Pros turn to ‘posture shirt’ to help improve performance

NBA star Dwight Howard has worn one, so has Peyton Manning. Major league pitchers have worn them. NBA player Eric Gordon of the New Orleans Pelicans was wearing one last Monday when he returned from a 21-game layoff with a torn labrum. It’s a “Posture Shirt,” made by a company called Alignmed, and its job is to help keep the wearer’s shoulders properly positioned, a key to reducing fatigue.

This Shirt is the best kept secret in sports. An athletic shirt that helps the pros can make a difference for you, too. Watch the Video.


2015-01-20-alignmed-posture-shirtPosture shirts do basically the same work as kinesio tape — the black strips seen pulling Olympians’ shoulders and backs into place on the volleyball court. Unlike the tape, there’s no precise spots or application — just put the shirt on. Variable stretch sections in the back of the shirt — the company calls them “neurobands” — work on the postural muscles in the upper body, including stimulating the muscles to hold your shoulder blades pressed against your rib cage. When the shoulder blade begins to pull away from the rib cage due to fatigue, the socket in which the shoulder rotates isn’t set up right — the arm angle changes, which reduces the accuracy and power of throws while also increasing risk for injury. With the shirt on, the stretch bands encourage the shoulders to return to the correct position.

While use of the shirts by professional athletes is on the rise, people who sit at a desk all day and use a computer are actually the ideal customer, says Craig Morgan, an orthopedic surgeon in Wilmington, Del., and a doctor for the Kansas City Royals. “That’s probably 30% of America.” The garment “takes the place of Mom yelling at you about your posture,” says Tom House, a former major league pitcher and a coach at USC who works with NFL quarterbacks and professional baseball players.

Morgan says Royals pitcher Greg Holland “wears it every game.” Holland saved 46 games in 2014, posting a 1.44 ERA. One year at spring training, Morgan dropped off Alignmed garments for Royals players to try. “It’s my understanding that he put one on, and he’s never taken it off.” Morgan says he uses the shirt to rehab pitchers in the Royals organization who have strength issues associated with control of their shoulder blade – an issue that, when fatigued, can cause changes in a pitcher’s arm angle that lead to a drop in velocity and accuracy. He said he partially credits its use with the team’s low injury numbers among pitchers. In 2014, only one Royals pitcher, Tim Collins, spent time on the disabled list with an elbow- or shoulder-related injury. And he’s been able to use the shirt to maintain velocity and control where, in the past, surgery might have been needed.

“Noel Arguelles was a Cuban defector who was signed three years ago by the Royals for $7 million,” Morgan says. “He shows up at (Wilmington, N.C., the Royals’ high-A affiliate), and his first two starts were spectacular. His third start … in the third inning, all of a sudden, this guy can’t throw a strike, and he’s lost 10 mph on his fastball.” In previous experiences, Arguelles’ problem – weakness of muscles around the shoulder blade – would take Morgan about three months to rehab. By using the posture shirt, Arguelles recovered faster and pitched a complete game shutout just two weeks later.


Professional athletes tend to talk up any product they feel helps them play better, even if it invites skepticism — energy necklaces, pressure point bracelets, copper-infused elbow sleeves. And it’s not as if Alignmed garments aren’t readily available — they sell for $80 and up from the company’s website. So why aren’t the shirts better known among the general public?

Morgan says athletes, noting that the shirts’ stretchy bands have a level of compression, may be reluctant to be too public about using them, lest they run afoul of Under Armour, Nike or other major sponsors who also manufacture compression garments. The makers of Alignmed say they don’t want to compete with the likes of Under Armour. Though both types of garments feature compression, CEO Bill Schultz says the Alignmed shirts are medical devices and have been classified as such by the American Medical Association. The highest-level and most sophisticated shirt in the Alignmed line can be obtained with a prescription, and as such, the shirts have been subjected to medical studies by sports scientists as well as physical therapists and medical schools.

In one study of college and high school pitchers, Morgan found that pitchers’ accuracy can be maintained for 20 percent longer when wearing an Alignmed shirt. In another study at USC, House found an increase in accuracy among pitchers who wore the posture shirt. Morgan and House are both medical advisers to the company. Eric Cressey, the owner of Cressey Performance in Jupiter, Florida, is a baseball training specialist who works with Major League pitchers including reigning AL Cy Young winner Corey Kluber. “(With pitchers,) you have to be careful about anything that’s ‘one-size-fits-all,’ ” Cressey says.

