Knee ACL Injuries: Can we prevent them in our athletes? Part 1

Knee ACL injuries: Can we prevent them in our athletes? Part 1 By Dr. John Mishock, PT, DPT, DC    Knee injuries account for up to 40% of all sports injuries, commonly occurring in soccer, basketball, lacrosse, skiing, football, and gymnastics (Nessier et al. 2017). Knee injuries are the most common cause of surgery in [...]

Blood Flow Restriction (BFR ) Exercise Part II: Enhancing Strength, Hypertrophy, and Power

Blood Flow Restriction (BFR) Can Optimize strength, endurance, motor control, and power whether an individual is focusing on recovering from an injury or training to enhance sports performance.  By Dr. John R. Mishock, PT, DPT, DC           In Part I of Blood Flow Restriction (BFR), we reviewed the history of the [...]

Blood Flow Restriction (BFR ) Part 1: Accelerating Rehab from Injury & Post-Surgical Recovery

Blood Flow Restriction (BFR) can accelerate rehabilitation from injury and from post - surgical recovery. By Dr. John R. Mishock, PT, DPT, DC     BFR Exercise Part I: Accelerating Rehabilitation from Injury and Post-Surgical Recovery By Dr. John R. Mishock   Aaron Rodgers, the NFL superstar quarterback of the New York Jets, sustained an [...]

Physical Therapy and Osteoarthritis

Exercise is as good as NSAIDs in relieving pain from Osteoarthritis! By Dr. John R. Mishock, PT, DPT, DC     Osteoarthritis (OA) is the most common form of joint disease and the leading cause of pain in older people. OA often begins by age 40 and can worsen as we age with twenty-four percent [...]

Baseball and Softball Arm Injuries: How do I return to throwing?

Baseball and Softball Arm Injuries: How do I return to throwing? By Dr. John Mishock, PT, DPT, DC    The success of the baseball pitcher requires not only high-level ability but also durability and prevention of injury. The baseball throwing motion has been described as one of the most violent and stressful motions in all [...]

Throwing Program Guideline: Return from Injury

Throwing Program Guideline: Return from Injury By Dr. John Mishock, PT, DPT, DC            1. Proper warm-up is essential. Perform the dynamic warm-up prior to throwing. 2. Perform 5 throws and holds prior to each set of throws. 3. After each set of throws, rest 3- 5 min. Perform shoulder stretches [...]

Early Referral to Physical Therapy for Low Back Pain Reduces Cost, and Improves Outcomes

Early Referral to Physical Therapy for Low Back Pain Reduces Cost, and Improves Outcomes By Dr. John Mishock, PT, DPT, DC    Low back pain (LBP) is a common and costly medical condition associated with significant physical pain, impaired function, and loss of productivity. LBP is the leading cause of disability in the US exceeding [...]

Baseball Arm Throwing Injuries: A possible solution?

Baseball Arm Throwing Injuries: A possible solution? By Dr. John Mishock, PT, DPT, DC    Overuse injuries in the shoulder and elbow are the most common problems in baseball players. Injuries of the shoulder account for 14-21%, whereas the elbow account for 16%-22% of all baseball-related injuries. (Agresta et al. Orthop J Sports Med, 2019, [...]

Throwing Program Guideline: Return from injury

Throwing Program Guideline: Return from injury By Dr. John Mishock, PT, DPT, DC            Dynamic warm-up: Perform the dynamic warm-up prior to throwing. Throw and holds: Hold the baseball and go through the throwing motion without releasing the ball (10 times). Rest-recovery: After each set of throws, rest 60-90 sec. (Perform [...]

Baseball Sports Performance and Injury Prevention: Interval Throwing Programing Following Arm Injury

Baseball Sports Performance and Injury Prevention: Interval Throwing Programing Following Arm Injury By Dr. John Mishock, PT, DPT, DC    The baseball throwing motion has been described as one of the most violent and stressful motions in all sports. The arm experiences velocities greater than 9000 deg/s and distraction forces (arm bone pulling away from [...]

Sports Performance: Should I wear an ankle brace to prevent ankle injury?

Sports Performance: Should I wear an ankle brace to prevent ankle injury? By Dr. John Mishock, PT, DPT, DC    Ankle sprains are one of the most common reasons to visit an emergency department. Ankle injuries are the most common injury sustained by basketball players accounting for 54% of all injuries. Seventy-six percent of these [...]

Sports Performance Nutrition: How important is protein in my training?

Sports Performance Nutrition: How important is protein in my training? By Dr. John Mishock, PT, DPT, DC    Building powerful explosive lean muscle can be a game-changer in optimizing sports performance and injury prevention. To optimize muscle growth and development specific training relative to sport is needed, however, exercise alone is not enough. Nutrition and [...]

Chronic Disease Prevention: Muscle vs. Fat, why is it critical?

Chronic Disease Prevention: Muscle vs. Fat, why is it critical? By Dr. John Mishock, PT, DPT, DC  The world health organization reported that the population older than 60 years surpassed that of younger adolescents in 2020 and estimated that people aged > 60 years will be 20% by 2030. (WHO, 2022) The older population increases [...]

