The Power of the Stick: Rehabbing Lacrosse Injuries

By: Kate Saccocci, PT, DPT


Lacrosse is one of the fastest-growing sports in the United States today. An article from the Healio Orthopedics Journal in 2007 states that the overall growth rate since 2003 has been 41%. Since 1995 the number of varsity high school teams in the U.S. has grown 200%. With such a fast growth in popularity, orthopedic surgeons as well as physical therapists will be called to treat patients with injuries that are unique to the game.


According to the NCAA, lacrosse is considered a “collision sport”; however, it has a lower reported injury rate compared to other intercollegiate collision sports. Lacrosse has been rated as seventh overall in game injury rate. It has been reported that most injuries above the waist are due to direct trauma, whereas injuries below the waist are the result of non-contact mechanisms, cutting, pivoting, or rolling. According to the NCAA, the most frequently injured body parts are the ankle, upper leg, and knee, which when combined, account for 48% of injuries in lacrosse.


Physical therapists have unique and effective exercises that are utilized to rehab any lacrosse injury from head to toe. Due to the nature of the game, every player carries and uses his or her stick, which can often be incorporated in rehab. While playing on the field, an athlete uses the stick to check, throw, pass, catch, shoot, block, guard, or push, which limits upper-body strategies for maintaining balance during locomotion. A study from the Experimental Brain Research Journal suggests that  “…whole-body balance corrective strategies employed during walking are selected based upon the demands of the general features of the task, but that components of the strategy are scaled according to the specific context-dependent needs of the task.” This article validates the use of a lacrosse stick in later stages of lower-extremity rehab, to increase balance and joint preconception when sport-specific activities are being strengthened. Increasing upper-extremity stick skills can help to improve reaction and balance for lower extremities based on the specific task being performed, whether it’s passing, catching, or shooting.


Physical therapy programs are individualized to a patient’s specific goals, including the timeline for a return to the sport and athletic competition. At Sports PT, we utilize evidence-based strategies and exercises to optimize physical performance. As the sport of lacrosse grows in popularity, so will our knowledge and expertise in treating and returning players to the game.



Barefoot And “Minimalist” Running: Is It Right For You?

By James Maska, SPT


“Way before we were scratching pictures on caves or beating rhythms on hollow trees, we were perfecting the art of combining our breath, mind, and muscles into fluid self-propulsion over wild terrain.” – Christopher McDougall


Humans have been accomplished endurance runners since the time we were forced to hunt and gather our food for survival. It wasn’t until the late 1970s that the running shoes we see today began to surface. Before this time, humans essentially ran in thin-soled, flat footwear, or even on our bare feet.


Over the last few years, there has been plenty of discussion regarding barefoot and “minimalist” running. It is obvious that running barefoot, for most of us, is out of the question. After relying on our shoes for most of our lives, our feet would not be able to withstand that kind of wear and tear. So the question becomes: Is a minimalist shoe right for me?


If you go outside and run barefoot, you will see that you land much more softly, and likely on the middle or ball of your foot. When you use traditional cushioned running shoes, you’ll find yourself landing on your heel with each stride. In this position, your foot lands typically lands in front of your knee. With a midfoot or forefoot strike, your feet tend to land under your hips, and your body leans slightly forward as a result. You’ll also run with a shorter stride.


A Harvard University study shows that forces are three times greater when the foot initially hits the ground when landing on your heel versus on your forefoot.1 Another study has shown that reducing your stride length by 10% decreases risk for a stress fracture for runners who run up to 49 miles per week.2 Perhaps the most telling research to this date shows less force going through the knee and hip joints with a forefoot strike.3 Although the joints of the lower body are under less stress, there is an increase in force at the ankle with a forefoot strike, and caution must be taken to avoid stressing this area too much during a transition.


There is no research to say running form is better than another; however, studies are beginning to show the positive effects of running with a more “natural” stride. If you’re tired of running injuries and haven’t had luck getting rid of them, perhaps a change in form is something to think about. With the help of a PT, you can get yourself on the path toward running without pain, whatever that path may be.




