Pilates Program: 6-Week Program for Athletes

Pilates Program SeptemberFor young athletes, a well-rounded strength and conditioning program can improve sports performance and reduce the risk of injury.  The benefits of Pilates include improved posture, relaxation and stress management, injury prevention, increased core strength, increased body awareness, and improved recovery after injury. At CHKD, we know that cross-training and exposing children to various types of training can lead to lifelong changes.

Register at www.chkd.org/classes

Posted in Athlete, Fitness, General, Injury Prevention, Pilates, Sports Performance | Tagged , , , , , , , , , | Leave a comment

Scapular Dyskinesis: What is a SICK Scapula?

By: Sara Stites, DPT, ATC

SICK ScapulaThe scapula or “shoulder blade” is a large flat triangle shaped bone that sits on the back of our rib cage. While the scapula has only one bony attachment to the body at the clavicle, it has over 18 muscular attachments. The scapula also forms the shallow socket that our humerus or upper arm bone sits in. Proper positioning of the scapula is important in normal shoulder motion and function, especially in overhead athletes. When there is weakness or muscular imbalance around the scapula it can cause issues that may lead to shoulder and upper extremity injuries and postural dysfunction. The acronym SICK (Scapular malposition, Inferior medial border prominence, Coracoid pain/malposition, disKinesis of movement). “Dys”- alteration of “kinesis”- motion, means loss of normal control of the scapular motion. There are three different types of scapular dyskinesis.

Scapular Dyskinesis TypesType I- Prominence of the inferior medial scapular border

Type II- Prominence of the entire medial scapular border

Type III- Superior translation of the entire scapula and prominence of the superior medial scapular border

There can be multiple causes of scapular dyskinesis. They can be grouped into bony causes, joint causes, neurologic causes, and/or soft tissue causes. Bony causes can include thoracic kyphosis, clavicle fracture, or scapular fracture. Joint causes can be AC (acromioclavicular) or shoulder joint instability. Neurological causes can include cervical radiculopathy or nerve palsy. Soft tissue causes typically involve muscle inflexibility and stiffness and decreased muscular control. Risk factors for having or developing scapular dyskinesis include:

  • Intense or repetitive overhead activity
  • Overuse and fatigue
  • Direct trauma
  • Muscle strain
  • Muscular imbalance

Scapular dyskinesis can be painful by itself, or it can be a contributing factor in other upper extremity injuries including shoulder impingement, shoulder labral injuries, shoulder instability, and/or increase stress on the elbow. These types of injuries are common in swimmers, overhead athletes, and throwing athletes. Recognizing and treating scapular dyskinesis in these athletes is important to both help prevent other upper extremity injuries and also improve scapular motion and control to keep injures from returning. Physical therapy can help to address scapular dyskinesis by evaluating the athlete and determining the cause of the dyskinesis. Once the cause of the dyskinesis is determined physical therapy will work on restoring normal scapular function for optimal shoulder and scapular mobility and stability. Proper scapular mobility, stability, and control is important in everyday function of the shoulder, and especially important for overhead athletes.


Kibler et al. Clinical implicatins of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the scapular summit. Br J Sports Med 2013 47: 877-885.

Posted in General | Tagged , , , , , , , , , | Leave a comment

Basic Bike Fitting

By: Tim McDonald, PT, ATC

With summer here, and the culmination of another exciting Tour de France led by winner Chris Froome, it’s a great time to make sure you’re positioned correctly on your bike. Here are some basic recommendations:

  1. Bike Fit 1Your kneecap (the front of your knee) should be over the pedal spindle (the “axle” of the pedal) when your foot is at the 3 o’clock position of the pedal spin (pink line).
  2. With foot at bottom of spin and “ball” of foot (metatarsals) over pedal spindle, knee flexion (bend) should be 25 to 30 degrees (orange line below).
  3. Trunk angle should be 25 to 45 degrees from horizontal (yellow lines).
  4. Bike Fit 2Trunk/shoulder angle should be 90 degrees with hands on brake hoods (light blue lines).
  5. Elbow angle should be 15-25 degrees with hands on hoods (light green lines).
  6. Handlebars should be level with saddle to 4” below saddle level (bars above are below saddle height).
  7. Bottom section of drop bars should be parallel to ground or angled down 10 to 15 degrees.
  8. Knees should clear elbows by 1-2” during pedaling.


