Monthly Archives: October 2017

Jumper’s Knee for the Basketball or Volleyball Athlete

Jumper’s Knee for the Basketball or Volleyball Athlete
Written by : Dr. Paul Mackarey

As an athlete in many sports you are asked to run, cut, and jump. You ask your body to go through many different movements and forces day in and day out. We all have aches and pains, but some pains are better to be aware of than others.

Are you a jumping athlete?

Do you play basketball or volleyball?

Have you ever had pain just below your kneecap?

If you answered yes to any of these questions than this post is just for you!

Pain, ache, tenderness and/or soreness in the tendon just below the kneecap is a very common injury called patellar tendonitis or jumpers knee. Usually the pain seems to appear one day out of nowhere, this is known as insidious onset.

There are 4 stages of patellar tendonitis.  The first stage is associated with pain only after activity. It does not limit anything else that you do. The second involves pain during and after activity, however, you can still perform without limitation. The third stage is accompanied with lasting pain during and after activity and your performance starts to suffer. The fourth and final stage results in a complete tear of the tendon, which would require surgery. But don’t worry! If you are reading this, you will know what to do to help this long before you need surgery!

This type of injury is called jumpers knee because it is commonly associated with athletes who play sports that often involve jumping, like basketball or volleyball. If you play these sports, it is not uncommon to have some pain in the knees and if you start having pain at that spot below the knee, don’t worry! It is a very common injury and it can be treated with some easy exercises that you will learn today.

Patellar tendonitis has been shown to be associated with stiff ankle joints or ankle sprains (a very common injury that all basketball and volleyball players know too well). It is important not only to keep the knee strong but also the ankle strong as well. Another joint to consider is the hip and it’s strength. Your hip abductors (or the muscles along the outside of the hips) can help control and stabilize your knee when you are jumping and cause less pain.

Here are some exercises to consider:Decline Pistol Squats

Decline Pistols:

  • Stand on 20 degree slant board (or dumbbell)
  • Squat down (very slowly) with one leg, keeping knee over toe.
  • Go back up with 2 legs
  • It is OK to have 1-2/10 pain with this exerciseHeel Taps
  • Perform 2 sets of 15-20 reps.

Lateral Heel Taps:

  • Stand on step. Lower leg slowly until you tap your heel.
  • Remember to sit back and keep the knee over the toe.
  • Perform 2 sets for 10-15 reps.

Skater Squats:Skater Squats

  • Decline on one leg, bringing the backward until it taps the block.
  • Keep the knee over the toe.
  • Lunge back up with same leg.
  • Perform 2 sets for 10-15 reps.

Get Up!

By now you’re probably aware of the negative consequences of a sedentary lifestyle. For many, it’s the most detrimental health exposure faced on a daily basis. It’s an epidemic that should concern anyone invested in improving general health, fitness or movement.

Most kids probably sit more than their parents (which is saying something). A child who is stuck in a chair all day at school… And then stuck in a seat on the bus… And then slouched in a couch at home.

Today’s youth, just like today’s adults, tend to spend a lot of time at computers. Most people don’t sit at a computer in a good postural position. As we hunch over keyboards, the muscles of the front of the shoulders and chest shorten and their tension increases. Back muscles and those behind the shoulders elongate and have less tension. As we lean forward and peer into that computer screen, the same elongation occurs in the neck muscles. Together, those changes account for that hunched-over, head-thrust-forward look.

Grab a tennis ball, or lax ball and roll the front of your chest (pec muscles). Try to set a timer, every 30 minutes to remind yourself to sit up straight and pinch your shoulder blades together.

It gets worse. Having your legs bent under a desk all day shortens your hip flexors and psoas muscles, which attach to your pelvis and lower spine. That helps pull your lower back out of alignment, also affecting your posture.

Kneel in front of your desk chair. Prop one foot on the seat and pull your other leg into a half-kneel position. Slowly bring your chest up tall. You should feel a good stretch in the front of your hip-thigh.

