5 Tips To Avoid Injury At CrossFit

 By: Elizabeth A Dungan, PT, DPT


Below are five essential tips from a PT’s perspective to remember when performing your basic CrossFit movements:


1.)  CORE: From an air squat, to a heavy back squat, a power clean, to a shoulder overhead press; one’s core should always be engaged. Many CrossFit athletes feel like they activate their core, but in reality many are activating their core incorrectly or not at all. Engaging your core does not mean “sucking in.” It is about abdominal bracing. This involves activating transverse abdominus muscle, keeping the spine in neutral, and making sure the pelvic floor is strong. To active transverse abdominus one needs to draw their spine into neutral and pop their abdominal muscles outward. By palpating the top of your iliac crest or pelvis, you can feel if this muscle is harder and “turned on.” This core activation should be used with every heavy lift. This is the container that provides stability and strength to your entire body and prevents low back pain, disc problems, and lower extremity injuries.


2.)  THE SQUAT: The air squat is one of the most common movements in CrossFit. It’s important to make sure one has a proper form and doesn’t push their limits just so they can reach a new 1 rep max. When completing a squat with or without weight make sure the back is flat and low back and shoulders are not rounded at all (this is key). Keep feet are a little wider than shoulder width, feet facing forward, back and shoulders flat, hip hinge backwards (like you’re about to sit in a chair), and then bend knees (knees never over the toes). As soon as the sacrum or tailbone area starts to dip down and tuck under you, you’ve gone too far. As the sacrum tucks under you, it’s gapping your lower lumbar spinal segments and allowing those discs to be pushed outward, causing potential injury. Have a partner or coach make sure you’re performing the squat properly.


3.)  THE DEADLIFT: Similar to a squat, it’s essential to engage your CORE first. Secondly, while you’re keeping feet at shoulder width, facing forward, slightly bend knees and keep the back flat the entire time. As you lower down to grab the bar, do not round the low back or upper shoulders. Both of these could cause disc injuries to your spine or disengagement of your core due to poor posture. Once you are about to grab the bar, look down and make sure that shins are perpendicular to the floor (knees not over toes), back is straight, hinging at the hips first, squeezing glute muscles and standing up to neutral. The low back and shoulders should remain straight as a board through the movement, especially when lifting a weight that’s causing you to round your back to get the weight up. If you’re feeling soreness in your low back during the movement or a day or two after, you are not doing them properly. Hamstrings should be sore but no low back pain should be felt with a deadlift!


4.)  THE KETTLEBELL: Here, it’s important to make sure that your back remains neutral and flat and that you limit the amount of shoulder involvement during the movement. This should be a movement that the hips perform, not the shoulders or arms. To start, make sure feet are in squatting stance and the back is flat. Hips sink backwards like a mini squat, momentum is created by swinging the bell using your hips, and when the bell continues to move upward snap your hips open, squeezing the glutes and standing tall. Be careful not to round the shoulders when bringing the kettlebell above your head. Keep the neck stable when the bell is overhead and don’t shift it forward. If your back is not flat when starting, just like with the squat and deadlift, you are at risk for disc injuries. If your neck and shoulders round when weight is overhead, you’re more prone to a shoulder injury or cervical issues and pain.


Lastly, it’s important to recognize the difference between soreness and pain. Delayed onset of muscle soreness is real and natural. Recover, stretch, mobilize, and take a rest day. Form is everything, not just because it looks good, but because it is what keeps you injury free and able to stay active for years ahead.


How Many PT Sessions Are Needed To Get Results?

By: Chris Campoli, SPT


A question that invariably comes up when discussing the course of treatment with a patient is how many sessions they’ll need until they have a desired result. The first step to come up with this number is determining your diagnosis. From there, physical therapists combine their assessment of you along with their research on tissue recovery and treatment to help decide the frequency and duration of your therapy. As exercises are added to your program it is crucial that they done with good form, so the feedback and reinforcement from your therapist is vital. After a few visits, hopefully you are beginning to feel better, but this is just the beginning! Muscles, tendons, and other structures take weeks to adapt to the new stresses on your body from therapy. Often the focus is on pain, but when you begin to feel an improvement it is important to continue addressing the cause of that pain to make those positive changes more permanent.