Auto Accident Injury: Physical Therapy the best Treatment option Neck, Shoulder, and Low Back Pain

Auto Accident Injury: Physical Therapy the best Treatment option Neck, Shoulder, and Low Back Pain By Dr. John Mishock, PT, DPT, DC  Five million Americans yearly suffer from whiplash-associated disorders (WAD) secondary to motor vehicle accidents. These accidents cost over $498 billion in wage loss, medical expenses, vehicle damage, and employer costs. (NSC Injury, 2022) [...]

Diabetes: A Wake-Up Call! We Can Do Better! Part III

Diabetes: A Wake-Up Call! We Can Do Better! Part III By Dr. John Mishock, PT, DPT, DC  View Part I and Part II of this series. Approximately 35 million adults in the US have Type 2 Diabetes, 12.6 million of whom are undiagnosed. In addition, nearly 166 million adults are also categorized as having prediabetes. [...]

Baseball Related Arm Injuries: A Possible Solution

Dr. John R. Mishock, PT, DPT, DC Approximately 40 million children and adolescents between the ages of 4 and 17 begin participating in organized baseball worldwide. Many young athletes develop elbow and shoulder injuries commonly seen in physical therapy clinics and orthopedic surgeons' offices. Despite pitch count rules and guidelines, youth injuries and surgeries are [...]

Diabetes: A Wake-Up Call! We Can Do Better! Part II

By Dr. John Mishock, PT, DPT, DC Irrefutable evidence supports the importance of physical activity, exercise, and cardiorespiratory fitness in preventing and treating chronic diseases, such as cardiovascular disease, obesity, type 2 diabetes Mellitus, cognitive decline, and many cancers while enhancing the immune system, health span (years healthy free of disease), longevity, and resilience. Eighty […]

Diabetes: A Wake-Up Call! We Can Do Better – Part 1

By Dr. John Mishock, PT, DPT, DC Approximately 30.3 million Americans, or 9.4% of the population, have Diabetes. Globally, diabetes prevalence has climbed from 108 million in 1980 to 425 million in 2017, with 640 million expected by 2040. (Uusitupa et al. Nutrients, 2019) From 1990-2019, the incidence of type 2 diabetes among people from […]

Golf Sports Performance: The “Quiet Eye” to Improve Your Golf Game!

By Dr. John R. Mishock, PT, DPT, DC The ability to be a great golfer is multifaceted; however, it minimally takes countless hours (10,000 or more) of tedious, high-quality, perfect rehearsal to create great swing mechanics. Possibly, the most underrated aspect of golf mechanics is the eyes, which are the most important organ of sense. […]

Pre-Season/Winter Workout Throwing Program Guideline:

Dr. John R. Mishock, PT, DPT, DC 1. Dynamic warm up: Perform the dynamic warm-up prior to throwing. 2. Throw and holds: Hold baseball and go through throwing motion without releasing the ball (10 times). 3. Rest-recovery: After each set of throws, rest 60-90 sec. (Perform push-ups, front planks, side planks) 4. Phase progression: Progress […]

Golf Sports Performance: Functional Exercise Training Improves Ball Accuracy and Flight Distance

By Dr. John R. Mishock, PT, DPT, DC Golf is a popular sport in the US, with over 32 million participants annually (National Golf Foundation, 2020). The most critical determinant of golf performance is the resulting combination of ball accuracy and driving distance. A significant amount of skill and deliberate practice is needed to hit […]

Golf Specific Exercise Improves Golf Performance and Prevents Injury: Part 2

By Dr. John Mishock, PT, DPT, DC In the first article, “Golf Specific Exercises Improves Golf Performance and Prevents Injury: Part I”, I reviewed the essential biomechanics of golf and how improving strength and power through exercise training can improve golf performance. Found at: https://mishockpt.com/golf-specific-exercise-improves-golf-performance-and-prevents-injury-part-i/ In this article, I will review the importance of training […]

Golf Specific Exercise Improves Golf Performance and Prevents Injury: Part I

By Dr. John Mishock, PT, DPT, DC Worldwide, 55 to 80 million people from 136 countries play golf. (HSBC Group, 2020) With this popularity, golf has been among the most highly studied sports. Advances in technology and sports science have allowed healthcare providers to use this information to create specific sports performance exercise programs to […]

Basketball Sports Performance: The Difference Between Good and Great Basketball Shooting… The Eyes???

By Dr. John R. Mishock, PT, DPT, DC The elite NBA shooter can make 90% of free throws, 50% from the field, and 40% of their three-point shots. Nine players in NBA history have accomplished this sharp shooting feat of efficiency and consistency in a season. Steve Nash (Phoenix Suns) has done this four times, […]

Hey golfers! Start your Exercise Training Now to Improve your Golf Game and Prevent Injury!

by Sally Caldwell, DPT TPI-Medical Provider Clinical Director, Phoenixville With golf season over, now is the time to prepare for the next golf season. Our Titleist Performance Institute (TPI) golf exercise training program will improve your golf game, prevent injury, and make you healthier overall. Few golfers emphasize exercise to improve their golf game and […]

Nutritional Considerations in Recovery from Orthopedic Injury or Surgery

By Dr. John R. Mishock, PT, DPT, DC Nutritional interventions are not commonly used as the standard of care in recovery from injury or orthopedic surgery. However, it is well known that good nutrition is critical to optimizing health and wellness. The nutritional needs become amplified when individuals are healing and recovering from physical injury […]

Sports Injury Prevention: What are the benefits of single-limb exercise vs. bilateral exercise?

