Author Archives: Greg Macionsky

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

Risk Factors and Prevention Strategies for Noncontact Anterior Cruciate Ligament (ACL) Injuries

One out of every 1,750 individuals between the ages of 15- 45 will suffer an ACL injury. While the total number of ACL injuries seen is greater for males, females are up to eight times more likely to sustain an ACL injury when compared to their male counterparts. So, what are some risk factors and what can be done to prevent an injury?
Currently there are several different avenues being researched to find direct links to ACL injuries. The primary risk factors that have been identified are as follows:
  1. Influence of shoe to surface interaction- There has been some problems with keeping consistent variables within this portion of research; however, there does seem to be one primary indicator. The greater the friction between the shoe surface and the ground, the greater the risk. While that information is easy to digest, it’s counterproductive to what an athlete wants/needs for optimal performance.
  2. Anatomical Risk Factors- The male and female lower extremities are built quite differently. The most commonly attributed differences to ACL injuries include increased femoral anteversion, increased Q angle, excessive tibial torsion, and excessive foot pronation. While one or all of these could be contributing factors, there has not been sufficient research to determine the functional movement effects of these differences. Joint laxity and muscular development are also commonly noted possibilities. All of the above are possible considerations; however, none of these factors have been directly correlated to in an increased risk of injury.
  3. Hormonal Risk Factors- There have been several recent research articles that have determined that female sex hormones can influence the composition and mechanical properties of the ACL. A couple of articles have analyzed the specifics of an individual’s menstrual cycle and its effects on injury risk, but there is not enough evidence to be conclusive due to conflicting results. More research is needed prior to making any conclusions specifically about ACL injury risk factors or prevention methods.
  4. Biomechanical Risk Factors- Neuromuscular and proprioceptive control are highly accepted as major factors in an individual’s risk of injury. These control both the conscious and unconscious motor units that are acting during movement and are needed for joint stability. The two primary locations of focus involve the knee as well as the hip-trunk in regards to being risk factors.
  5. Other Notable Risk Factors- From watching video and individual reports, these other risk factors include; deceleration, cutting, and poor movement quality.

Studies have shown that simply wearing a knee brace isn’t the solution, neuromuscular prevention programs are the best solution we have currently available. Ample research is consistently coming out pointing toward neuromuscular prevention programs as significantly decreasing the injury risk for individuals. A two year study of a Division I women’s basketball program saw a decrease of 89%. The techniques used in these programs are not complicated. They most often include learning proper mechanics for landing , cutting, and deceleration through drills and exercises. Kinetic offers multiple programs that offer help with injury prevention, don’t hesitate to ask about how we can help keep you, your child, or your team with a neuromuscular prevention program!


So, it’s a little over a week before District Playoffs begin, and the intensity at practice is the highest it’s been all season. Coach decides to conclude practice with a scrimmage, and it’s getting physical. It’s only practice, but you and your teammates are playing like it’s a playoff game. You advance the ball up the field and cut hard toward the goal. As you plant your right foot, you step on your teammate’s foot, and your right ankle collapses. You feel and hear a “pop”, followed by brief tingling in your foot, then intense pain on the outside of your ankle. You crumple to the ground, writhing in pain. Your teammates rush over to you, followed by the Athletic Trainer. You don’t want anyone to know how much pain you’re in, so you try to stand up, but you’re unable to put any weight through your right leg. Your teammates help you to the sideline, where the Athletic Trainer examines your ankle. After a thorough exam, she cannot be sure, but she believes your ankle is not broken, but that you have a “significant” ankle sprain. After a long night with your ankle wrapped, iced, and elevated, an AM X-ray thankfully confirms that you did not break your ankle. You lower leg is now very swollen and bruised, and you still cannot put any weight on it. How will you possibly be ready for District Playoffs in 10 days!

