineworker Darren Greeley saw this sign on Oliver Road, he had to stop and show off his moves. And even better, he won a free roll of TP!
#belmontma
#publicpower
#communitypowered
#PowerOn
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Stop telling everyone you're an expert and start letting people tell you you're an expert.
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Seeing a trend towards an increased incidence of Batter's Shoulder, or posterior instability. Not sure why? More offseason hitting, focus on max effort EV, one hand drills, weighted bats, etc? But something is up...
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Are Velocity Programs to Blame for the Rise in Baseball Pitching Injuries?
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Here's a good NM drill that's simple to try. By using an unstable surface and slight bend in the knee, he has to control his hip in multiple planes of motion as he performs the single leg RDL exercise. Adding multiple cones to touch adds even more challenge.
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Limited Ankle Dorsiflexion Correlates to Poor Dynamic Knee Valgus
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Our latest research on weighted baseballs has been published in
@Sports_Health
! The Acute Effects of Weighted Baseball Throwing Programs on Shoulder Range of Motion.
@LenMacPT
@ASMI_INFO
@AndrewsInst
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The conclusion of every research study should be "more research is needed." That's not a bad thing. No study ever tells you everything. We should never stop researching.
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I’m still amazed at how many young athletes are eager to go to a showcase when exhausted or even injured, then perform poorly. Seems like the quickest way to get crossed off a coach’s list.
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The Difference Between Experts and Beginners. Rather that self proclaim expertise, embrace the fact that you are learning and share your journey.
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Too many people try to simply force through poor mobility.
Jamming your shoulder or hip into end range of motion usually isn't a good idea. You're just jamming your anatomy together or facilitating compensations.
Take a step back and find what's actually limiting the motion.
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Lead by influence, not authority. Educate our professions with your knowledge, not by arguing with those that disagree. Get ahead by elevating yourself, not by bringing others down.
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GIRD is the most common issue for baseball pitchers with shoulder or elbow pain. Improving IR with the sleeper stretch and posterior capsular mobilizations is the key to reducing baseball pitching injuries.
April Fools! 😂 🤪
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Many atraumatic injuries can simply be attributed to overuse. But "overuse" is very specific to each person and their capacity. Factors that need to be considered:
1. Volume
2. Intensity
3. Frequency
4. Capacity
Don't neglect considering the person's underlying capacity.
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⚾ Big news! Our interval throwing program for baseball pitchers based on workload models is now published in
@IJSPT
!
Check it out here:
But please keep reading 🧵 👇
@KevinWilkDPT
@LenMacPT
@GlennFleisig
@DowlingBrit
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6 Keys to the Early Phases of Rehabilitation Following ACL Reconstruction Surgery
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