Deceleration Injuries in Baseball Pitchers


In reference to a right-handed pitcher I will discuss the proper biomechanics of the pitch and likely areas to accumulate stress and strain from unlikely sources.

Have you ever thought of the left foot being the cause of right shoulder injuries such as rotator cuff and bicep tendonitis?

Have you thought of the right inner thigh as the reason for slower speed in the throw?

How important is the left hip flexibility in preventing lower back pain?

If you have ever wondered about the “Why” behind the obvious “What” please read on!

It’s easy to diagnose what the injury is (tendonitis, muscle or tendon tear, stress fracture) but how many athletes undergo thorough evaluation of why it occurred in the first place? Yes, it is true that repetitive motion can cause these things but what if there was a way to prevent or slow down the destructive process?

In a right handed thrower there are a few key points to look at in their body movement. As soon as the left foot hits the ground the maximal load is on their shoulder. It’s the point where the more length you can generate the more power you’ll have. So you can imagine if the inner thigh of the right leg or hamstring on the landing leg were at all tightened it could potentially cause an early acceleration of the trunk and throwing arm. Such timing of a highly repetitive motion can accumulate tension on the anterior (front) part of the shoulder including the bicep tendon. It can also be the cause of many side arm techniques that lead to elbow injury.

And let’s look at the landing gear! How important is the ability to balance on one leg not to mention being stable while the mass and momentum of your body spins around it!? If the arch of the foot is flat or unsupported you can see how that could impact the rest of the body in the throw. The foot itself could be the culprit in early acceleration of the arm and also faulty deceleration of the body over the landing leg. Consequently a restricted hip on the landing leg could lead to the lower back compensating that extra torque which it is not designed to do. With this understanding of throwing mechanics how important do you think Flexibility is in training!? If you aren’t currently incorporating sport specific flexibility training in your daily routine it’s not too late to start.

Dr. Donna Copertino is the Director of Back in Action: Athletic performance training center and Founder and Lead Instructor of For free Sport Specific Flexibility training we recommend or Youtube channel Standard of Flexibility

Saving our Young Athletes: Help Raise Awareness!


There is an epidemic happening in youth sports. Injuries are occurring from overtraining or in my opinion under-training in flexibility and mobility.

High School athletes account for over 2 million injuries per year! (Journal of Athletic Training) Over 500,000 sprain/strain injuries occur each year in our teenage athlete population. That’s too many!

Here are my questions:

  • Why are so many sprains and strains happening in non contact sports?
  • Can they be prevented?
  • Are athletes spending time on flexibility?
  • How many injuries have caused lost time at play?
  • How many injuries have caused a lost season?
  • How many injuries have ended a career? A college Scholarship?

If you have wondered the answers to any of these questions you are not alone. Every time I see a new athlete in my clinic I ask the same questions, what do you do for flexibility training? How often do you stretch? The answers are usually astonishing, “not much” or “only a little bit”. When I ask why not they usually tell me the coaches don’t do it because there is not enough time.

What that tells me is that either they don’t know the value of it or they simply don’t know how to do it. I have offered several times and at various locations to come into the high schools and demonstrate FREE flexibility training, even sport specific programs. Every time I get the same answer, “We already have an athletic trainer here doing that and we don’t want to step on their toes bringing in someone else”. REALLY??!!

Here’s my dilemma that I NEED your HELP with:

Help me to educate TEAM SPORTS about the importance of flexibility training. DEMAND that every sport and every team have DESIGNATED time for flexibility training.

I want to pioneer a STANDARD of Training that everyone can utilize. I don’t need acknowledgment or financial gain from this, I simply want to see less children getting injured. Our motto is simple:

Move Better. Perform Better


  1. Talk to the Athletic Director at your school and ask what their policy is on flexibility training. If they don’t have one, email me that person’s contact information so I can offer help. If they do have one, ask for a copy then send it to me for review of effectiveness
  2. Begin your own flexibility training program and see if you feel better and perform better. I have some videos posted that can give you a good start. A professional video of my Standard of Flexibility is underway currently.
  3. Make some NOISE! Start talking about this among friends, family, coaches, anyone. See for yourself how much we can improve this area of youth athletics. Comment on this Blog, share it with as many as you can and let me know how loud our voice can be.