The length of time you may need to come to PT will vary based on the injury. For a case like shoulder impingement (compression of rotator cuff), research recommends 8 weeks of therapy to allow the PT time to improve flexibility and strength as well as educate the patient on postural awareness and how to control symptoms at home. The case of a surgical procedure like rotator cuff repair with a greater amount of tissue healing may require therapy over a 16 to 20 week period, as it is key to gradually stress the tendons involved. The average frequency of physical therapy recommendations is two visits per week, however there could be a routine that consists of one visit per week or 3 visits per week, depending on the extent of injury and urgency to return to activity.


Factors that can impact the amount of time it takes for your body to adapt:


  • Physical activity level
  • Posture
  • Age
  • Diet
  • Medications
  • Smoking


It’s important to keep all of the following in mind when talking with your physical therapist about frequency and duration of a physical therapy program.



Mueller MJ, Maluf KS. Tissue Adaptation to Physical Stress: A Proposed “Physical Stress Theory” to Guide Physical Therapist Practice, Education, and Research. 

Tate AR, McClure PW, Young IA, Salvatori R, Michener LA: Comprehensive impairment-based exercise and manual therapy intervention for patients with subacromial impingement syndrome: a case series. 


How to Avoid Back Pain While Hiking This Fall

By: Steven Schuhmann, SPT


Whether you are taking a long or short hiking trip, a backpack is an essential item for carrying equipment, emergency items, or just a lunch. When I first hiked in the Adirondacks, I wore a backpack. I had no idea whether it was the right kind or if it fit correctly. By the end of the day, my shoulders and lower back were killing me. What I learned is that a poorly fitted backpack could turn a good trip into a journey filled with neck, shoulder, or low back pain.


Here are some tips on making sure your backpack fits correctly:

To maintain a proper fit and better distribute your load throughout the hike, a good backpack should include hip, shoulder, and chest straps.

Hip Belt:
 Your legs are much stronger than your shoulders. To offload weight from your shoulders to your hips, secure your backpack’s waist belt making sure the top-edge is 1 inch above the iliac crest (top of hip bone).












Shoulder Straps: Adjust your shoulder straps so there is no gap between your shoulder blades and the backpack. The connection points of your shoulder straps to the pack should begin about 2 inches below C7 or the top of your shoulders.











Chest / Sternum Strap:  This maintains comfortable positioning of shoulder straps during your hike. Adjust the straps to 2 inches below your collarbones and lightly cinch it down. Pulling tight will restrict your chest from expanding when you are breathing.












Size:  To make sure your backpack fits correctly and comfortably, it must be proportional to your torso size.  Have a friend measure along your spine from your seventh cervical vertebra (the knobby bone at the base of your neck when you put your head down) to the level of your iliac crest (the top of your hip bones).  This will ensure that your pack is a comfortable and the correct size.


Proper posturing on the trail:  When you’re wearing your backpack, your body’s center of gravity changes. To maintain proper balance, lean forward slightly by bending at the hips. If you were to stand straight up, the bottom of the pack would increase the weight placed on your lumbar region (the lower back).


Weight distribution:
 Inside your backpack, place heavier items closer to your back, leaving lightweight items to the periphery to better control the load of your pack. This will also decrease any added stress to your shoulders or lower back.












For more information on proper posturing during hiking, please contact us at info@sptny.com.


ACL Injury and Sportsmetrics

Matt Sweet MS, ATC, PTA 

Approximately 300,000 anterior cruciate ligament (ACL) tears happen each year in the United States. The cost to repair and rehabilitate this injury runs about $20,000 per person. With that in mind, Sportsmetrics was created to reduce the occurrence of non-contact ACL injuries with a scientifically proven training method.


As a certified and licensed Athletic Trainer, one of my duties is to help prevent athletic injuries. At a recent course at Cincinnati Sports Medicine, I gained some valuable tools for preventing ACL injuries and safely returning to play after an ACL repair. The good news is we are excited to start a Sportsmetrics program in the Syracuse area very soon.


So what is Sportsmetrics?


Sportsmetrics is a four-component program that takes place three days a week for six weeks total. The components include:

  •  A dynamic warm-up
  • Jump training (three phases advanced over six weeks)
  • Speed and agility training
  • Strength training


Why does Sportsmetrics work (Hewitt et al., 1999)?