Single-limb exercises mean that the individual moves with one limb vs. two limbs—for example, a single-arm curl vs. a double-arm curl. There are many advantages to unilateral exercise training that I will highlight in this article. Benefits of unilateral exercise: 1. Increase motor unit recruitment: There is more significant muscle firing during the unilateral exercise. […]

Total Joint Replacement: Physical Therapy “More Than Just Exercise”

By John R. Mishock, PT, DPT, DC Our body has over 360 joints. All joints (where two bones meet) have cartilage at the bone’s ends which helps to reduce friction and provide shock absorption. With aging, this cartilage wears out, leading to pain, swelling, joint deformity, weakness, and altered function. Nearly 70 million Americans have […]

Physical Therapy and the Shoulder Joint Replacement: Returning to the highest level of function

By Dr. John R. Mishock, PT, DPT, DC Shoulder replacement surgeries have dramatically increased in number over the past few decades. There are nearly 53,000 shoulder replacement surgeries performed in the United States annually. Over the years there have been dramatic advances in this surgical procedure and rehabilitation allowing it to enjoy a success rate […]

Try Physical Therapy 1st: Pre-habilitation for Knee Joint Replacement Improves Outcomes and Saves Money

By John R. Mishock, PT, DPT, DC Total knee arthroplasty (TKA) has become the third most common inpatient surgery in the United States, with 750,000 yearly procedures projected to double in the next decade. (Sloan et al. 2018) There has been a marked increase in the utilization of TKA, estimated to be 600% by 2030. […]

Sports Injury Prevention: What risk factors can we control?

By Dr. John R. Mishock, PT, DPT, DC In the US, there is over 8.6 million sports-related adolescent (age 10-20 years) injuries annually; 42% happen in the lower extremity, 30% in the upper extremity, and 16% in the head and neck. (NHSR, 2016) Many of these are over-use injuries that occur due to excessive intensity, […]

Injury Prevention: Can Monitoring and Managing Training Load Reduce Injury?

By Dr. John R. Mishock In organized sports from youth to pro there are approximately 4-6 million injuries each year. The majority of these injuries occur as sprains and strains of the upper and lower extremity. (Hopkinsmedicine.org) Many of these injuries are preventable with proper exercise training and load management of training/competition volume, which ultimately […]

Sports performance: Why is Strength and Rate of Force Development Essential to Run Fast, Jump High, Throw Hard, and Hit Far?

By Dr. John R. Mishock, PT, DPT, DC When watching professional athletes play their sport, we marvel at how they effortlessly hit a baseball over 400 feet, throw a baseball a 100 mph, jump over 40 inches to dunk a basketball, and run sub 4.2 sec on the football field. Advancements in strength and conditioning […]

Knee ACL and Lower Extremity Injuries: Can we prevent them in our young athletes? Part I

By Dr. John R. Mishock, PT, DPT, DC Lower extremity injuries make up 66% of all sports injuries, the knee being the most commonly injured joint. (Med Sci. Sports Exerc. 2002) The anterior cruciate ligament (ACL) is one of four ligaments in the knee that holds the thigh and leg bones together. The ACL ligament […]

Sports performance: Is there a benefit to muscle damage during resistance exercise?

By Dr. John R. Mishock There is a belief that resistance exercises or weightlifting create muscle damage, leading to tightness and limiting function in sports such as baseball, basketball, golf, and others. Does resistance exercise damage muscle? Can the muscle damage be helpful? Resistance training exercise creates micro-damage to the muscle. This muscle damage is […]

Try Physical Therapy First! – Direct Access Improves Outcomes and SAVES MONEY

By Dr. John R. Mishock, PT, DPT, DC Studies show that seeing a physical therapist first through direct access can: improve musculoskeletal pain faster; reduce or remove the need for some types of musculoskeletal surgery; reduce opioid use; improve patient satisfaction; reduce expensive medical testing; and help patients get needed treatment faster. (Physical Therapy, 2017) […]

Baseball Sports performance and Injury Prevention: Short Arm vs Long Arm Action in Baseball Pitching

By Dr. John R. Mishock, PT, DPT, DC The baseball pitcher is the most vital position in baseball. The success of the baseball pitcher not only requires high-level ability but also requires durability and prevention of injury. Science has also shown that in elite baseball pitchers, 85% of throwing velocity comes from leg drive (push-off […]

Growth-Plate Injuries of the Shoulder and Elbow in Baseball Players

By Dr. John R. Mishock, PT, DPT, DC Growth-plate injuries of the shoulder and elbow are common injuries in youth and adolescent baseball players. The growth-plate (epiphyseal plate or physis) is an area of cartilage at the end of a bone that is responsible for the bones growth. The growth plates close at the completion […]

Sports performance: Is there a benefit to muscle damaged during resistance exercise?