The CRITICAL age for injury is 15 years old! I see more injuries at this age than any other. This is a pivotal age in development when growth plates begin to close and that super bendable little girl/boy who we marveled at as they never seemed to tire out suddenly feels tension, restricted motion, pain! We all know that as we get older our bodies begin to stiffen.


Truer words were never spoken. Our young athletes that we enjoy watching on the field or on the court, supporting and encouraging all the way to do their best and get better NEED our protection too! They want to please the parents and the coaches and their teammates as well as themselves. There seems to be no shortage of advice on how to get stronger and play better yet no one is saying, “Rest, Relax, Sleep, Meditate, Breathe, Stretch!”

There are many aspects to being the BEST at a sport. Just look at the entourage of people that work for Professional sporting teams. It’s a full time job being a Pro. Our children admire them and we need to too. Admire their dedication and commitment to their sport but also admire all the preparatory work that takes place too.

Our kids start young in athletics and never seem to have an ‘off season’. They play multiple sports and are on multiple teams. Their developing bodies are failing by the middle of high school where performance should PEAK not slow down.

If you agree with what I am saying and you’d like to see me develop a Standard of Flexibility Program for our youth please LET ME HEAR YOU! Comment here or send me a private message.

Let’s make a change!

Dr. Donna Copertino, DC, DACRB

Director of Back in Action: Athletic Performance Training Center

Spinal Stress Fractures in Athletes. Who’s to blame?


There is a growing concern happening now to our young athletes. Lumbar Spine stress fractures are on the rise. Who is to blame?

Stress fractures occur because of overuse and repeated tensions, usually a torque, on the bone. It can happen as a change of activity or too much of the same activity. In the case of spinal stress fractures, in the lower back, it is commonly found in athletes who use a high amount of rotation (baseball pitchers and hitters) or in those that have to quickly change direction of movement (soccer, tennis).

“In the confrontation between the stream and the rock, the stream always wins–not through strength but by perseverance.” – H. Jackson Brown

Repeated stress on a bone no matter how strong it is will eventually wear down and break. In the cases I have been seeing lately there seems to be an alarming number involving the lower Lumbar vertebrae. The parts of these bones that are breaking are a result of repeated torque or rotation of the spine caused by overuse. Normal body mechanics of the spine show that on rotation and extension (bending backwards) the vertebrae get closer together and in some cases can even touch together. In a controlled and slow manner this wouldn’t be any big deal. In the case of a gymnast who does obvious extreme back bends and tumbling repeatedly compressing these joints you might easily understand how their bones could break under the pressure. But what about the less obvious sports such as soccer and baseball/softball/cricket? What are these athletes doing to cause such compression? They are not bending backward? What can be causing their spine to over-rotate or extend? What part of their body is not working and causing the back to take up the slack?

It’s really very simple. Our bodies move in the path of least resistance. As we are growing and developing as young athletes we tend to overuse the muscles of our hips. We run and play hard and sometimes there is no “off season”. This accumulation of tension around the hips might go unnoticed in younger ages because of how quickly they grow but as we develop into our teenage years our growth slows and hormones shift and we begin to feel the tightness develop. If you are over the age of 35 now are you as flexible as you were when you were 10? Can YOU touch your toes??

As we age our tissues naturally tighten. This means we need to work a bit harder to keep or gain that flexibility. It’s NOT easy especially if you never had to do it when you were younger. If we had learned how to MAINTAIN our childhood flexibility by creating a ‘muscle memory’ for the movement stretch then it would be alot easier to feel loose today.

SO who is to blame???

