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Baseball Archives » Physical Therapy Clinic | CA | ReVITALize Rehab Club

Physical Therapy Clinic | CA | ReVITALize Rehab Club

Category: Baseball

  • 8 Effective Stretches for Loosening Up Tight Hips

    Does pain prevent you from doing the things you love? If your lower back, knees, or ankles are constantly aching, you could have tight hips. The number one cause of hip tightness is sitting still, a habit that is hard to avoid in today’s world. 

    If you spend many hours at a desk, in a car, or in front of the television, it’s important to make time for movement. Waking up your hip flexors will relieve pain and help you get back to enjoying your favorite activities. 

    Are you wondering how to release tight hips? Practicing a series of yoga-inspired hip flexor stretches daily is a great idea.

    Keep reading to learn more about the hip flexors and 8 effective stretches for loosening up tight hips. There’s no equipment required, so try these movements anywhere! 

    What Are Hip Flexors?

    Your hip flexors are a group of muscles that connect your upper legs to your hips. They help you walk, kick, bend at the waist, and swivel your hips. 

    Tightness in the hip flexors and related areas of the body is often caused by a sedentary lifestyle. Pain is a signal that you need to take better care of your body by exercising and stretching every day. 

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  • Patterns & Pain, Stability & Mobility, What do They Have in Common?

    Welcome to another article written by intern Marvin Perkins during his mentorship at ReVITALize Rehab Club. The topic at hand is to determine which factor is important during your physical therapy rehabilitation or sports medicine performance enhancement experiences. This complex but crucial topic was meaningful for Marvin since he was dealt with a common but under-managed sports injury. As a collegiate sports athlete, we felt it was fitting for him to learn more on building movement from a foundation of mobility and stability.

    Hope you enjoy his article. Share your thoughts about your injury.

    Medicine is often viewed as a parts-based system. While that may be true to a certain extent, in reality, patterns often play as large, or a larger factor in medicine than most individuals realize. What does that mean? I will explain it. On the day to day, medical professionals see athletes or individuals come in with all sorts of complaints. It can be seen they are well versed in the anatomical parts that are creating the issue for them. However, when it pertains to function, they are less educated.

    For example, a woman might come into the office and say, “Hey Doc, I am having pain in my knee, I think it is just deteriorating due to all my years as a powerlifter.” In my case, I once strained my quadricep during a track meet in the spring of 2019. I went to a Physical Therapist for rehabilitation, but I did not fully understand what he was doing concerning my therapy.

    When we have pain, there is a tendency to point to the part as the main issue or focus. While in some instances that may have some merit, often it can be a misleading idea. Let’s go back to the powerlifter example, she is complaining of knee pain, but the imagery shows her knee is normal. The actual problem is that she suffers from poor hip stability, which is perpetuating that knee pain. In discussing my quad, when I was attending therapy, I expected that my PT would be focusing solely on that area, which was not the case. He had me performing rehab exercises that focused on my hips, ankles, and feet.

    The point is that patterns of movements created from multiple areas largely contribute to the function of a part. Primarily people are uneducated about this aspect to misguide their thinking regarding what is wrong with them. Using a parts based perspective will not yield the desired results. On the other hand, investigating with a pattern-based perspective provides the most efficient method in seeking a part.

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  • We Got the Power! Four Power Tests Professional Sports Teams Are Using To Test Their Athletes.


    This article is designed to help you to learn the 4 power tests we use and other professional sports teams are using to assess for power. You can train hard but it may not be translating towards power. If you have to train one region of your body, which includes the upper body, spinal core, or lower body, would you know which one is holding you back? This article will help you identify this question without you guessing.

    As a provider that specializes in producing rotational power, we thought it would be nice to have one of our interns write a special article for you. Marvin Perkins Jr is not new to the idea for power. He is a college student that is aspiring to become a Sports Physical Therapist or Athletic Trainer with an emphasis on performance training. He is a college football player and track-and-field athlete himself. We taught him principles of developing power and here is his summary write up on the assessment of power.

    HOPE YOU ENJOY! Here it is below.


