Progress is a Process


Results. Every one wants them, and everyone wants them FAST. Time and time again I tell my patients to not get caught up with the rate of change, but rather, focus on the changes themselves.

A few years ago I discovered the motto of my life. “Progress not Perfection”. I found myself discouraged at making changes in my life because I knew I couldn’t do it perfectly. This perceived reality turned me off from even trying to change, rationalizing that it was pointless to try if I couldn’t do it perfectly. This couldn’t be further from the truth.

They say that the only way to guarantee an outcome is to never try at something. I have found this to be a profoundly true statement. Realistically, progress is a process, and to the dismay of many, not an expedited one.

Identifying progress can be a challenge for many of us. One of the reasons for this is because progress is often very subtle. We want that drastic, radical change, especially when it comes to getting healthy or losing weight, but that’s just not how it works. Because of that, it can be hard to pin point significant change, when we see ourselves day in and day out. The only encouragement I can offer in that regard is to use objective markers to track progress. Tracking your weight trends will be important, but that’s not the end all. Other markers to use are an old pair of jeans you want to fit into again, waist or hip measurements, fasting blood glucose levels and cholesterol levels just to name a few.

Ultimately, the secret to lasting change is commitment and consistency. As long as we stick to it, we will achieve the results we want eventually. It may take longer than we would have liked, but slow and steady wins the race.

By: Revolution Physical Therapy Weight Loss

Revolution Training


screenshot of the Baseball injury prevention info

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Injuries in young athletes are on the rise, but elbow and shoulder injuries in children are on the verge of becoming an epidemic. Thousands of children are seen each year
complaining of elbow or shoulder pain. Damage or tear to the ulnar collateral ligament (UCL) is the most common injury suffered and is often caused by pitchers throwing too much. This ligament is the main stabilizer of the elbow for the motions of pitching. When it becomes damaged, it can be difficult to repair and rehabilitate.


If a young athlete is throwing too hard, too much, too early, and without rest, a serious elbow or shoulder injury may be on the horizon. If the athlete complains of elbow or shoulder pain the day after throwing, or movement of the joint is painful or restricted compared to the opposite side, see a physician familiar with youth sports injuries immediately.


Overuse injuries – especially those related to the UCL and shoulder – are preventable. Some tips to keep you in the game throughout your life include:

photo: youth baseball athlete

  • Warm up properly by stretching, running, and easy, gradual throwing
  • Rotate playing other positions besides pitcher
  • Concentrate on age-appropriate pitching
  • Adhere to pitch count guidelines, such as those established by Little League Baseball (See tables)
  • Avoid pitching on multiple teams with overlapping seasons
  • Don’t pitch with elbow or shoulder pain, if the pain persists, see a doctor
  • Don’t pitch on consecutive days
  • Don’t play year-round
  • Never use a radar gun
  • Communicate regularly about how your arm is feeling and if there is pain
  • Develop skills that are age appropriate
  • Emphasize control, accuracy, and good mechanics
  • Master the fastball first and the change-up second, before considering breaking pitches
  • Speak with a sports medicine professional or athletic trainer if you have any concerns about injuries or prevention strategies


Age Pitches / Game
7 – 8 50
9 – 10 75
11 – 12 85
13 – 16 95
17 – 18 105

Source: Little League Baseball


Ages 7–16 Ages 17–18 Required # of Rest Pitches
61+ 76+ 3 calendar days
41 – 60 51 – 75 2 calendar days
21 – 40 26 – 50 1 calendar day
1 – 20 1 – 25 None

Source: Little League Baseball


Pitch Age
Fastball 8 ± 2
Slider 16 ± 2
Change-up 10 ±3
Forkball 16 ± 2
Curveball 14 ± 2
Knuckleball 15 ±3
Screwball 17 ± 2

Source: From work by James R. Andrews, MD, and Glenn S. Fleisig, PhD


The most obvious treatment for overuse is rest, especially from the activity that created the injury. Ice is also used to reduce soreness and inflammation. Ibuprofen can be taken to help with any pain. If symptoms persist, it is critical that a physician be contacted, especially if there is a lack of full-joint motion. An examination and radiographs should be done. An MRI scan may also be helpful.

Usually a simple “rest cure” approach will not be enough, because even though it allows symptoms to subside, it also creates loss of muscle bulk, tone, flexibility, and endurance. Once pain is gone and full motion is present, a throwing rehabilitation program can start.