  1. Bike Fit, Arnie Baker, MD. www.arniebakercycling.com/
  2. Cycling & Physical Therapy Rehab, Erik Moen, PT, CSCS, 2006 seminar. http://bikept.com/
Posted in Bike Fit, Cycling, General | Tagged , , , | Leave a comment

Tips For An Injury Free Summer

By: Laura Clarke, ATC

School is out for the summer which means sports, camps, playing outside, and inevitably, injuries.  Here are some basic tips to avoid injuries and enjoy your summer:

Ease into it.  Know your skill level and do your best not to bite off more that you can chew.  Also, don’t forget a proper warm up and stretch prior to any activity to avoid any muscle strains or cramping.

Riding Bikes Rollerblading






Mix it up.  Try to avoid playing the same sport everyday for weeks on end.  This may be difficult with practices and tournaments, but be sure to take a break.  Go for a swim or ride your bike for some different physical activity.

HelmetsWear protective gear.  Whether you are playing a sport or having fun in your neighborhood, be sure to protect yourself.  Make sure to wear helmets, knee and elbow pads when riding your bike, rollerblading, or skateboarding.

Maintain healthy Fruits and Vegetableseating habits.  It is important to make good food decisions over the summer to properly fuel your body.  You will no longer be sitting inside for a good portion of the day but constantly moving, which means you will need energy to last throughout the day.  Try to avoid foods high in sugar that will cause a spike in energy and then a crash.  Most importantly, don’t forget to stay hydrated!

Rest.  Listen to your body and take breaks often, especially if you begin to experience any lingering aches and pains.  The more you push the more likely these little ailments will turn into bigger problems that could keep you sidelined and indoors for the rest of the summer.

And lastly, have fun!  It is your summer vacation after all!

Posted in General, Injury Prevention, Nutrition | Tagged , , , , | Leave a comment

CHKD is now offering Sports Dietitian services!

What is a Sports Dietitian?

A Sports Dietitian provides individual and group/team nutrition counseling and education to enhance the performance of competitive and recreational athletes.  Some responsibilities include counseling individuals and groups on daily nutrition for performance and health; translating the latest scientific evidence into practical sports nutrition recommendations, serving as a food and nutrition resource for coaches, trainers, and parents; providing sports nutrition education to athletic teams, and community groups; and maintaining professional competency and skills required for professional practice.

What type of nutrition service do we offer and to whom?

  • Nutrition Assessment and analysis of current diet
  • Determining  caloric needs, protein needs, hydration needs and other macro and micro nutrient needs
  • Sport related improvement through better nutrition
  • Under or over nourished athletes
  • Weight gain or weight loss
  • Body fat assessment (triceps skinfold) for athletes
  • Female Athlete Triad
  • Meal planning for athletes
  • Food/supplement selection and buying advice for athletes
  • Specialty diets (i.e. plant-based, allergy/intolerance restrictions, etc.) in athletes
  • Help to manage GI symptoms during performance
  • Recovery from injury
  • Medical condition (i.e. low iron, compromised bone health) related to poor nutrition for active, otherwise healthy, individuals
  • Specific sport (i.e. gymnastics, running, baseball, etc.) nutrition consultation

Your appointment: Typically a visit will last one hour and include Nutritional Analysis, Evaluation and a Nutrition Prescription.  Follow up is encouraged but not required. Body composition testing is available by request and will be done by skin calipers and or bio electrical impedance.

Fees vary depending on the length of visit. CHKD discounts given to self-pay patients. A one hour visit will be billed at 151.00 but patients paying on the same day of service will receive a 30% discount.  A 30 minute follow up appointment will be billed at 75.50 and the same discount applies when self paying. 

Not all insurance companies cover nutrition services. If the insurance company does not cover this service, patients will be asked to pay for services prior to their visit.

Call (757) 668-PLAY to schedule an appointment with Sue Fogarty, Dietitian at CHKD’s Primary Care Sports Medicine & Adolescent Medicine.

Posted in Athlete, General, Nutrition, Sports Performance | Tagged , , , , , , , , , | Leave a comment