Our children face additional challenges. Some youngsters carry school backpacks that weigh as much as 30 percent of their body weight, far too much for young muscles.

Keeping an extra set of books at home or school to help cut down on the amount of weight in your bag.

Sports Nutrition

Nutrition for the Athlete

Written by: Connor Thompson


Every serious athlete must have a daily commitment to maintaining adequate nutrition and hydration. For adolescents in particular, nutrition habits directly affect growth, development, wellness, and athletic performance. We are frequently asked questions such as these:

  • What should I eat before a practice or game?
  • Is eating time-sensitive with physical activity?
  • Should I drink water or drink sports drinks for the next game?
  • What are some healthy post-game snacks that will help muscle recovery?

There is a lot of misinformation in the media and marketplace that specifically targets young athletes. The purpose of this article is to outline some simple, evidence-based eating practices to ensure peak athletic performance. Due to the high nutritional needs, adolescent athletes must fuel their bodies frequently and consistently throughout the day. If adolescent athletes don’t eat enough, their bodies are less likely to reach peak performance and may break down muscles, rather than build up. They aren’t as fast and/or as strong as they could be. This ultimately increases the risk for fractures and other injuries.


  1. Eating Before Exercise
  • Why? Promotes normal blood glucose concentration and prevents hunger
  • What? Consume about 200-500 kcal, rich in carbs/moderate in protein, which are easily digestible
  • When? Consume meal 2-4 hours prior to activity
  • Avoid? Fatty Foods; Fiber; Energy Drinks
  • Examples? Most Breakfast Cereals with Milk; Turkey or Chicken Sandwich; Pasta with Meat Sauce
  1. Eating During Exercise
  • Why? Help refuel and keep energy levels high
  • What? 30-60 grams of carbs/hour
  • When? If activity lasts more than 60 minutes
  • Avoid? Fatty Foods
  • Examples? 16 ounces of a Sports Drink; ½ Sports bar; 1 Banana; 1 Orange
  1. Eating After Exercise
  • Why? Allow muscles to rebuild and ensure proper recovery
  • What? Water; Carbs; Protein
  • When? Consume within 30-60 minutes after activity
  • Examples? Sports Bar and Orange; Veggies and Hummus; Banana and Peanut Butter; Healthy meal rich in carbs and protein
  1. Hydration
  • Why? Even mild dehydration can affect an athlete’s physical and mental performance
  • What? WATER!! Sports drinks are not better than water unless exercising for more than 60-90 minutes and/or in hot weather
  • When? Drink water before exercise, after exercise, and every 15 to 20 minutes during exercise
  • Avoid? Waiting until you feel thirsty (thirst is a sign that you’ve been dehydrated for a while); Forcing yourself to drink more than you need (hard to run with a stomach full of water)

Kinetic offers unique additional services that focus on Sports Nutrition for adolescent athletes. Please don’t hesitate to ask us about them!


Soccer and the Concussion Dilemma: Are They Preventable?

Over the past decade, there has been a 60% increase in the number of sports and recreation-related emergency room visits due to concussions and traumatic brain injury.1  As a result, concussions are at the forefront of media coverage, prompting investigations into management of concussions at multiple levels of play.  This has also prompted a surge of research into Concussionconcussion management and prevention, including the well-known Heads Up campaign.  Concussions are highest in football and girls soccer with females between the ages of 10-19 being most at risk for soccer-related concussions.  There is minimal research to support that concussions are preventable however, there are ways to modify the factors involved in the mechanism of concussions.  Thus far, the majority of the focus has been on modifying helmets and other headgear versus within the players themselves.  The goal of this article is to educate coaches, parents, and athletes about the signs and symptoms of a concussion as well as to explain potential injury prevention strategies.