  • Corrects deficits in strength
  • Decreases landing forces with jumping
  • Increases power, strength, and jump height


We are excited to develop our Sportsmetrics program in the Syracuse area so we can better the performance of the athlete while reducing costly season-ending injuries.


We trained many athletes using the Sportsmetrics program in Saratoga this summer with huge success.

Stay tuned to find out when the Sportsmetrics program arrives at Sports PT’s Syracuse location. Visit their website to learn more about Sportsmetrics.


To contact Sports PT, please email us at info@sptny.com


Want to Build a Strong Core? Meet the Slosh Pipe.

By: Dan Marmo, SPT


The importance of building a strong core and stabilization in the extremities is the guiding theme to most physical therapy programs. This is true whether you have lower back pain, neck pain, shoulder pain, or nearly any other issue.


There are many ways to accomplish these goals, many of which you may be doing in physical therapy right now. And once you reach a higher level, you’ll feel the need for more complex exercises. Introducing the Slosh Pipe.


The slosh pipe is a 5–10-foot PVC pipe filled with an amount of water that can give you an awesome workout. As the pipe moves, the water “sloshes” inside the pipe, causing an increased need for you to use your muscles to stabilize. So when those squats and lunges you’re doing get too easy, we now have a tool to make them even more challenging. Even simply carrying the slosh pipe, which typically weighs 20 pounds, is a workout in and of itself.


Examples of exercises that the slosh pipe may be used with:

  • Lunges
  • Squats
  • Bench press
  • Grip strength training
  • Simulating potential work environments


Do you think you’re up to the challenge? Come to your local Sports PT location and check it out!


Physical Therapy and Pregnancy: Meet Lisa S.

One of our patients, Lisa, was in her first trimester of her second pregnancy and having significant low back and sciatic pain down her right leg. She had a three a three-year-old son at home and went to her OB/GYN for some guidance on what to do, as she didn’t want to take any medicine.


Lisa described her pain as a 7/10 when she would get in and out of bed, pick up her son, and get in and out of a car. The pain was affecting her sleep and she wasn’t able to be a care giver for her son.


Her OB/GYN referred her that day to Sports PT of NY. The Physical Therapist evaluated Lisa and determined that her increased joint laxity was creating sacroiliac instability and putting tension on her sciatic nerve.


The Physical Therapist was able to diagnose and effectively treat Lisa within 7 visits so that she was able to restore function and reduce her pain for the remainder of her pregnancy.


Lisa was thrilled because she enjoyed her pregnancy and was educated on the exercises to reduce her symptoms as the pregnancy progressed!


As it was with Lisa, physical therapy can be a natural alternative to reducing pain during pregnancy. Contact us to learn more.


Falls Prevention and Physical Therapy: What You Need to Know

By: Dr. Aimee Alexander, PT, DPT, OCS


Have you or someone you know had a fall that caused injury? Perhaps your elderly parents or another loved one seems to be at risk for falls.



The good news: Licensed physical therapists are experts at identifying and helping to reduce the risk of falling among older adults by creating an individualized program for each person.


Did you know?

    • Falls are the no. 1 reason why older individuals lose their independence!
    • One-third of adults over the age of 65 fall each year – and less than half of these people tell anyone about it.
    • Every 29 minutes, an older adult dies from a fall
    • One out of 5 falls cause serious injury (fracture/head trauma)
    • Direct medical costs for injuries related to falls is over $28 billion annually.


Risk Factors

Most falls occur due to a combination of risk factors, and a risk for falling increases with each fall. But the overall risk can be reduced; it just requires a level of awareness and some extra planning.


Risk factors are categorized as extrinsic (environmental factors) and intrinsic (those that relate specifically to the individual).


Intrinsic risk factors may include:

  • Advanced age
  • History of falls
  • Weakness in the lower body
  • Gait abnormalities/difficulties
  • Generalized muscle weakness
  • Vision deficits
  • Postural blood pressure changes with position changes (postural hypotension)
  • Balance deficits
  • Conditions such as: stroke, Parkinson’s disease, diabetes, arthritis, incontinence (in a hurry to get to the bathroom), dementia
  • A person’s fear of falling actually increases the risk
  • Depression


Extrinsic risk factors may include:

  • Home environment: stairs, lack of grab bars in the bathroom, throw rugs, pets, dim lighting
  • Slippery surfaces
  • Polypharmacy: the more medications you take daily, the more likely your risk of falling. Certain types of medications create more risk than others (psychoactive medications such as benzodiazepines, “sedatives,” and sedating medications such as Tylenol PM, Benadryl, and any medications having anticholinergic side effects, including blurred vision)
  • Improper use of an assistive device or improper device for level of weakness/function


What can you do to reduce your risk?