By Dr. John R. Mishock There is a belief that resistance exercises or weightlifting create muscle damage, leading to tightness and limiting function in sports such as baseball, basketball, golf, and others. Does resistance exercise damage muscle? Can the muscle damage be helpful? When exercising, there is micro-damage or small amounts of physiological tissue change […]

Golf Sports Performance: Will resistance exercise training negatively impact my Golf Swing? What’s the benefit?

By Dr. John R. Mishock, PT, DPT, DC Golf is a popular sport in the US, with over 32 million participants annually (National Golf Foundation, 2020). The most critical determinant of golf performance is the resulting combination of ball accuracy and driving distance. A significant amount of skill and deliberate practice is needed to hit […]

Sports performance: Will weight training negatively impact my basketball shot?

By Dr. John R. Mishock Today’s elite-level basketball player needs high-level athleticism with elite-level skills in shooting, ball handling, and passing. When I was growing up, it was a common belief that lifting weights would make you too bulky and tight, negatively impacting your shooting form and accuracy. Some basketball coaches and trainers still hold […]

Auto Accident Injury: Physical Therapy the best Treatment option Neck, Shoulder, and Low Back Pain

By. Dr. John R. Mishock, PT, DPT, DC Each year, two million Americans suffer from whiplash-associated disorders (WAD) secondary to motor vehicle accidents. Studies using high-speed cameras and sophisticated crash dummies have determined that rear-impact car accidents cause the lower cervical vertebrae (lower bones in the neck) to be forced into a position of hyperextension […]

Baseball Arm Throwing Injuries: A possible solution?

By Dr. John R. Mishock, PT, DPT, DC Overuse injuries in the shoulder and elbow are the most common problems in baseball players. Injuries of the shoulder account for 14-21%, whereas the elbow account for 16%-22% of all baseball-related injuries. (Agresta et al. Orthop. J Sports Med, 2019, Posner et al. Am J Sorts Med, […]

Sports Performance:  Which is better, training two or four times per week for strength and hypertrophy?

By Dr. John R. Mishock, PT, DPT, DC Resistance training is an essential tool to optimize an individual’s athletic potential. To optimize the effects of resistance training, the manipulation of volume (total amount of reps or sets), load (amount of weight), frequency (training sessions of a body part per week), and intensity (effort per rep) […]

Sports Performance: Using Motor Imagery to Achieve Elite Level Status Part II

  By Dr. John R. Mishock, PT, DPT, DC In sports, most high-level athletes (70-90%) and elite sports coaches (94%) report using motor imagery (mental or kinesthetic imagery) to enhance sports performance. (Ridderinkhof et al. J Physiol, 2015) There have been over 122 studies demonstrating the effectiveness of motor imagery in basketball, baseball, soccer, volleyball, […]

Sports Performance: Using Motor imagery to Achieve Elite Level Status

By Dr. John R. Mishock, PT, DPT, DC Coaches, trainers, and athletes are often looking for the “next thing” that will allow them to reach the highest level of sports performance. One training technique to optimize sports performance is motor imagery, also known as mental imagery or visualization. Motor imagery is defined as the mental […]

Early Referral to Physical Therapy for Low Back Pain Reduces Cost, and Improves Outcomes

By John R. Mishock, PT, DPT, DC Low back pain (LBP) is a common and costly medical condition associated with significant physical pain, impaired function, and loss of productivity. LBP is the leading cause of disability in the US exceeding $100 billion per year in treatment, reduced productivity and lost wages. Approximately, 70 million adults […]

Acute Ankle Sprains: Key Scientific Information for Optimal Recovery and Early Return to Play

By Dr. John R. Mishock, PT, DPT, DC An acute ankle sprain is the most common lower limb injury accounting for up to 40% of all sports-related injuries. The highest incidence of injury occurs in basketball (41.1%), American football (9.3%), and soccer (7.9%). (Vuurberg et al. Br j Sports Med, 2018, (McKay et al Br […]

Sports performance: Understanding Why Nutrition Optimizes Sports Performance

By Dr. John R. Mishock, PT, DPT, DC Why is nutrition essential to me as an athlete? Good nutrition is essential to improve or maintain health parameters (blood glucose, cholesterol, blood pressure), maintain optimal weight, prevent disease (infection, heart disease, hypertension, cancer), and improve healing from injury. A diet that is primarily whole food and […]

Sports Performance Nutrition: How important is protein in my training?