“I called our family doctor, and he gave me the name of a very good orthopedic specialist”, says your mom, as you hobble into the kitchen. “I made an appointment with Dr. Smith next Monday at four.” “NEXT MONDAY!” you exclaim. “But that’s not for six days, and Districts start that Friday! If I have to wait that long to see a doctor, I’ll never be ready to play!” “This doctor is the best, and it’s the soonest he can see you. We also need time because he wants you to get an MRI of your ankle.” “An MRI”, you question. “Why do I need an MRI? It’s just a sprain.” “The doctor wants an MRI before he sees you, so that’s what we’re going to do.” “Why can’t I just go see Dr. Michelle at Kinetic Physical Therapy? She’s treated me before and knows me really well.” “You have to get a prescription from the doctor before you can go to PT”, your mother reminds you. “Mom, Pennsylvania has Direct Access. I don’t need a prescription.” “Direct Access? What’s that?” asks your mom. “Direct Access means I can go see my physical therapist for up to 30 days without a prescription. And our insurance will pay for it. This way, I can get started on rehabbing my ankle right away. And I know Dr. Michelle will do everything she can to get me ready for Districts.” “Are you sure about that?” asks your mom. “Positive. You can even call Kinetic and ask.” “OK, I’ll call Kinetic right now.”

I don’t have to tell you how this story ends, but I will. You see Dr. Michelle, she evaluates your ankle, gets you started rehabbing immediately, and with her skill, your determination, and a little luck, you’re in the starting lineup for the first District Playoff game.

Yes, this story is fictional, but Direct Access is REAL. Just like you told your mom, the state of Pennsylvania has Direct Access, which allows you to see your physical therapist for up to 30 days without a physician prescription. YOUR physical therapist is a Doctorate level professional, a movement specialist, and a first contact provider. YOUR physical therapist will perform a thorough, FULL BODY examination, identify your movement impairments, and recognize any red flags that may necessitate referral to another health care provider (e.g. your pediatrician). YOUR physical therapist will then work with you to create goals that are important to you, and use those goals to develop a unique, personalized treatment plan. YOUR physical therapist has the knowledge and the skill to help you get back on the playing field and stay there. Did you know that with some common orthopedic conditions, going to a physical therapist first saves you and your insurance company thousands of dollars?

So, the next time an injury puts you on the sideline, don’t stay there long. Contact YOUR physical therapist at Kinetic. We specialize in “moving athletes back to the field”!

How Does Sleep Affect Your Performance on the Field?

We all know that exercising, eating right, and staying hydrated are important components of a healthy lifestyle; however, many forget about other important factors. With the increasing demands of school, students are staying up later and sleeping less. Sleep is an incredibly important component to a healthy lifestyle, but the majority of athletes are not getting the sleep they need. The National Sleep Foundation has developed new sleep times for children, teenagers, and adults with recommendations for 6-13 year olds sleeping 9-11 hours a night, 14-17 year olds sleeping 8-10 hours, and 18-25 year olds sleeping 7-9 hours. With only 15% of teenagers getting the recommended amount of sleep each night, we are seeing many athletes and students functioning at below optimal levels.

Inadequate sleep has detrimental effects on the body, such as: elevating blood pressure, decreasing function of the immune system, reducing memory and cognition, and increasing risk for injuries. How does this affect an athlete though? Reduced sleep also has been shown to reduce production of key nutrients needed for energy, reduces accuracy and quick decision making, increases stress, decreases focus, and limits an athlete’s ability to recover after a hard work-out or game. Getting sufficient rest could make the difference between scoring the winning goal or losing a championship game. Sleep should be a priority for all athletes and students and is something that can easily be achieved by making a few quick adjustments. Avoiding use of laptops and cell phones right before bed, stopping homework and stressful activities an hour before resting, decreasing use of caffeinated beverages/foods in the evening, and not eating within 3 hours of going to bed are easy ways to improve sleep and overall health.

Information can be found on the The National Sleep Foundation website

The Role of Hamstring Strength for the Aquatic Athlete.

Every swimmer understands the necessity for perfection in the water. The endless chase for the perfect race, where everything falls in place. This is something in the back of your head every time you step up on the block and wait for the horn. But perfection not only comes from what you do in the water, but also what you do when you are on “land”.

Strong entry and flip turns are a crucial part of success in the water. The start of every race begins with your entry off the blocks; and a key muscle necessary for a strong entry are the hamstring muscles (the muscles in the back of you legs). Unfortunately, this muscle is commonly incorrectly strengthened, stretched and utilized by athletes and coaches.

Each year we see countless athletes sidelined due to hamstring strains or “pulls.” These injuries occur when there is a large force placed on the hamstring muscle. It is commonly injured with attempting to stop quickly or applying a quick forceful contraction through your leg muscles. This can be compared to a force the hamstring endures during a block start. Learning to strengthen your legs muscles most effectively can help prevent potential injury and improve performance in the aquatic athlete.