Under some circumstances, surgery may be necessary to correct a problem. Overuse and stress related problems can affect growing parts of bone, not just the soft tissue (muscles, tendons, and ligaments). If the condition is not treated, it could cause deformity of the limb and permanent disability. The athlete should return to play only when clearance is granted by a health care professional.

From work by James R. Andrews, MD, and Glenn S. Fleisig, PhD

Preventing Re-tears of the ACL; Treating Fractures of the Hand and Wrist

Episode 15.11 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.


 Segment One: Preventing Secondary ACL Injuries

Christopher Kaeding, MD

Dr. Kaeding

Dr. Charles Bush-Joseph sitting in for Dr. Cole this week, talks with Dr. Christopher Kaeding, Professor, Department of Orthopaedics, Executive Director, OSU Sports Medicine, Head Team Physician, The OSU Athletic Department: discussion on protective ACL bracing; advancements in the potential use of meniscus replacement implants.

Dr Kaeding is a member of The American Orthopaedic Society for Sports Medicine, The American Academy of Orthopaedic Surgeons, The American College of Sports Medicine and The US Olympic Committee Sports Medicine Society and Head Team Physician for the OSU Buckeyes’ 36 varsity sports. He was the team physician for the USA basketball at the World University Games in China in 2001 and has worked with winter sport athletes at the US Olympic Training Center in Lake Placid. His research interests include stress fractures, ACL reconstruction and clinical outcomes studies. He is a founding member of the MOON group (Multi-center Orthopaedic Outcomes Network) which is a NIH funded multi-center ACL reconstruction outcomes research consortium. Having over 60 peer reviewed publications, Dr. Kaeding has made over a 100 presentations at national and international meetings.

 Segment Two: Multiple fractures of the wrist and hand

Dr. Bush-Joseph and Dr. John Fernandez from Midwest Orthopaedics at Rush, discuss treatment and return to play for athletes with fractures of the hand and definition, diagnosis and treatment for Golfers wrist.

An Ohio native, Dr. Fernandez graduated magna cum laude from the University of Akron Ohio and then graduated salutatorian from the Northeastern Ohio Universities College of Medicine in 1990. He served his residency and internship at the University of Pittsburgh Medical Center and his fellowship in hand and microvascular surgery at renowned Indiana Hand Center. Dr. Fernandez is board certified in Orthopaedic Surgery and was named a Diplomate, National Board of Medical Examiners in 1990.

The Washington Wizards guard John Wall underwent multiple examinations that revealed five non-displaced fractures in his left wrist and hand.

Wall initially felt as if he had fractured his wrist — which he said he broke in high school — when he came crashing down hard late in the second quarter of Game 1. He remained in the game and said X-rays after the game revealed no breaks. Wall also said he got two opinions on his injury and was told it was just a bad sprain. His left hand swelled up considerably after Game 1 and he was unable to get the swelling to go down significantly.

10 Tips and Tools for Gardening with Arthritis or Other Physical Limitations

Gardening has a multitude of health benefits. Since most people find enjoyment in gardening, they do it regularly without any coaxing or aiding in cardiovascular health, strength, and flexibility. One’s immunity is also boosted as skin soaks in vitamin D from the sun and healthy bacteria and microbes from the soil. Gardens are full of a variety of textures, smells, sights, and sounds which have been known to reduce stress and promote relaxation as it stimulates the brain and aids in better mental health. Lastly, we cannot forget nutrition and all the amazing vitamins, minerals, and nutrients that are provided to us when we consume all the fresh produce we harvest. It’s no wonder that gardening appeals to the young, the old, and everyone in between.

10 Tips for Gardening with Arthritis

1) Raise it up.

If you have trouble bending, why not do a raised bed, grow bags, pots, hanging baskets, or even a straw bale garden? These can all give you some height while saving your back at the same time.

2) Have your knees started to talk back to you?

Consider an elevated and cushioned kneeler/seat combo, which also has arm rests giving you some leverage for getting back up. You can also go fancy with a wheeled scooter that has a swivel seat so you minimize strain and don’t have to kneel.

3) Is lifting and carrying becoming a challenge?