He acknowledges a posture shirt could be good for certain pitchers with certain shoulder problems, but he thinks it’s more useful for the regular office worker. “If you were going to generalize and say, ‘You need this,’ I’d say it’d be for them … they have a lot of utility in the general population who spend too much time sitting at a computer.” Studies back up Cressey’s opinion. In a four-week study of office workers conducted at the Utilities Center for the city of Colorado Springs, those wearing the Alignmed shirt decreased their overall fatigue by 21 to 29 percent, and increased productivity by as much as 20 percent.

“If you’re sitting at a desk, working at a computer, that’s going to create a compensation that creates postural dysfunction,” says Gary Vitti, athletic trainer for the Los Angeles Lakers. “If you’re an airline pilot, if you drive a truck, if you sit in a car a lot, whatever it is … a garment like this can help you.” It also can be tiring. Posture shirts not only squeeze the wearer, the stretch bands encourage use of muscles that a person may “cheat around” if poor posture is a habit.


The reason may be as simple as time. Posture exercises or workouts attempt to overcome eight hours of poor, desk-bound posture with 10 minutes of correction – a balance that, without fixing the posture problem, is virtually impossible to overcome. The shirt evens out the clock by stimulating the muscles to practice proper position throughout the day, as House says, “reminding” your body of the neutral position “to start any movement,” an optimal position that will increase power and reduce injury risk.

That means, Vitti says, that when worn while training – whether for the NBA or for a half-marathon or just to look better – the shirt can improve most of the exercises you do, because you’re training them in the position that’s ideal for those exercises. Vitti wears a posture shirt garment while running and lifting weights, when trainers and other coaches aren’t there to correct his position. So while it’s great for training the Lakers and other pros, Vitti says, if athletes can get such benefits “as easily as wearing the correct garment, why wouldn’t everyone want to do that?”


Greg Presto, USA TODAY Sports


Photo Courtesy of the Grand Forks HeraldFor Sydney Boike, a star high school basketball player, a devastating knee injury threatened her academic and athletic goals. Averaging 19 points and 11 rebounds per game, Boike hoped to play basketball in college while she worked towards medical school.

Her orthopedic surgeon implanted a cartilage allograft in her injured knee, hoping the OATS procedure would allow Boike to return to her favorite sport.

OATS is an abbreviation for osteochondral autograft/allograft transfer system. A chondral defect is like a “pothole” in your femur. When the chondral defect is small, an autograft transfer is usually done. Autograft refers to taking tissue from your own body to “fill in” the defect.




When the defect is large, an allograft is used. This involves taking tissue from a cadaver to replace the bone and cartilage loss. It is like putting a “plug in the pothole”. Not all patients are candidates for this surgery. Contraindications include advanced osteoarthritis, rheumatoid arthritis, total menisectomy, and ligament tears. Return to activities after OATS is generally 6-9 months.



Key Points:

  • Kneecap instability can be a frustrating source of pain and limited function for the young female athlete
  • A combination of anatomic and sport-specific factors is involved in creating the instability
  • Kneecap instability can often be treated successfully without surgery but surgery may be needed for recurring instability
  • Recovery can be very long, sometimes taking six to 10 weeks without surgery and four to nine months with surgery

The kneecap can be a source of trouble for young athletes, especially girls. There are some features in a growing young girl’s anatomy that place her at risk for kneecap instability. When combined with some sports in which a high amount of twisting torque is involved we have a recipe for problems such as the kneecap partially shifting (“subluxation”) or completely shifting out of place (“dislocation”).A00707F02

In a growing girl there are changes in the shape and length of the pelvis and legs that are normal, such as a widening of the pelvis and an increase in the angle the legs form at the knees. These changes tend to cause an increase in the angle of pull on the kneecap, resulting in the kneecap sitting towards the outside of the knee.

The changes in the angles are normal but when combined with sports that require twisting of the body around the knee, it can create a situation where the normal motion of the kneecap is overwhelmed by the outward pull. The result can be kneecap instability. A classic situation that we start to see in springtime is instability of the right knee in a right-handed softball batter. Other sports where we’ll often see kneecap instability are basketball, soccer, and lacrosse.

What the athlete feels with patellar instability depends on how far out of place the patella has moved and how much damage occurred when it happened.