By Dr. John R. Mishock, PT, DPT, DC Building powerful explosive lean muscle can be a game-changer in optimizing sports performance and injury prevention. To optimize muscle growth and development specific training relative to sport is needed, however, exercise alone is not enough. Nutrition and more specifically protein are needed to attain optimal results. Why […]

Physical Therapy: Nutritional Considerations in Recovery from Injury or Orthopedic Surgery

By Dr. John R. Mishock, PT, DPT, DC The economic burden of treating orthopedic injuries is estimated at $9 billion annually for those 17-44 years of age. (Harlan et al. Am J Public Health 2020) Nutritional interventions are not commonly used as the standard of care in recovery from injury or orthopedic surgery. However, it […]

Injury Prevention and Durability: The Significance of the “Core”

By Dr. John R. Mishock, PT, DPT, DC In the US, 30 million children and teens participate in organized sports with more than 4 million injuries each year. The majority of these injuries occur as sprains and strains of the upper and lower extremity. (Hopkinsmedicine.org) Many of these injuries are preventable with proper exercise training, […]

15 minute Holiday Home Exercise Program

The goal of the Mishock Physical Therapy Holiday Home Exercise program is to promote the development of the individual’s ability to become strong in fundamental movement patterns (relative maximum strength) that are critical to improving function and preventing injury. The scientifically based program trains the body’s major muscle groups by focusing on the core, upper, […]

Basketball Exercise Training: What is the best way to train to optimize explosive power?

By Dr. John R. Mishock, PT, DPT, DC In today’s game of basketball, a high-level player must have sprint speed, vertical and horizontal jumping ability, first-step-quickness, explosive change direction movements, physical strength, and balance to endure and compete at the highest level. The player needs to have all of these attributes and be able to […]

Basketball: Preventing Ankle Injuries with Balance Training and Bracing

By Dr. John R. Mishock, PT, DPT, DC Basketball is one of the most popular sports, with an estimated 300 million people playing worldwide. (www.sfia.org) Ankle injuries are the most common orthopedic injury in basketball. In a study of NCAA Division 1 basketball players, 27% of all musculoskeletal injuries occur in the ankle. Many of […]

Try Physical Therapy FIRST – an Alternative to Opioids for Pain Relief

By John R. Mishock, PT, DPT, DC An estimated 100,000 Americans died of a drug overdose this year, a never-before-seen milestone according to the Center for Disease Control and Prevention (CDC, 2021). Experts believe that the increase in deaths is due to the growing use of fentanyl, an opioid prescription drug that is typically used […]

Aquatic Therapy:  An Alternative to Pain Medication

By John R. Mishock, PT, DPT, DC; Owner of Mishock Physical Therapy & Associates Aquatic therapy is well known for its amazing effects on decreasing pain, speeding recovery and improving function. Aquatic therapy, or pool therapy, consists of an exercise program that is performed in the water. The water provides buoyancy and hydrostatic pressure. The […]

Mishock Arm Care Program: Return to throwing after injury

By Dr. John R. Mishock The Mishock return to throwing program is a guide designed to gradually build the player’s throwing capacity when returning from an arm injury. All athletes are different through their age, genetics, previous training, physical conditioning, and previous injury. In that, care must be taken to modify this program to meet […]

Shoulder Joint Replacement: Returning to the highest level of function with Physical Therapy

By Dr. John R. Mishock, PT, DPT, DC Shoulder replacement surgeries have dramatically increased in number over the past few decades. There are nearly 53,000 shoulder replacement surgeries performed in the United States annually. Over the years there have been dramatic advances in surgical procedure and rehabilitation, allowing a success rate as high as 92% […]

What is Pelvic Floor Therapy?

Do you struggle with any of the following? • Frequent bathroom visits • Trouble controlling your bowels or urine during every day activity, leading to leakage • Pain during intercourse • Constipation You could be suffering from Pelvic Floor Dysfunction. When you have pelvic floor dysfunction, your pelvic muscles can’t relax or work together the […]

Football and Concussions: The Physical Therapists Role

By John R. Mishock, PT, DPT, DC Despite COVID-19 the NFL, college, high school, and youth football is being played. Beyond the concern for prevention of COVID-19, concussion prevention and management are at the forefront of health providers’ concerns. According to NFL injury data, 224 reported concussions were reported in 2019, up 4.7 % from […]

Knee ACL and Lower Extremity Injuries: Can we prevent them in our young athletes? Part II

By Dr. John R. Mishock, PT, DPT, DC In our last article, (Knee ACL and Lower Extremity Injuries: Can we prevent them in our youth athletes? Part I) we determined that lower extremity injuries make up 66% of all sports injuries, with the knee being the most commonly injured joint.(Med Sci Sports Exerc. 2002) These […]

Knee ACL and Lower Extremity Injuries: Can we prevent them in our young athletes? Part I

By Dr. John R. Mishock, PT, DPT, DC Lower extremity injuries make up 66% of all sports injuries, the knee being the most commonly injured joint. (Med Sci. Sports Exerc. 2002) The anterior cruciate ligament (ACL) is one of four ligaments in the knee that holds the thigh and leg bones together. The ACL ligament […]

Hydration during Exercise and Competition: Improving Sports Performance and Reducing the Potential for Serious Illness or Death

By John R. Mishock, PT, DPT, DC, Owner, Mishock Physical Therapy & Associates Each year there are numerous deaths of youth and adolescent athletes connected to dehydration related illness, while playing sports, especially pre-season football camps. There was a time when drinking water during practices and games was seen by coaches as a weakness or […]

Try Physical Therapy First! – Direct Access Improves Outcomes and Saves Money

By Dr. John R. Mishock, PT, DPT, DC Studies show that seeing a physical therapist first through direct access can: improve musculoskeletal pain faster; reduce or remove the need for some types of musculoskeletal surgery; reduce opioid use; improve patient satisfaction; reduce expensive medical testing; and help patients get needed treatment faster. (Physical Therapy, 2017) […]

Baseball Pitcher Injury: Fatigue, Learning to Recognize the Critical Signs!