    People have many ideas of what power is. Some will tell you it is the abilities that superheroes have. Others will say power is another way to discuss electricity. Athletes or the avid weight lifter will likely tell you power is one’s strength. Of course, these various connotations of power are valid, but what if I were to say you have the power within you at this moment? Would you believe me if I said it is possible to test for this as well? No, the test will not uncover a superpower you never knew you had. However, the results will show whether one has low or high power. Before I further discuss the screening process for power, it is essential to understand what power is.

    To comprehend the functionality of power, we must make a quick shift to physics. I know many dread the “p-word,” so I will express my apologies in advance; however, I would not mention it. Power can be defined as the amount of work done over some time. Work can be represented by force multiplied by displacement (W= F x D). As a result, we can re-write the formula for power as P = F x D/T. The formula for velocity is displacement over time (V= D/T). Therefore, we can simplify the formula for power as P= F x V. What this tells us is that a high amount of power equates to a large force and a large velocity. Now that we have a fundamental understanding of power we can transition to testing for power.

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  • Why should eye-hand coordination matter to your spinal tension?

    Eye-hand coordination is more than the idea of see and catch. What matters to most people is to move and to perform at a comfortable level. If you look at the brain, almost a third of your mind is dedicated to using your eyes! That should give you an idea of how vital your vision systems are. As a duel Sports Medicine and Orthopedic Specialist, we have been amazed at how much lasting changes happen when we address the software (brain + mind) with the machine (human body).

    Your spinal muscles are taken for granted when you feel great. When you have tension or discomfort, we push through it, and then the discomfort goes away. When you take the body signals seriously or have a convenient time to help, the typical path is to target the neck or spinal muscles as the first-line treatment. We are here to help you understand that it may be wise to manage the body holistically, so you are not in the quick-fix trap.

    Types of movement

    There are two types of movement: power and strength versus balanced and finesse. We chose different words because we are implying movement necessary for daily and reflexive tasks. Tasks that need less cognitive thinking to execute. Then some jobs require training and different sets of skills to acquire. You might be wondering how strength is an acquired skill? You have been working on building strength your whole life. However, if you are sedentary as a child, you can still move, but lack strength. There is a lack of cognitive training to allow you to access more of the nerve to muscle connection called the motor unit.

    Yes, this is a very simplistic explanation. We can break it down into reflexive and non-reflexive. Vision helps us bring a more transparent connection and intuitive control to your spinal muscles: neck, torso, rib cage, lower back, and pelvis. You can add your hips and shoulders to this.

    Research has shown that when you need to react or quickly decide to reach or lift for something, your body reacts before moving your arms and legs!

    You have seen the athlete that moves with finesse. Think Kobe Bryant. He makes everything look easy, but when we try, we find it harder to dribble, sneak through two defenders, and know where everyone is. Your spinal muscles need to have this Goldilock phenomenon. Your lower back and hips need to contract just enough: not too strong and not too relaxed. Your next quick step forward or decision to pounce backward is executed efficiently like you have been doing this for the 1000’s of time, or clunky. His peripheral vision is clear and his ability to manipulate his body based on his sight of the vision and vice-versa is what he has mastered.

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  • Pitching with a sway and how it can impact your rotational power.

    Swaying is one of the big 12 pitching technical characteristics that OnBASE University have identified. This article will dive into what swaying looks like and what can lead to swaying. All of the identified big 12 does not necessarily equate to poor performance. But when a pitcher has trouble with consistent delivery, understanding how your physical body make-up can give you clues on why you might be swaying during the early part of your pitching sequence.  Improve your pitching rotational power by knowing if you have sway or not with this article.

    The good news is that this step-by-step article will help you tease out if you have physical mobility, stability, or pitching technique problems.  

    What is the “sway” pitching posture?

    Swaying can be seen when you look at the pitcher face-on. As the pitcher raises his front leg (“pivot” to “top of leg lift”), an energy-efficient strategy will have the pitcher’s torso be vertical or leaning forward to the inner knee of his stance leg. A pitcher will sway if they shift behind this imaginary vertical line drawn from their inner stance knee towards their head.  

    What does this mean from a physical standpoint?

    The goal of the pitching sequence from “pivot” to “top of leg lift” is to prepare and load the body to produce explosive rotational power. The power that needs to be displayed as precise pitching accuracy towards the home plate. The back stance leg sets the tone as two factors: setting up the stability of delivery and transfer the ground reaction force up to the pitching arm. The muscular or dynamic coordination of the entire stance leg, from hip to ankle muscles, will titer the torso to stand erect, swayback, or direct forward towards home plate. Two important muscles that will impact stance leg control are the Gluteus medius and Posterior Tibialis muscle. More to come on this.