Anatomical Synopsis:

 The hamstring group is comprised of three muscles. This muscle group connects with two joints, the hip and the knee. The most widely known action is knee bending. The other is the hip moving backward. These actions are essential for sport motions such as running, jumping and for this specific instance, flip kicks and block starts.

Anatomy Applied:

 At the start of a swimmers race, the athlete is bent at the hip and the knees. At this position the thighs and legs are fixed, allowing for the hamstring to assist in push off. When the horn is heard the swimmer will quickly bend the knees and forcefully push off the block. When this occurs the hamstring quickly goes from a slight static stretch to a forceful contraction. A similar movement is performed during a flip turn.

Commonly, the hamstring is more widely understood as a muscle that bends the knee, rather than moving the hip backward. Many coaches and athletes strengthen and stretch this muscle for knee bending. A popular stretch used prior to a completion or practice is sitting poolside, bending at the hip with knees straight and grabbing the toes. Similarly, strengthening is performed in a seated position kicking backward at the knees. Yes, these two positions are one way to strengthen and stretch the hamstrings, however both of these exercises are focused primarily at the wrong location, the knees.

The role and position of the hamstrings off the block and during a flip turn is for the hips. Strengthening and stretching the muscle group in a more sport specific motion would (in my opinion) be a more effective approach to improve sport performance and prevent muscle injury.

Sport Specific Strengthening and Stretching:

 When strengthening the hamstring for a swimmer it is important to mimic the point at which the muscle will be recruited. In this scenario, the hamstring will be recruited for max push off on the block. Therefore, strengthening the hamstrings into a backward motion is critical for carryover to the pool. Below are some strengthening and stretching exercises specific to the aquatic athlete.

Single Leg Romanian dead lift

Kneeling hamstring curl

Supine ecc hamsting

Active SLR stretch

Cable hamsting stretch.

These can be found using a simple Google search. Take a look and get back to the pool stronger and faster!


Cardiovascular Deficits After a Concussion and What That Means for Return to Play


If you ask someone what the signs and symptoms of a concussion are they may say they have complaints of a headache, nausea, dizziness, blurry vision, balance difficulties or short term memory issues. Did you know, it is common for someone with post-concussion syndrome to have deficits with their cardiovascular system, which causes poor activity tolerance? Some of these deficits include altered CO2 sensitivity, low heart rate variability, and altered blood flow to the brain. When they try to participate in physical activity that increases their heart rate it may lead to increased reports of headache, difficulty concentrating, fogginess, and nausea. Someone with poor activity tolerance has an increase in symptoms due to their altered cardiovascular system.

A physical therapist is someone who can diagnose and treat a concussed athlete with poor activity tolerance from these cardiovascular deficits. By using the Balke Treadmill test and tracking symptoms and vital signs, a physical therapist is able to appropriately prescribe an aerobic conditioning program to help get an athlete back to the field quicker.

Make sure after a concussion a physical therapist is ensuring the cardiovascular system is ready for return to play. We are the movement specialists!

5 Ways To Change The Way You Move (& to make you a better athlete)

If you’ve ever watched a child learn to crawl,  walk or develop a new skill, it’s amazing how persistent they are until they have achieved their goal.  It’s even more incredible how quickly they can master these skills and how smoothly they move in the process. As athletes, our rapid growth interferes with this innate ability to move.  Here are some suggestions on skills to practice to regain  what we lost in adolescence or to maintain it while we still have it.