  • Begin an individualized exercise program designed by a physical therapist to improve your strength and balance
  • Review your entire medication list with your physician or pharmacist
  • Have an annual eye examination and update your eyewear
  • Reduce extrinsic risk factors at home: remove tripping hazards such as clutter or throw rugs, put railings or grab bars on all stairs and in bathrooms, improve lighting in all rooms


Sports PT is committed to reducing falls in the community, and we’re proud to participate in Falls Prevention Day on Tuesday, September 23. Each Sports PT location is serving their community with a Falls Risk Assessment that week. For more information on Falls Risk Assessment in your area, please contact us at info@sptny.com.


Resources: www.cdc.gov/injury/STEADI



Are You a Runner With Knee Pain? It’s All In The Hips.

By: Sean Noonan, SDPT, CSCS


Imagine a long piece of strong plastic; together it is strong enough to withstand fair amounts of pressure. Now, anchor one end strongly and allow the opposite end to move freely back and forth without control of the forces placed on it. Over time where do you think this piece of plastic will deform or fail? Usually in the middle.  The portion that fails is your knee; the free flowing end is your hip. Without proper control of our proximal joint, the hip, other distal joints can fail without being the causation of the problem. The knee may be the painful area but it may not be the culprit. Joints that are distal and proximal to the painful joint can have a substantial effect on the area involved.


Current and emerging research has shown that various manifestations of knee pain may be a result of weak hip musculature, particularly the abductors and external rotators. Weakness of the hip abductor muscles was found in both male and female distance runners with illiotibial band syndrome when compared to their non-injured leg. Females with patellofemoral pain had lower strength measures in hip strength when compared to healthy uninjured females.


Hip strengthening exercises have been shown to assist in preventing knee pain, as well as decreasing current pain levels. Sample exercises that best activate these muscles include:


1. Single Limb Squat









2. Single Limb Deadlift









3. Single Limb Wall Squat









Visit a physical therapist; a trained movement specialist that can assist you in determining your cause of pain, proper exercise execution, and put you on a path to injury free training.



1. Ayotte NW, Stetts DM, et al.  Electromyographical analysis of selected lower extremity muscles during 5 unilateral weight-bearing exercises.  Journal of Orthopedic and Sports Physical Therapy.  2007.  37: 48-55.

2. Distefano LJ, Blackburn JT, et al.  Gluteal muscle activation during common therapeutic exercises.  Journal of Orthopedic and Sports Physical Therapy.  2009. 39: 532-540.

3. Dolak KL, Silman C, et al.  Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial.  Journal of Orthopedic and Sports Physical Therapy.  2011.  41: 560-570. 

4. Fredericson M, Cookingham CL, et al.  Hip abductor weakness in distance runners with iliotibial band syndrome.  Clinical Journal of Sports Medicine. 2000; 10: 169-175.

5. Ireland, ML, Wilson JD, et al.  Hip strength in females with and without patellofemoral pain.  Journal of Orthopedic and Sports Physical Therapy.  2003; 33: 671-676.

6. Krause DA, Jacobs RS, et al.  Electromyographic analysis of the gluteus medius in five weight-bearing exercises.  Journal of Strength and Conditioning Research.  2009.  23: 2689-2694.


The Importance of a Functional Squat

By: Matt Ryan, PT, DPT, FMSC


When I mention the word squat, what do you think of? If you frequent the gym, you may visualize a bodybuilder who loads a barbell with the heaviest weights available and then lowers his or her body as close to the ground as possible, with the hope of not collapsing under the pressure of the weight. Or you may think of some popular aerobic-type workouts, where the participants have to perform as many body weight squats, squat jumps, or other variations of the basic squat movement as possible in a short amount of time, with minimal regard for form.