Some general symptoms the athlete may experience include:

  • Pain, usually in the front of the knee near the kneecap
  • Feeling the kneecap shift or slide out of the groove
  • Feeling the knee buckle or give way
  • Hearing a popping sound when the patella dislocates
  • Swelling
  • A change in the knee’s appearance — the knee may appear misshapen or deformed
  • Apprehension or fear when running or changing direction.

Treatment for kneecap instability has improved substantially over the last 30 to 40 years. Gone are the days of placing the knee in a cast, with total immobilization for perhaps 6 weeks. A recent scientific publication in the journal Sports Health outlines the changes in our treatment process for this common problem.

Nonsurgical treatment usually works for first-time patellar dislocations, but surgical treatment is recommended for first-time dislocations accompanied by cartilage injuries. Nonsurgical rehabilitation takes some time, and six to 10 weeks is common before full sports are allowed. Surgery is sometimes needed to stabilize a kneecap that repeatedly becomes unstable. The surgery can be very successful but the rehabilitation can take quite a long time. I have seen a four to nine month timeline to return fully to sprinting, twisting, and jumping sports after surgery.

By Dev Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University


Athletic Trainers: The Unsung Heroes of Sports Medicine; Advancements in Ortho Bracing

Episode 15.02 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:

Mike Gilboe, MS, ATC, Head Athletic Trainer at Lake Forest College talks with Steve and Dr. Cole about the importance of National Athletic Training Month (March) and the role of athletic trainers in Sports Medicine as the “physician extender”: interacting with the sports medicine physician to facilitate care. Discussion includes collaboration with Midwest Orthopaedics at Rush and the IATA to develop the Knees for Life program and the process of becoming an athletic trainer using as a resource.

Watch the Advocacy Video: Unsung Heroes of Sports Medicine

Michael Gilboe has been Head Athletic Trainer at Lake Forest College since August of 2001 and received his graduate degree (MS) from Illinois State University and undergraduate (BS) from Arkansas State University. Recently, appointed to the Public Relations Director position for IATA in March 2014. Michael is certified by the NATA-BOC, and is a licensed athletic trainer in the state of Illinois. He is a member of the National, Great Lakes, and Illinois Athletic Trainers’ Associations.

Segment Two:

Michael McBrayer, Senior Vice President Business Development DJO Global discusses the importance of bracing, advancements in bracing and growing use by athletes at all levels of play; Bracing to prevent injury, post-injury bracing, post-operative bracing, functional bracing, OA bracing.

DJO Global is a leading global developer, manufacturer and distributor of high-quality medical devices that provide solutions for musculoskeletal health, vascular health and pain management. The Company’s products address the continuum of patient care from injury prevention to rehabilitation after surgery, injury or from degenerative disease, enabling people to regain or maintain their natural motion.

Its products are used by orthopedic specialists, spine surgeons, primary care physicians, pain management specialists, physical therapists, podiatrists, chiropractors, athletic trainers and other healthcare professionals. In addition, many of the Company’s medical devices and related accessories are used by athletes and patients for injury prevention and at-home physical therapy treatment.

The Company’s product lines include rigid and soft orthopedic bracing, hot and cold therapy, bone growth stimulators, vascular therapy systems and compression garments, therapeutic shoes and inserts, electrical stimulators used for pain management and physical therapy products. The Company’s surgical division offers a comprehensive suite of reconstructive joint products for the hip, knee and shoulder. DJO Global’s products are marketed under a portfolio of brands including Aircast®, Chattanooga, CMF™, Compex®, DonJoy®, Empi®, ProCare®, DJO® Surgical, Dr. Comfort® and ExosTM. For additional information on the Company, please visit

         Knees For Life

Are You Overtraining?; Meniscus Tears 101

Episode 15.01 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:

Elizableth Racioppi, DPT from ATI Physical Therapy discusses Over-training with Steve and Dr. Cole: definition, symptoms, injuries; recommendations for avoiding over-training while maximizing performance.

Elizabeth received her BS and DPT from USC and participated in research at the USC Kinesiology department including injury prevention in overhead athletes. She is an APTA Credentialed Clinical Instructor and has completed APTA’s Orthopaedic Management of the Runner, Cyclist, and Swimmer.

Segment Two:

Dr. Brian Cole discusses Meniscus Tears in detail with Steve Kashul: definition, causes,difference between lateral and medial tears, relation to ACL injury, function of healthy meniscus; frequency of incidents, treatment, rehab, recovery time, potential future problems.