John R. Mishock, PT, DPT, DC With the baseball season is in full swing, the Major League Baseball injury rate is reaching an unprecedented level. The throwing injury rate is also increasing in college, high school, and youth level baseball players. Most coaches look at pitch count guidelines to help reduce throwing overuse injuries. Limiting […]

Baseball Arm Throwing Injuries: A possible solution?

By Dr. John R. Mishock, PT, DPT, DC In my clinic, a 12-year-old boy and his parents present for a sports medicine consultation regarding his elbow pain. Following a 105 pitch outing, he felt significant sharp elbow pain. He stated the pain started about an inning before, but he was encouraged by his coach and […]

Physical Therapy: Exercise Therapy and Manual Therapy the Treatment of Choice for Osteoarthritis

By Dr. John R. Mishock, PT, DPT, DC Osteoarthritis (OA) is a common disease of aging responsible for chronic disability among older adults with approximately 70 million (20% of the population) being affected currently in the United States alone. The prevalence of OA increases with age, especially in individuals over age 50 (40% having OA). […]

Growth-Plate Injuries of the Shoulder and Elbow in Baseball Players

By Dr. John R. Mishock Growth-plate injuries of the shoulder and elbow are common injuries in youth and adolescent baseball players. The growth-plate (epiphyseal plate or physis) is an area of cartilage at the end of a bone that is responsible for the bones growth. The growth plates close at the completion of bone growth […]

Reduce Overuse Injury and Minimize Burn Out in Youth and Adolescent Athletes

by John R. Mishock, PT, DPT, DC It is estimated that 60 million children and adolescence aged 6 to 18 years participate in team sports, with 44 million participating in more than 1 sport (The National Council of Youth Sports). Of those 60 million athletes approximately 45% to 54% will develop some type of overuse […]

Baseball pitcher throwing mechanics: Is it important to reduce the near “Epidemic” of Elbow and Shoulder Injuries in Baseball Players?

By Dr. John R. Mishock, PT, DPT, DC The baseball pitcher is 36 times more likely to develop a shoulder or elbow injury if they throw while the arm or body is tired and fatigued. (Am Sports Med Inst, 2017). We know that limiting pitches thrown per game, per week, and per year can reduce […]

What is Pelvic Floor Rehabilitation, and how can it help me?

Mishock PT & Associates is now offering Pelvic Floor Rehab in our Boyertown clinic, and Phoenixville. In the United States, individuals are led to believe that pelvic pain, urinary leakage, prolapse, sexual dysfunction, and the feelings of “damage” to their body after pregnancy are the “norm.” These outdated ideas can make a huge impact on […]

Lymphedema- You Don’t Have to Live with Chronic Swelling

By: Megan Repko, MPT & Melissa Bennett, MS, ATC; Mishock Physical Therapy & Associates               One cause of chronic swelling could be lymphedema. This is a condition where swelling occurs in the extremities due to a compromised or damaged lymph system. Lymph is the fluid that bathes the cells […]

Physical Therapy: Nutritional Considerations in Recovery from Injury or Orthopedic Surgery

By Dr. John R. Mishock, PT, DPT, DC The economic burden of treating orthopedic injuries is estimated at $9 billion annually for those 17-44 years of age. (Harlan et al. Am J Public Health 2020) Nutritional interventions are not commonly used as the standard of care in recovery from injury or orthopedic surgery. However, it […]

The “Triple Extensors”: Run fast and Jump high!

By Dr. John R. Mishock, PT, DPT, DC To run fast or jump high, you must have explosive push off of the “triple extenders” of the ankle (plantar flexion), knee (extension), and hip (extension). The muscles that make up the “triple extenders” are the; gluteus maximus at the hip, the hamstrings (biceps femoris, semimembranosus, semitendinosus, […]

COVID-19 “Long-haulers”: Physical Therapy – The Treatment of Choice

By Dr. John R. Mishock, PT, DPT, DC Researchers estimate about 10% of COVID-19 patients become “COVID long-haulers” (Rubin, JAMA, 2021). “Long-haulers” are people who experience persisting symptoms of COVID-19 long after the infection is defeated. The condition can affect both young and old with very mild to severe symptoms. COVID-19 has far-reaching pathology, potentially […]

Winter Workout Baseball and Softball Performance and Injury Prevention Program

By Dr. John R. Mishock, PT, DPT, DC, Owner, Mishock Physical Therapy & Associates The Mishock Winter Workout Baseball and Softball Training Program is a home exercise program that prepares the athlete for pre-season baseball. It also can be used as a warm-up or training station in a winter work-out program or as an in-season […]

The “Core”: Preventing Injury and Improving Sports Performance in the Overhead Throwing Athlete

By Dr. John R. Mishock Major League Baseball (MLB), injuries cause an estimated half-billion dollars in lost revenues annually. (MLB injury stats, 2019) Arm injuries account for > 50% of all MLB injuries, equating to 460,432 days on the MLB disabled list, with the numbers continuing to rise. (Conte S. Am J Ortho 2018) At […]