1. Deep squat every day.  If you’ve ever watched a child play, they are able to hold a deep squat for ten minutes at a time.  We quickly lose this as we grow due to tight calf muscles, stiff ankles and hips,and decreased body awareness.  Start by holding onto something such as a couch or Hold deep squatchair if needed.  Gradually increase your hold time until you’re able to text, scroll through your social media feed, do homework, or make it through a whole commercial break in this position.
2. Get outside and “play”.  Kids love to be outside and practice free play.  Too often this is the part that we cut out of our lives when it gets hectic. Free play allows for improved creativity and mental/physical growth.  Every day, no matter the weather, get outside.  Take a walk as a family, swing on the monkey bars, sit and read a good book, or just enjoy mother nature’s beauty.  This helps us to reset our internal clocks and our minds as well as to help develop stability on uneven surfaces.
3.  Get enough sleep.  Children usually get 12-16 hours of sleep per day to fuel their rapid growth and development.  Obviously athletes can’t expect to get that much sleep, however 8-10 hours is recommended for adequate recovery between workouts and especially when injured. If our body and mind works hard during the day, there may not be enough blood flow to the body parts that need it for recovery.  Easier said than done? Try to avoid procrastination for a week and I bet you’ll be able to get to sleep earlier than usual.  Even 30 minutes extra per night can be helpful.
4. Spend some time barefoot.  Help to develop arch control and strength in your foot.  Shoving your foot in shoes, especially non-supportive shoes helps to undo the practice we got as kids.  Being barefoot also helps to develop the body’s natural ability to balance.
 Deep squat
5. Practice mindfulness. Kids have naps to rejuvenate  but you might not have that luxury.  Find at least 10 minutes a day to practice meditation, mental imagery, or to just let your mind wander. If you need help, search for apps that help guide this such as Headspace.
If you start to forget these things, just spend some time watching a small child.  You’ll quickly realize how fast we lose those little things which make us strong yet mobile and stable.  This is often part of what leads us down the path of injury and pain.
**Deep squat picture compliments of**

Are You Wearing the Right Sneakers?

Proper-fitting sports shoes can enhance performance and prevent injuries. Many problems in the feet can respond to stretching and conditioning, choosing a different shoe, and simple over-the-counter shoe modifications. Right off the bat let me say that Nike does not make the best shoe on the market. Nike has the best marketing team in the business, no one can argue that. If you want to know how to brand and market a business, look at Nike. But please don’t look at them for footwear. Now some people swear that Nike makes the best shoes and I am not going to argue with them. If you run in them and you have no pain and they feel comfortable, then by all means continue. However, bio-mechanically they are generally not the best for your feet. Your feet are essentially designed to do 2 things: absorb shock and act as a lift so they can push your body off the ground. In a nutshell, this is what sneakers are designed to do too.

In the beginning I stated that Nike’s were generally bad, only in the fact that most of their shoes were designed to look good and they all act as shock absorbers so when you put them on for the 2 minutes in the store they feel great. Unfortunately they just don’t feel so great after an intense workout. If you can twist or fold your shoes in half, your foot is not getting proper support and may lead to foot problems down the road. Some of the best shoes are Brooks, New Balance, Saucony and Asics. All of these brands have very good shock absorbing and stability shoes.


How can you tell what shoe is right for you? The 3 F’s of shoe selection can help you.

  • Function
  • Shoes should bend near the ball of the foot and not near the center. Also, a good shoe will not twist excessively in the center of the shoe.
  • Fit
  • Proper lacing should allow the upper to fit snuggly around foot to platform.
  • Feel
  • Shoes should be comfortable, stable, and supportive while walking and running.


***Check out the American College of Sports Medicine website for more information on finding the right athletic shoe for you!


Concussion Signs and Symptoms

As we discussed in a previous post, the mechanism of a concussion is not always immediately observable by a coach, parent, or athletic trainer.  Often the only way to diagnose a concussion on the field is from an athlete self-reporting his or her symptoms.  To ensure that an athlete is reporting a possible concussion he or she must have a full understanding of how those symptoms may present.


So what should the athlete report?

  • Headache
  • Dizziness
  • Nausea
  • Balance Issues
  • Sensitivity to light or noise
  • Feeling foggy
  • Confusion or memory issues
  • Not feeling “right”


What should parents and coaches be looking for?

  • Appears dazed or stunned
  • Is confused about assignment, position
  • Forgets plays/responsibilities
  • Is unsure of the score or opponent
  • Moves clumsily
  • Loss of consciousness
  • Shows behavior or personality changes
  • Cannot recall events prior to the hit or fall
  • Cannot recall events after the hit or fall


It is very important that the athlete, parent, and coach recognize the above signs and symptoms of concussion and immediately seek medical attention by a medical provider who specializes in the management of sport-related concussion.  If an athlete is returned to play with concussion-like symptoms he or she is at risk of suffering a second trauma that could complicate the recovery process.  Parents and coaches need be playing an active role in keeping athletes safe, and knowing what to look for after a suspected head injury is a step in the right direction.