    You do not want any movement “leaks” during the pitching sequence, as that will result in higher energy use. A pitcher will later be fatigue and this can cost him pitching control in later innings. They will force the throw to make up for this movement leak during the wind-up.  

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  • Early flexion in pitching and arm pain.

    12 key characteristics are described by OnbaseU that can impact a pitcher’s consistency, promote overload problems like tendinitis, and potential loss of playing time. The one pitching characteristics that this article will talk about is called Early Flexion.  

    Before we go into what Early Flexion is and the possible consequences of Early Flexion from a medical standpoint, let us establish how to best use this article. Pitching characteristics are not correlated with pitching problems or faults. You can find numerous pitchers with early flexion pattern and still excel to the level of being a Cy Young pitcher. We can strongly demonstrate that the need to show early flexion is due to compensation for a physical-mechanical or physical performance issue. The compensation will be decided necessary or unnecessary from a collection of tests, movement screen, and clinical collaboration with the team and the pitcher.

    Problem is considered a problem when it matters. What this statement implies is that if you cannot bring results, then the characteristic needs to be evaluated by your team of baseball professional providers: medical, pitching coach, and performance fitness.  

    So, what is early flexion? 

    When you take a look at a side view of a pitcher in action and freeze-frame at the Maximal External Rotation position, you will notice the spine is not in a neutral or extended spinal position. If you draw a line from the tailbone to the scapular landmark, an early flexion pattern is demonstrated as not having any open space in front of this line. The lower half of the spine is rounded while the pitcher is in the maximal shoulder external rotation position.

    Why does this matter from a medical standpoint?

    Your shoulder is naturally a joint that moves too much. The triple actions of torquing the arm into layback external rotation and subsequent act in throwing the arm fast and forward to decelerating control of the arm places the shoulder in high stress. When you calculate 1000’s of pitches over months and years, the shoulder myotendinous unit starts going into failure strain territory. Basically, your rotator cuff muscles and others cannot perform at a high level to protect your shoulder.

    The early flexion characteristics put more strain on the shoulder and elbow ligaments and passive stabilizers. Your labrum starts to tugged and strained. When you raise your arm overhead, your thoracic spine needs to naturally couple the motion with extension and rotation to the same side of the throwing arm. The combined shoulder and thoracic spine arthokinematics occur to allow efficient contraction of your rotator cuff muscles and open clearance of humerus bone on subacromial joint space. When your spine is positioned in the inefficient early flexed position, your shoulder starts to become hypermobile in the front aspect and under-recovered to the back aspect of the shoulder.

    An upright and efficiently postured hip, pelvis, and lower spine usually dictate how hard you will have to work to have a well-distributed upper body posture.  

    As a Sports Medicine Physical Therapist, we can focus on rebuilding the rotator cuff muscles and shoulder complex, but it will likely continue to fatigue from the strain of pitching. This idea goes to the elbow complex, especially the ulnar collateral ligament (UCL). The key to sustained success is to identify the reasons for the early flexion characteristics.

    What are the common mechanical faults?

    1. Lower spine dysfunction.  You lack the mobility or awareness to isolate extension to your lumbar spine, thoracolumbar junction, or lower thoracic spine and rib cage. You choose to go into early flexion because that is your only physical option.  Treatment includes getting manual therapy directed to your spine, and most importantly, upgrade your movement habit to allow non-early flexion pattern.
    2. Pelvis.  Your sacroiliac joint helps to transfer load from your legs to your spine. Your ability to bring one leg forward and one leg to trail behind requires a coordinated movement sequence conducted by the sacroiliac joint. You can have a stiff pelvis and/or uncoordinated sacroiliac region.  Treatment includes strengthening your pelvic stabilizers such as your Gluteus Maximus, Gluteus Medius, Hamstrings, Iliopsoas, and deep pelvic muscles. You may benefit from manual therapy to your sacroiliac region to allow better exercise tolerance.
    3. Hip Joint.  When your front hip cannot flex, then your pelvis and/or spine will have to make up for the hip limitations. This is commonly under-detected since the pitching characteristic is looking at the spine.  Treatment includes stretching and self-soft tissue exercises to regain hip flexion while the spine is stabilized.  