A concussion is defined as “…a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.”2  What does this actually mean? A concussion can occur as a result of a direct blow to the head, face, neck, or any other part of the body where the force is transmitted to the head. This usually occurs during sports or as a result of a fall or car accident.  This trauma usually results in short-lived neurological symptoms (headache, dizziness, tingling, numbness, vision changes) that typically resolve quickly on their own.  These symptoms reflect a change in function of the brain but usually do not cause an injury evident on imaging.  Basically, a decrease in blood flow to the brain causes an energy crisis.  With exercise, blood is pulled away from the brain to support the lungs and muscles that work to sustain activity.  Therefore, if an athlete attempts to return to sport before their brain heals, too much stress is placed on the brain.  This can cause continued symptoms and place the brain at risk for further damage including Second Impact Syndrome.

Symptoms of a concussion may include: loss of consciousness, confusion, headache, dizziness, nausea, vomiting, loss of memory from before or after the injury, mumbling, drowsiness, blank stares, personality change, irritability, mood swings, exaggerated emotions, seizures, poor performance on the field, unsteady gait, poor balance, slow speech, poor coordination, difficulty concentrating, ringing in the ears, double or blurred vision, sensitivity to light or sound, feeling mentally foggy, and numbness or tingling.  If any of these signs or symptoms are present in an athlete after a blow to the body or head, the athlete should be removed from play until cleared by a medical professional specializing in concussion management.  Never return an athlete to play on the same day.

Recovery from a concussion varies.  The metabolic dysfunction (change in blood flow) that occurs in the brain after a concussion is commonly present for up to two weeks.3  About 80% of high school athletes recover within 3 weeks which means the remaining 20% of these athletes have continued symptoms lasting longer than 3 weeks (protracted recovery).Recovery may be longer in athletes with: memory loss, confusion, loss of consciousness, dizziness, and vomiting after the concussion as well as those athletes with a pre-existing learning disability, prior concussions, migraines, younger age, and athletes who tend to over-exert themselves.3

Many important factors may increase the likelihood of suffering a concussion in soccer and therefore, prevention programs should aim to modify these factors.  Females are more likely to sustain a concussion due to differences in head-neck strength as compared to males.  However, this being said, females are also more likely to report their symptoms.2,3  There is an increased risk of concussion in the 10-19 year old female soccer athlete since they start to compete at a higher level but have not yet developed the strength and awareness to control their body.1  Core strength is vital to head control and far too often, developing the correct kind of core strength is overlooked in modern day training regimens.  The core must have good strength as well as endurance to help stabilize the hips, shoulders, and head during contact, especially in soccer.  Many athletes attempt to complete exercises that are too difficult, resulting in loss of form and control. Often these athletes must go back to the basics of core strengthening prior to completing more advanced exercises.   It is vital to maintain a neutral spine at all times during exercise.  The chin should be tucked, pelvis should be in neutral, core should be drawn up and in, and shoulder blades should be lightly pinched.   The deep cervical spine neck flexors are the most important component in neck stabilization during head contact, and unfortunately, one of the most poorly recruited muscle groups.  Strategies to correct this are listed in the exercise table.  By improving core muscle timing, strength, endurance, and recruitment patterns, decreased strain is placed on the head and neck, and therefore the brain during repeated contact in sports such as soccer.

Another important factor in concussion prevention is visual tracking and postural awareness.  Soccer athletes must be able to dribble and kick a ball while accelerating, decelerating, changing direction, cutting, and heading a ball.  They must be able to follow the ball effectively with their Postureeyes and head while paying attention to their surroundings.  Often times when young athletes attempt to head a ball, they are somewhat hesitant, forgetting to protect their head by putting their elbows up.  Occasionally, they will even close their eyes prior to the time of contact.  This loss of visual control and awareness may increase the likelihood of head contact with another player.  Improved education about correct heading mechanics as well as practice to improve visual tracking will only make for a better soccer player.  Some strategies to improve visual tracking are listed in the exercise table as well.  Improved visual tracking may decrease the likelihood of concussions in youth soccer by improving an athlete’s body awareness, heads-up play, and ability to brace their body with contact.