If so, you may want to try a wheeled cart, wagon, or wheelbarrow to help transport your gardening supplies. Also, use those forearms for more support and keep objects close to the body to minimize strain.  Smaller loads will also make things easier.

Tips for Taking the Pain out of Gardening4) Are watering cans too much of a strain for your hands or your arms?

An easy solution is a lightweight garden hose with an attached wand, which will definitely help to decrease the workload and demand. You can also consider soaker hoses to cut down on effort as well as water usage.

5) Has gripping become a problem?

One option is to buy foam pads that you can place on your gardening tools, allowing for a wider grip should you be having issues with dexterity. You can also free up your hands by utilizing a gardening or tool belt to help carry all of you gardening accessories.

6) Is endurance an issue?

Take a moment to pre-plan before you go into the garden so you are not wasting time going back and forth to make multiple trips. Another option is to work in smaller chunks of time. Rather than spending 45 minutes in the garden. Go out for 5 or 10 minutes in the morning, afternoon, and evening gardening for a shorter duration but slightly greater frequency to conserve some energy. Work smarter, not harder.

7)  Is weeding or soil prep becoming too much of a chore?

A variety of labor saving and ergonomic tools now exist which are lightweight and longer to help maximize your reach while minimizing your effort, which you may find beneficial. Another solution is to do a thick layer of mulch with straw, leaves, or even wood chips as it inhibits weed growth, minimizes watering requirements, and improves the soil as it breaks down while attracting earthworms that help fertilize and aerate soil naturally.

Gardening4_Blog28) Are you lacking hand strength?

You may want to move away from manual shears or clippers for an electric variety requiring less effort. However, do be wary of the vibration component that could cause repetitive stress if used for too long of a duration. You can also recruit a gardening buddy to help assist with those tasks that are too demanding.

9) Is altered balance becoming a safety concern?

Why not move your garden out of the yard that is an uneven surface and onto a solid surface such as a deck, porch or patio. There is a large variety of planters, decorative pots, and grow bags which can satisfy your gardening needs but keep you safer at the same time.  You could even elevate your garden to a railing or table by using specialized planters and containers made for this purpose.

10) Feeling too ill, limited or painful to do any garden tasks?

In some instances, gardening will not be feasible at home so head out to a local park, community garden, arboretum, botanical garden or conservatory to get your fix.  You still get the beauty, serenity, and sensory stimulation without the work while creating more of a social event as you interact with other likeminded patrons or gardening enthusiasts which can still give a healthful boost to the body, mind, and spirit.

As a physical therapist and fellow gardener I hope these ideas presented help to get you back out into and enjoying your own garden or someone else’s.  If you have any other, helpful suggestions please don’t hesitate to share in the comments below.  If you are a visual person like myself then head over to Gardener’s Supply Company, one of my personal favorite gardening sites, to see actual pictures of the tools and products discussed above.  Happy gardening!

By Lori Diamos for Athletico

Athlete of the Month: Competes after Hamstring Surgery

Ray Bell, 55, of River Forest, IL, is the owner of a Chicago area printing business, a husband of twenty-eight years, the father of two daughters and a competitive athlete.

Although Ray did not start competing until his mid-forties, he now cycles approximatelyRay Bell 4,000 miles per year, in addition to swimming and running regularly. He recently placed in the top third in a Wisconsin Ironman, was a top ten finisher in his age group in the Chicago (Olympic distance) Triathlon and completed both a half and full marathon.

Ray currently trains with the Lake and Harlem Cycling Group in Oak Park and believes the strenuous exercise is both physically and mentally energizing. He also notices his thoughts are clearer and more focused after a workout.

However, after ten years of success and excellent health, Ray never expected a recreational sport injury to take him out of competition.

In the summer of 2013, Ray was water skiing near his Michigan lake home when he fell and injured his hamstring. He remembers being pulled forward and somersaulting underwater with his ski extended. He surfaced in great pain. Fearing the worst, he was anxious to get to a good doctor, so he immediately drove several hours back to Chicago.

Shane Nho, M.D.

Dr. Shane Nho

Ray went to see sports medicine physician Dr. Brian Cole of Midwest Orthopaedics at Rush (MOR) who, after a thorough exam, confirmed that he had completely detached two hamstrings tendons. He referred Ray to Dr. Shane Nho, also a sports medicine physician and surgeon at MOR. Dr. Nho recommended immediate surgery.