Should endurance athletes such as basketball players supplement with Beetroot Juice or powder?

  by John Mishock, PT, DPT, DC, Owner Mishock Physical Therapy & Associates Many professional and amateur endurance athletes use the supplement beetroot powder or juice to enhance their endurance during sports. Beetroot juice increases levels of nitric oxide which; increases blood flow, improves O2 gas exchange, increases mitochondrial biogenesis (helps with energy) and efficiency, […]

Basketball: Preventing Ankle Injuries with Balance Training and Bracing

    By Dr. John R. Mishock, PT, DPT, DC   Basketball is one of the most popular sports, with an estimated 300 million people playing worldwide. (www.sfia.org)  Ankle injuries are the most common orthopedic injury in basketball. In a study of NCAA Division 1 basketball players, 27% of all musculoskeletal injuries occur in the […]

COVID-19: A Proactive, Optimistic Approach during the Resurgence

By Dr. John R. Mishock   The number of cases of COVID-19 is increasing throughout our community and Nationally. COVID-19 has negatively impacted all of our lives in many ways, from severe illness, death of loved ones, social separation, anxiety, depression, suicide, job loss, business bankruptcies, and schools’ closure.   However, over the last seven […]

15 minute Holiday Home Exercise Program

The goal of the Mishock Physical Therapy Holiday Home Exercise program is to promote the development of the individual’s ability to become strong in fundamental movement patterns (relative maximum strength) that are critical to improving function and preventing injury. The scientifically based program trains the body’s major muscle groups by focusing on the core, upper, […]

The “Core”: Preventing Injury and Improving Sports Performance

By John R. Mishock, PT, DPT, DC In the US, 30 million children and teens participate in organized sports with more than 4 million injuries each year. The majority of these injuries occur as sprains and strains of the upper and lower extremity. (Hopkinsmedicine.org) Many of these injuries are preventable with proper exercise training, which […]

Physical Therapy: Enhancing Movement in Sports through Brain Training

By Dr. John R. Mishock Physical therapists use various treatment techniques to help their patients improve pain, enhance function, and optimize the individual’s quality of life. Physical therapists are highly trained in helping their clients acquire and optimize functional movement skills. Whether it is to learn to walk or perform the highest level sports performance […]

Football and Concussions: The Physical Therapist’s Role

By John R. Mishock, PT, DPT, DC Despite COVID-19 the NFL, college, high school, and youth football is being played. Beyond the concern for prevention of COVID-19, concussion prevention and management are at the forefront of health providers’ concerns. According to NFL injury data, 224 reported concussions were reported in 2019, up 4.7 % from […]

A New Training Method to Increasing Vertical Jump, Speed, and First-Step Quickness in Basketball Players and Other Explosive Athletes

In most sports, power and explosiveness are essential physical attributes to reach elite level status, especially in basketball. In training to achieve this elite level status, it is vital to challenge the body in sport-specific ways rooted in sports performance science. I will describe a new training technique that can enhance; vertical jump, speed, and […]

Baseball Throwing Injuries: Injuries to the Shoulder and Elbow increasing in Young Baseball Players

Most states have moved away from self-quarantine and are now resuming the “new normal” with COVID-19 in our midst. From March through June, youth and adolescent sports were canceled. Sports organizations are now trying to play catch up by squeezing spring and summer sports into July and August. With this ramp-up in games, we have […]

Stay at home orders over, now is the time to start physical therapy

By Dr. John R. Mishock, PT, DPT, DC As of June 5th, our area moved from red to yellow loosening stay-at-home orders. Now is the time to focus on your health and treat the pain that is limiting your function, leading to poor quality of life. This is the perfect time to start physical therapy. […]

Speed and Agility Training

By Dr. John R. Mishock, PT, DPT, DC Elite-level athletes (football, basketball, baseball, softball, soccer, lacrosse, field hockey, rugby) can quickly read and react to game situations significantly better than novice level players. From a sheer athletic perspective, speed, agility, quickness, and reaction time can separate a good athlete from a great athlete. In my […]

Physical Therapy better than Injections for Osteoarthritis of the Knee

By Dr. John R. Mishock, PT, DPT, DC Osteoarthritis (OA) is a common disease of aging frequently treated in physical therapy. OA of the knee joint occurs when the cartilage that separates the thigh and leg bone wears out or breaks down. Twenty-five percent of people over 55 years demonstrate persistent episode of knee pain […]

COVID-19 Scientific Update: Protecting the Most Vulnerable and Hand Washing

By Dr. John R. Mishock, PT, DPT, DC Seven weeks ago, we began this journey in shutting down our schools, businesses, and our familiar ways of life due to the impending doom of COVID-19. At the time, scientific knowledge was limited regarding this dreaded virus. There was a belief that our health system would be […]

COVID-19 Scientific Update: The Local Impact and Masks

By Dr. John R. Mishock, PT, DPT, DC In our local communities, it appears the COVID-19 “curve has flattened” with a 14% positive infection rate (individuals tested at the community-based testing sites Whitpain and Norristown) down from a high of 24%. The bottom line, 14% of individuals who have symptoms are positive for COVID-19 at […]