  1. Lieberman, D. E., Venkadesan, M., Werbel, W. A., Daoud, A. I., D’Andrea, S., Davis, I. S., . . . Pitsiladis, Y. (2010). Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature, 463(7280), 531-535. doi: 10.1038/nature08723
  2. Edwards, W. B., Taylor, D., Rudolphi, T. J., Gillette, J. C., & Derrick, T. R. (2009). Effects of stride length and running mileage on a probabilistic stress fracture model. Med Sci Sports Exerc, 41(12), 2177-2184. doi: 10.1249/MSS.0b013e3181a984c4
  3. Williams, D. S., Green, D. H., & Wurzinger, B. (2012). Changes in lower extremity movement and power absorption during forefoot striking and barefoot running. Int J Sports Phys Ther, 7(5), 525-532.


5 Health Tips For Your Next Plane Ride

By: Alanna Pokorski, PT

Planning a spring getaway? Here are some quick tips to keep in mind while on the plane:


1. Hydrate, hydrate, hydrate! Drinking 8-10 glasses of water per day is recommended especially when going on an airplane. Airplanes are very dry and you don’t want to kick off your vacation with dehydration (muscle cramping, headaches, body aches, nausea).


2. Bring a travel pillow. Airplane seats are certainly getting more comfy. However, when you’re resting on a plane, your neck needs more support to prevent the “neck flop”. A travel cervical pillow keeps your neck and mid-back in good alignment as you dream of your vacation plans. Don’t forget your kids either! Their little necks need support as well.


3. Minimize swelling. Move your ankles and feet in fun alphabet shapes randomly throughout the flight. This will help decrease any swelling that can occur in your calves, especially if you struggle with circulation.


4. Straighten up! Take that extra sweater you have and carefully roll it into a log shape. This will serve as a “lumbar roll” for your low back during the flight to maintain good seated posture.


5. Balance That Luggage. When carrying your luggage, keep it symmetrical on both sides of you, if possible. Maybe carry one bag on one shoulder and one suitcase in the other hand. This will help keep your spine straight as you walk (or run) through the airport.





Preventing ACL Injuries in the Female Athlete

By: Josh Fede, SPT

In my short time in the field of physical therapy, one of the most common injuries in the orthopedic and sports arena are ACL ruptures in female athletes, mainly in the age group of high school to college. Most recently, Olympic alpine skier Lindsey Vonn suffered a reinjury of her already repaired ACL. Hewett, Meyer, and Ford report that females are 4-6 times more likely suffer ACL injuries in landing and cutting sports compared to their male counterparts, and conservative estimates range between $17,000-$25,000 for surgery and rehabilitation per injury.1 We can see not only a financial burden that this kind of injury can have on a patient, but also loss of participation in sport, losing a scholarship opportunity, or even the emotional effects of having a surgery.


The mechanisms of ACL injuries between sexes are roughly the same, but makes women more susceptible? For the sake of this post, the intrinsic factors will be discussed and how to prevent injuries.




  • Shape of the Pelvis: Women have a wider shaped pelvis which changes the dynamics of biomechanical control compared to men.
  • Hamstring Flexibility: Women tend to be more flexible than men, thus leading to a lack of control of the knee during activity.
  • Hormonal: Estrogen and Relaxin concentrations peak during ovulation.
  • Decreased Neuromuscular Control: Anatomical differences, timing of muscle contractions, and laxity of ligaments leave women vulnerable.




Evidence supports plyometrics as an important part of a training program along with combination of strength, agility, and balance.2 With Spring on the horizon and preseason for fall sports right around the corner, seek the expertise of a physical therapist that can help prevent injury during the season and offseason.



  1. Hewett TE, Myer GD, Ford KR. Anterior Cruciate Ligament Injuries in Female Athletes: Part 1, Mechanisms and Risk Factors. Am J Sports Med. 2006. 34(2)299-311
  2. Stevenson JH, Beattie CS, Schwartz JB, Busconi BD. Assessing the Effectiveness of Neuromuscular Training Programs in Reducing the Incidence of Anterior Cruciate Ligament Injuries in Female Athletes: A Systematic Review.  Am J Sports Med. 2014. Published online before print. Accessed. March 9th, 2014.


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