After a successful operation, Ray completed six months of physical therapy with an Athletico physical therapist. Dr. Nho was pleased with the outcome and explains, “He was in great shape overall and was very diligent with his rehab. Both of these contributed to his great outcome.” In fact, Ray’s recovery has exceeded both his and Dr. Nho’s expectations.

Less than a year after surgery, Ray enjoyed a cycling challenge starting in Lyon, France which finished on top of L’Alpe d’Huez in the central French Alps regularly used in the Tour de France. This ride involved a five-day trip spanning three hundred miles, ascending 30,000 feet.

Ray realized his goal to recover fully from his injury to continue competing. He is grateful to Dr. Nho who was able to successfully get him back doing what he loves.

Visit MOR OrthoCare Now to learn more or call 844 BONES DR (844.266.3737) to schedule an appointment.


screenshot of the Basketball injury prevention info

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Basketball was first introduced to the world in 1891 by Dr. James Naismith, using a soccer ball and two peach baskets. Today’s high-speed, physical sport scarcely resembles the original game. With modern basketball’s fast pace game come many opportunities for injuries. It is estimated that more than 1.6 million injuries are associated with basketball each year.


  • Ankle Sprains
  • Jammed Fingers
  • Knee Injuries
  • Deep Thigh Bruising
  • Facial Cuts
  • Foot Fractures


Ankle Sprains
Treatment for an ankle sprain involves rest, ice, compression, and elevation (RICE). The need for X-rays and evaluation by a physician is determined on aphoto: youth basketball player case-by-case basis and depends on the severity and location of pain. Pain and swelling over the bone itself may need further evaluation. An injury to the ankle in a child who is still growing could represent a simple sprain or could be the result of an injury to the growth plates located around the ankle and should be evaluated by a physician.
Jammed Fingers
Jammed fingers occur when the ball contacts the end of the finger and causes significant swelling of a single joint. Application of ice and buddy taping the finger to the adjacent finger may provide some relief and allow the athlete to return to play. If pain and swelling persist, evaluation by a physician or athletic trainer is recommended and an x-ray of the finger may be needed.
Knee Injuries
Basketball requires extensive stop and go and cutting maneuvers which can put the ligaments and menisci of the knee at risk. Injury to the medial collateral ligament is most common following a blow to the outside of the knee and can be often be treated with ice, bracing and a gradual return to activity. An injury to the anterior cruciate ligament is a more serious injury and can occur with an abrupt change in direction and landing for the jump. Although this ligament tear is most commonly a seasonending injury that requires corrective surgery, current techniques used to repair the ACL ligament generally allow the player to return to play the following season.
Deep Thigh Bruising
Treatment includes rest, ice, compression, and elevation. Commercially available girdles with thigh pads are now available for protection.

Facial Cuts

Depending on the depth of the injury, the cut may require stitches or a “butterfly” sterile tape. Ice may provide pain relief and decrease swelling. Players can return to play after all blood is removed and the wound is dressed.
Stress Fractures
Stress fractures can occur from a rapid increase in activity level or training or from overtraining. Stress fractures in basketball most commonly occur in the foot and lower leg (tibia). Once diagnosed, a period of immobilization and non-weight bearing is recommended. Return to play is permitted once the fracture has completely healed and the athlete is pain free.


  • Have a pre-season physical examination and follow your doctor’s recommendations
  • Hydrate adequately – waiting until you are thirsty is often too late to hydrate properly
  • Pay attention to environmental recommendations, especially in relation to excessively hot and humid weather, to help avoid heat illness
  • Maintain proper fitness – injury rates are higher in athletes who have not adequately prepared physically
  • After a period of inactivity, progress gradually back to full-contact basketball through activities such as aerobic conditioning, strength training, and agility training.
  • Avoid overuse injuries – more is not always better! Many sports medicine specialists believe that it is beneficial to take at least one season off each year. Try to avoid the pressure that is now exerted on many young athletes to over-train. Listen to your body and decrease training time and intensity if pain or discomfort develops. This will reduce the risk of injury and help avoid “burn-out.”
  • Talk with your coach and/or athletic trainer about an ACL injury prevention program and incorporating the training principles into team warm-ups
  • The athlete should return to play only when clearance is granted by a health care professional.

Daniel E. Matthews, MD; Jo A. Hannafin, MD, PhD – Andrews Institute