I blame the HIP! Not a slacker by nature but quite the opposite, a truly hard worker. Tight hips means less motion. Less motion at the hip means less rotation. If we can’t rotate through the powerful muscles of the hip then the next closest area to help out is the lower back. Take the case of an athlete swinging a bat. It takes ALOT of rotation through the spine especially if they miss the ball! Proper body mechanics would allow the HIP to decelerate the power behind that swing and not let you fall off balance if you miss the ball. Ever hit yourself in the back with the bat as you finish the swing?? Not Good! It means your hips are not doing their job.

Look at the full body movement of Soccer players as they accelerate down the field and have to suddenly decelerate and change directions. If you watch them you’ll see upper body and lower body going in opposite directions leaving the pivot point to be the lower back! If there is any loss of rotation through the hips you get excessive load and torque across the spine. Over time the path of least resistance becomes an overstressed bone in the spine that can eventually break under pressure.


This tension is NOT just muscle tightness. It is IMPORTANT to know that the real problem here is JOINT tightness. That is very different. If we can get the back side of the hip moving better it will allow a deeper motion for the muscles like the hamstring and adductors (inner thigh) to get a better stretch. If you don’t loosen up the back hip joint then the muscles can’t lengthen and your motion is altered. This is a reason that you can go through all the right stretches but never really feel loose.


I’ve put together a short video of one exercise we do with every one of our tight hip athletes. The more you do it, the more you’ll remember it and the easier your regular muscle stretches will be.

Please reference our earlier blog titled: 3D Warm up and Flexibility: Lower body for more ideas to further loosen the hips.

If you are experiencing spine pain please get a full evaluation by your movement specialist for a proper diagnosis. Please reference our previous post titled: University Athlete Away from home and Injured…

QUESTIONS to ponder…….

Are we overtraining our youth?

Should there be an OFF season for athletes under the age of 18?

Are the coaches and trainers spending the time for proper warm up and flexibility training?

Dr. Donna Copertino,DC, DACRB, FAFS

You are a University Athlete, Away from Home and You are Injured. What do you do?

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Find the right TEAM of experts to work together to fix you!

Your School provides the very best they know but sometimes we need more!

Here I hope to provide you with the insight that there are professionals out there who have studied the latest in therapies, body mechanics and evaluation procedures that your school might not know about. My hope is to educate you on some of these options and how to find them.

So many times I have a patient who comes home from college on a break and they want to be evaluated for their injury that isn’t quite getting better fast enough. They’ve received the best of care by the team medical staff but still feel less than 100%.  Some have returned to play but feel as though they can’t perform as well or maybe have a fear of reinjury so they hold back. Some are fearless and play hard but get hurt soon after their return and now they are frustrated. Once in a while you get that really bad one that needed surgery but just can’t seem to get back in the game.

No matter the situation they all have a similar issue; they need help. In some cases they have to wait until they get home, talk with their parents and hope to see a Specialist that can fix them. Oh, and get that all figured out in the three weeks that they are off from school! Or better yet, in the fours days they are off because they have to get back for practice.

As a parent you want what’s best for your child. You helped them find their sport, watched them excel and finally support and admire them while they play at a University level.

If they are injured you trust that the physicians and trainers and therapists at the University are taking the best care of them. After all, it IS a Top school in a major city surrounded by teaching hospitals and the world’s best research programs. Clearly they are in good hands and wouldn’t possibly need anything more!

As an athlete you would do anything to stay in the game, work through the pain, seek a second opinion, do all of the exercises, ice, heat whatever it takes just tell me what to do!! Right?

Why is it that even our professional level athletes who have access to the best of the best sometimes go out on their own to find the latest in therapies and travel out of the country for it?

Do we need to travel far and wide to find the right expert? Or is it that we just don’t know what or who we are looking for? My point is there are great people everywhere. Maybe the problem isn’t where to go to find them but WHO exactly do we need? We need a team!

