One of the most important things I do on a regular basis in the clinic is work on the basics.  To me, its extremely crucial and the difference between a successful rehab or training session, and an unsuccessful one.  I bring this up today because I recently had a conversation with a young physical therapist who was into sports rehab.  He was very eager and passionate about the importance of doing many different complex things with athletes, especially the professional athletes.  I remember having similar thoughts in physical therapy school, assuming that these pro athletes needed the most complex training out there.  After spending a few years out in the field and working on numerous professional athletes, I can tell you that this is just not the case most of the time.  

Here is my philosophy when working with high level athletes: Master the basics, know the demands of the sport (both energy system wise and biomechanically), train the movements, and know your athletes from a personal level.  By working on the basics you have to understand where I'm coming from.  So many of these incredible athletes have gotten by on their talent and playing their sport over and over again.  In addition, the amount of load and volume they get throughout the course of a season is very high.  With the intensity of their respective sports so high, why would I expect them to be able to handle very complex, hard workouts all year long?  I wouldn't and that is what drives my principles.  Every athlete is different but many of them need to build a baseline and master the basics to really excel.  Training and rehabilitation in my opinion are cohesive.  Therefore training should be a lower threshold in the beginning until the athlete has mastered the basics (depending on time of year).   

Many other factors play a role in what the higher level athletes need.  In upcoming posts I will talk about the demands of sport, training the movements, and knowing your athletes from a personal level.  

​Brian Schwabe, PT, DPT, SCS, CSCS
Board Certified Sports Clinical Specialist in Physical Therapy/Strength & Conditioning Coach/Fitness & Medical Writer
Sports Physical Therapist  in Los Angeles, CA

​Educating your patients is one of the most important things you can do as a physical therapist.  You can be the best physical therapist in the world but without proper education and communication with your patients they will never fully trust the process.  Most of our competition in physical therapy is the pharmaceutical companies.  Think about it- how many people just take a pill when they get injured?  It's easy and has been the way for a very long time.  However, if we as physical therapists can educated our patients and the general public better about what to do when getting injured then we can help so much more.  

One of the questions I get all the time from people outside the clinic is what to do when getting injured.  Many will suggest rest and ice.  Again, this is the common way of thinking for the mass but as physical therapists we know that is not always the best course of action.  We need to do a better job of educating the public so that they can understand that controlled rest becomes the norm.  In an article I was recently featured in, I explain some of the most important concepts for the general public.  Check it out below.  
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http://blog.paleohacks.com/rest-day-when-hurt/

Brian Schwabe, PT, DPT, SCS, CSCS 
Board Certified Sports Clinical Specialist in Physical Therapy/Strength & Conditioning Coach/Fitness & Medical Writer
Sports Physical Therapist in Los Angeles, CA​

​Check out the Insider Access Page for Advanced Evaluation Techniques, Manual Therapy, and Return to Sport Criteria! Board Certified Orthopedic (OCS) and Sports Clinical Specialists (SCS) give you over 70 videos, podcasts, and written criteria we use with our patients!  

I recently had a patient a few weeks ago that came into the clinic with a hip pointer.  We often do not see many hip pointers in outpatient clinics because they generally occur during sports and on the field.  For those of you unfamiliar with a hip pointer, it is basically a contusion to the iliac crest.  I've seen them typically during football games and they can be very painful.  These are injuries that often from a direct blow to the side of the hip.  

My patient was a street hockey player that had no history of hip trauma prior to his injury.  He was hit from the side during a game and fell to the ground.  He presented with lateral hip pain at the iliac crest, bruising in the quad/hip, and pain.  He did not have pain with AROM of the hip but with trunk movement.  It is important to understand that with the attachments to the iliac crest pain can occur with trunk movement or just sitting.  

So how do we treat hip pointers?  Typically rest is the most important for this type of injury.  In addition, soft tissue mobility, ultrasound, ice, and k-tape can be very useful.  With K-tape I like to use it for pain relief and feedback.  Below is an example video of how to apply k-tape to the hip for multiple conditions, including a hip pointer.  

- Brian