But would you believe me if I said you need to squat to work in your garden? Or, that a squat is essential for helping to lift your young children into and out of a car seat? And you should definitely be squatting to get that bag of groceries from the ground to the counter. Even sitting down in a chair incorporates the basic squat movement. A functional squat is part of our everyday routine – and many of us are potentially squatting with an incorrect movement pattern. Proper mechanics of a squat require stable feet with good arch support, flexible ankles, knee stability, hip and abdominal muscle activation, and a mobile mid-spine. Asymmetries in flexibility, muscle function, and joint mobility anywhere along the line can lead to poor squat mechanics – which may become a source of pain! 1


At Sports PT, we may ask you to squat as part of an evaluation – it is a tool that helps us diagnose what is contributing to pain in your feet, ankles, knees, hips, or back2. If we find any dysfunction, we will retrain your squat mechanics as part of a comprehensive treatment plan to get you moving through the day with greater function. By incorporating a functional squat into everyday life, you may also help to prevent future recurrence of pain (especially once the snow shoveling season starts up again!). So if you are having difficulty or discomfort with daily activities around the house, at work, or with gym or sporting activities, set up an appointment at one of our convenient Sports PT locations. And don’t be surprised if we ask you to show us your squat!


Photo Source:




1. Cook, G., Burton, L., Hoogenboom, B.J., & Voight, M.  (2014).  Functional movement screening: The use of fundamental movements as an assessment of function – Part 1.  The International Journal of Sports Physical Therapy, 9(3): 396-409.

2. Butler, R.J., Plisky, P.J., Southers, C., Scoma, C., & Kiesel, K.B.  (2010).  Biomechanical analysis of the different classifications of the Functional Movement Screen deep squat test. Sports Biomechanics, 9(4): 270-279.


Attention, All Runners: What You Need To Get Through Your Next Marathon

By: Julie Randall, PT and Julie Wolfley, DPT, OCS


Whether you’re a seasoned marathon runner or a newbie, these tips will help you get through your next race.


Don’t Just Run


Incorporating a strengthening routine into your race training can improve your race result. A strengthening routine can reduce injury risk, improve your running endurance, and improve your speed. As reported by Mackenzie Lobby for Running Times, according to one study, “Of more interest to runners looking for lower PRs (personal records), however, is the fact that they identified a 2.9 percent improvement in 3K and 5K performances. That’s like going from a 13:30 5K to a 13:06.5.”


Don’t train through pain


Know when to stop if an injury creeps up, and don’t train through pain. Get it checked out early to allow yourself enough time to get back to running sooner and to prevent a major injury that could keep you sidelined for a long time.


Many physical therapists complete running assessments. An assessment can provide useful information on areas of weakness that can be worked on to reduce injury risk. New York State now has Direct Access for Physical Therapy. This allows you to see a physical therapist without having to wait to see your doctor first. Don’t wait; get yourself checked out to stay healthier on the run.


Use proper footwear


Most local running stores provide a shoe fitting service. Getting the proper footwear not only can make a big difference in your comfort level while running, but it can also also help prevent injury.


Conserve your energy


Don’t go out too fast in the first 1-2 miles, as you will need to conserve your energy to complete the race successfully. Be aware of your pace and avoid that initial rush in the beginning. It will be worth it in the end!


Try dynamic stretching before you run


Running is a dynamic activity, so avoid static (long hold) stretching prior to running. Static stretching may actually turn your muscles off. Learn how to dynamically stretch your hamstrings, quads and calves to get your blood flowing, muscles stretched out, and muscles turned on to run a great race.


Improve endurance of your butt muscles


Endurance is very important for marathon runners, and one of the most neglected muscles to be trained is your gluteus medius muscle (one of your three gluteal, or butt, muscles). If your gluteus medius is not trained for endurance, then it fatigues, which puts more stress on your hips, knee and feet. You may experience pain when your gluteus medius fatigues, as well as have to slow down your pace, which will affect your final results. Physical therapists are very good at teaching gluteus medius exercises to maximize your performance.


Following these six tips can put you on the road to a better performance in your next marathon.


1. Lobby, M. (2011, January 14).  Run Stronger, Run Longer:  How Strength Training Benefits Runners.  Retrieved from: http://www.runnersworld.com/race-training/run-stronger-run-longer-how-strength-training-benefits-runners?page=single

2. The running athlete: stress fractures, osteitis pubis, and snapping hips. (2014, March 6) Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/24587861