“The Whole is Greater than the Sum of all its Parts”Aristotle

Remember that when you are trying to solve a dilemma  you might need more than one expert for the solution. I like to start with these three priorities when searching for WHO might be able to help:

  1. Identify the problem (What is injured? What type of specialist do we need?)
  2. How do you Fix it? (What are our options??? Corrective Exercise, Muscle Release, rehab, Therapy? Aren’t they all the same??)
  3. How do we prevent it from happening again? (Get to the source, the cause. Who can do that?)

There are so many professions out there, so many experts in many different fields. It can be difficult to sort out if you are not familiar. It is best to go to someone that specializes in the type of problem you have.  If all we know is Orthopedics and Physical Therapy then we are living in a very narrow minded small world. Remember that there is no one person who can know all and do all for every type of injury. A good physician, trainer or therapist will know when they need help. In many cases you’ll need to work with several different types of providers in order to get back in the game. My hope here is to simply educate you on just some of the other type of professionals or credentials/certifications you can search for should you need some expert opinion. If you are a parent and your child is away and is not responding well enough to their treatment you should have this information handy to guide you in the right direction for help.


I would like to provide you with a short list of Specialists out there and websites with search engines that can help you find someone in the area you need. These recommendations are based on my nearly 20 years of experience and education and what I personally have found helpful in my practice. There are many others that are just as good so please understand that this list is not all inclusive.

I advise parents and athletes too to start NOW and assemble a team of professionals in your area that you might need to find at a moment’s notice. Sometimes you can find one Professional that has multiple credentials so you may be able to combine therapies. Many Chiropractors and Physical Therapists and British Osteopaths will study the same areas so be sure to check out the full list of what they’ve certified in.

Types of Health Professionals to have on your call list:

  • Orthopedic Surgeon – for broken bones or torn parts (Specialist in area injured)
  • Physical Therapist – rehabilitation with at  LEAST these certifications (SFMA, FAFS)
  • Chiropractor – biomechanical correction with at  LEAST 1-2 of these certifications  (DACRB, SFMA, FAFS, ART)
  • British Osteopath – biomechanical correction with at  LEAST 1-2 of these certifications  (MOst, SFMA, FAFS, ART)
  • Massage Therapist – scar and adhesions in muscle (ART, Scarworks)
  • Acupuncturist – pain control
  • Nutritionist – metabolic efficiency testing
  • Sport Psychologist – Better Mind. Better Performance

Here are some sites to reference when searching for these types of professionals.

  1. SFMA: Selective Functional Movement Assessment – helpful in finding the right diagnosis whether soft tissue tension or neurological weakness. Click on Find a Certified Member and select SFMA in your search

  1. ART: Active Release Technique – useful for tight muscles, strains, pinched nerves, inflexibility Click on Find a Provider and search by Location/Zip code. Try to find the provider with the most certifications under their name

  1. FAFS: Fellow of Applied Functional Science – these experts are the TOP in their field who understand body function in 3 dimensions. You can find many types of movement specialists here including Strength Coaches, Athletic Trainers, Physical Therapists, Chiropractors and Osteopaths. Scroll to bottom of page and Click on Fellow Locator and search by location. Be sure to switch your miles radius to the lowest area. GIFT is the program with the highest level of education.

  1. ScarWorks This search is for Scar tissue release. Go to Contact Us and send a message to find a certified provider in your area

5. DACRB: (Diplomate of the American Board of Chiropractic) – These are Chiropractors who continued their post doctoral education in the physical therapy arena.

There are so many other techniques that are out there that can be very effective in the treatment of injuries both old and new. Some of my colleagues are certified in Graston technique, Class IV Laser therapy, Gait Analysis using Optogait system or RunScribe technology. If you take away any message from this post I hope it is at least to search for more than what is traditional or commonly recommended. Find your team of experts in a variety of fields who work together for you!

Coming soon……..Video of Soccer Specific Flexibility Training!