    There are other possible sources and getting a baseball pitching screen, and if there is pain involved, a follow-up Selective Functional Movement Assessment (SFMA) screen will give you a comprehensive plan of action.

    If you need an expertise to evaluate any stubborn muscle or joint tension or pain, click the orange button to get your free phone consultation or telehealth consultation with Dr Ngo. You will get a sense of what is holding you back and general guidance on what is your next best step to recovery.

    We specialize in recurrent muscle tightness and the pain the comes with it. Get your expertise second opinion with a click of the orange button below.

    CLICK HERE FOR FREE CONSULTATION WITH A SPORTS MEDICINE AND ORTHOPEDIC SPECIALIST

    One LOVE,

    Danh Ngo PT, DPT, OCS, SCS

    Doctor of Physical Therapy

    Board Certified Specialist in Orthopedic and Sports Medicine

    Onbase University Certified Pitching Specialist

    Certified Advanced Movement Specialist – RockTape

    Certified Mobility Specialist – Rocktape

    Mind Body Health Results Coach

    pulled a groin muscle

  • How does a perfect baseball pitch or hit look like?

    Who is your favorite baseball player? Pitcher? Hitter? Did you learn how to pitch or hit based on your baseball idols? When I was growing up, Nomar Garciaparra from the Los Angeles Dodgers and Boston Red Sox had a batting ritual that gave him the success he had as a Major League batter. Do you pitch like Dontrelle Willis or a Nolan Ryan? This article will dive into the core principle of perfect pitch or hit based on OnBASE University’s founding philosophy.

    Logo with a silhouette of a baseball player and 'OBU Certified' text.
    Click here to know more about OnBASE University.

    As a certified OnBASE University coach, the philosophy has resonated with the ideals of ReVITALize Rehab Club. We take everyone’s unique talent and try to get the most out of their body’s capabilities. Everyone has billions of factors that dictate their movement and health, such as DNA, structural anatomy, beliefs, sensory awareness, developmental movement, and emotional iQ, or fear-based thoughts. As there are infinite ways to play throw and hit, there is a common factor that impacts the ability to produce the best pitching and/or swinging sequence.

    Here is OnBASE University’s philosophy.  “We don’t believe there is one way to pitch; we believe there is an infinite number of ways to pitch. But we do believe that there is one efficient way for everyone to pitch and it is based on what they can physically do.” 

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  • The FOUR foundations that a player needs when using a weighted baseball throwing program.

    This article was birth out of a parent asking me to develop a program that incorporated weighted baseball. This is a tricky and hot topic currently in the baseball community. The touted benefit is the increase in throwing velocity, while the downside perception is the increased injury rate to the shoulder and elbow region. There is no debate that Tommy John surgery or surgery to the ulnar collateral ligament is on the rise. The shocking truth is that modern orthopedic medicine is full of great inventions such as othrobiologics or more accurate and better materials used during shoulder and elbow surgeries.

    As a Sports Medicine Physical Therapist with a high interest in baseball rehabilitation, I was excited and felt a higher level of responsibility to make sure I produce results without sacrificing his health. I wanted to incorporate my holistic approach that combined physical tactics with the knowledge of Functional Medicine. There are some key principles that this article will talk about that. It was what was conveyed to both the parent and client of mine.

    Before I started everything, I did not want to assume that my background was enough to ensure his physical safety. I dug to the researched and looked at the perspectives of a few of the leading baseball performance groups, such as DriveLine, OnBaseU, Cressey Performance, and a landmark research article written by my colleague Physio, Mike Reinold. There are overlapping themes that I agree with and will present in this article. 

    The overall answer with the weighted ball is that it is necessary for a player’s development.

    That being said, you need certain fundamentals before starting, and once you start, all players need to have a system that allows them to adapt and evolve due to the use of a weighted ball throwing program.

    This article is not about me telling you how many repetitions and sets you need for your weighted ball program. This article explains my logic in dosing and the holistic physical preparation that this player will need to throw successfully. I hope to show that there needs to be a sense of purpose and thought behind every exercise and baseball-related activities.  

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