Although many other strategies exist for potential concussion prevention, the main focus should be on improving core strength and control as well as visual tracking.  As young athletes grow, their ability to stabilize their body rapidly decreases, placing them at risk for a multitude of injuries.  A few simple changes to strength and conditioning regimens may be enough to decrease the risk for concussions.  A number of additional strategies for decreasing the likelihood of concussions are listed below.

Concussion injury prevention strategies:

  • Know the signs and symptoms of a concussion: The sooner an athlete is removed from play, the more likely they are to recover. Remember, just because they didn’t get “knocked out”, doesn’t mean they don’t have a concussion.
  • Play heads up soccer: Always watch the play happening around you, even when you aren’t involved. Concussions occur when an athlete is unable to effectively brace their head and neck.
  • Posture: Keep your head in a neutral position especially when heading the ball.
  • No blindsiding: Don’t hit people who can’t see you as this is dangerous to both athletes. Promote fair play and clean body contact from your teammates and opponents.
  • Avoid excessive contact at practice: This decreases the unnecessary force through the brain because as few as 50-60 blows to the head per week may lead to a change in brain function.
  • Heading the ball: Maintain good posture (chin tucked) while heading the ball.
  • Complete an injury prevention program: Improving your posture, awareness, core strength, and visual tracking may decrease your likelihood of concussion.
  • Improve your visual tracking: Just like any other muscle in the body, the eye muscles require use and exercise to get stronger. There are many exercises to improve your visual tracking.  An easy way is to start tracking the ball with your eyes every time you receive a pass, kick the ball, during throw-ins, or if you go up for a header.  Writing a different number on each of your practice balls and having the player call out the number as the ball is being passed to them is one unique way to train this.
  • Develop core strength: A strong core (including hips, shoulders, neck, and abs) helps to stabilize your head during contact, thus decreasing the strain through your neck and brain with contact.
  • Improve your conditioning: The better your conditioning, the less likely you are to place your body into poor situations. You must be able to stabilize your body during all athletic activities.  As fatigue increases, body control decreases, increasing your likelihood for injuries such as ACL tears and concussions.  Cardiovascular fitness, flexibility, strength, agility, power, balance, and control are all important to injury prevention.
  • Correct your asymmetries: Have a medical professional assess side-to-side differences with strength, flexibility, and posture to prevent injury.
  • Cross-train: Find an activity or sport outside of soccer that you enjoy and do it! Playing soccer all year without a break or change in training leaves certain muscle groups weaker.
  • Growth and development: If the athlete is smaller (especially pre-pubescent females with longer necks) but plays against larger athletes, consider activity modifications until adequate strength develops.
  • Nutrition and hydration: The better your nutrition and hydration, the more likely your brain can prevent and recover from a trauma (including smaller, repeated traumas).
  • Skip the head gear: Understand that headgear may or may not prevent concussions (the research is mixed). Often athletes feel invincible with more protective equipment, which may leave them more vulnerable.
  • Advocate for rule changes: Children are not “little adults” and therefore should not play with the same rules as adults.
  • ImPACT testing: Remember ImPACT tests are of little value without baseline testing. Consultation of a skilled professional is also needed to interpret the results.

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Figure 1 credit to:

Figure 2 credit to:

  1. Concussion in Sports and Play: Get the Facts. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.  2011.  Accessed 2/20/2014.
  2. McCrory P, Meeuwisse W, Johnston K, et al. Consensus Statement on Concussion in Sport- the Third International Conference on Concussion in Sport Held in Zurich, November 2008. Br J Sports Med.  2009; 43 (suppl 1): i76-i90.
  3. Sabini RC, Reddy CC. Concussion Management and Treatment Considerations in the Adolescent Population.  Phys Sportsmed.  2010; 38 (1): 139-146.

Written by Michelle Feairheller