COVID-19: Scientific Update

By Dr. John R. Mishock, PT, DPT, DC I wanted to review some of the recent scientific research for the week regarding COVID-19. The objective is to educate the local community and our patients using science to guide our decisions and control or reduce panic while taking on controlled risk. When COVID-19 first started in […]

Coronavirus (COVID-19): Understanding the Science, Improving Immunity, and Preventing Disease Part I

By Dr. John R. Mishock COVID-19 has devastated the US population by; those being infected, the secondary impacts of social distancing/quarantine, school and business closures, and unprecedented unemployment. The economy is tumbling into recession with US job losses reaching 25 million, with the potential to reach over 50 million. (US Dept. Labor) COVID-19 has created […]

Coronavirus (COVID-19): Strategies to Optimizing the Body’s Immune System at Home

By Dr. John R. Mishock, PT, DPT, DC COVID-19 has challenged our world in many ways. One significant change is the strict social distancing and quarantine which has led to feelings of loneliness, hopelessness, and panic. This quarantine has also led to an inability to exercise and stay active lending to poor quality of life […]

Coronavirus (COVID-19) vs the Flu: Prevention and Understanding the Facts Based on Science

By Dr. John R. Mishock, PT, DPT, DC Coronaviruses is a large family of viruses that affects people and animals. Coronavirus (COVID-19) is a new strain that was first identified in Wuhan China in which it was transmitted from animal to human in December 2019. Since then, it has spread to a global pandemic (prevalent […]

Baseball Related Arm Injuries: The Sobering Statistics Based on the Recent Scientific Data

By Dr. John R. Mishock, PT, DPT, DC Approximately, 40 million children and adolescence between the ages of 4 and 17 will soon begin participation in organized baseball throughout the world. Many of these young athletes develop elbow and/or shoulder injuries commonly seen in physical therapy clinics and orthopedic surgeon’s offices. Despite pitch count rules […]

Brain Training: 12 training techniques to make you a better Coach or Trainer

By Dr. John R. Mishock, PT, DPT, DC In parts I through III of the “Brain Training, The Key to Developing Sports Skill” we learned how the brain and nervous system function with the musculoskeletal system to create proper movement patterns that can enhance sports performance. In this article I will outline key concepts that […]

Brain Training, the Key to Developing Sports Skill: Part III

By Dr. John R. Mishock, PT, DPT, DC In part I and II of the “Proper Training of the Brain is the Key to Developing Skill in Sports” we learned how the brain and nervous system learn and perfect movement. The underlying physiology of learning is a critical to how a coach or trainer should […]

Brain Training, the Key to Developing Sports Skill: Part II

By Dr. John R. Mishock, PT, DPT, DC In part I of the “Brain Training, the Key to Developing Skill in Sports: Part I” we learned how critical the brain and perfect practice is to developing proper movement. In this article I will review the mechanisms of how the brain and nervous system learn through […]

Brain Training, the Key to Developing Sports Skill: Part I

The saying goes, “practice makes perfect.” However, in the world of physical therapy and motor learning it is, “perfect practice makes perfect and permanent.” Perfect rehearsal, over time, allows the athlete to transfer the movement to competition at game speed. For example, in basketball, great shooters have mastered the movement pattern that allow them to […]

Active Release Technique: A fast and permanent fix for pain relief

by Dr. John Mishock, PT, DPT, DC Active Release Technique (ART) is a patented, soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia, and nerves. Many conditions (listed below) can be resolved quickly and permanently with ART. These conditions all have one important aspect in common: they are often a […]

Creatine Monohydrate (“Creatine”): A powerful supplement with clinical benefits beyond exercise training

By Dr. John R. Mishock, PT, DPT, DC Creatine Monohydrate (creatine) is one of the most popular nutritional aids in America with over 9 million pounds of creatine supplement consumed annually. Creatine first gained popularity in the 1990s with body builders and athletes. Many people take this supplement to improve training adaptation to enhance sports […]

Lymphedema Therapy – You Don’t Have to Live with Chronic Swelling

By: Megan Repko, MPT & Melissa Bennett, MS, ATC; Mishock Physical Therapy & Associates One cause of chronic swelling could be lymphedema.  This is a condition where swelling occurs in the extremities due to a compromised or damaged lymph system.  Lymph is the fluid that bathes the cells with needed nutrients, oxygen, and white blood […]

Manual therapy and exercise the best treatment option for Neck pain following whiplash

By. Dr. John R. Mishock, PT, DPT, DC; Mishock Physical Therapy & Associates Each year, two million Americans suffer from whiplash associated disorders (WAD) secondary to motor vehicle accidents. Studies using high-speed cameras and sophisticated crash dummies have determined that rear impact car accidents cause the lower cervical vertebrae (lower bones in the neck) to […]

Physical Therapy Helps Patients with Diabetes to Reduce Medication Use and Improve Quality of Life

By John R. Mishock, PT, DPT, DC Approximately 30.3 million Americans, or 9.4% of the population have diabetes mellitus. Twenty five percent of all Americans age 65 and older have diabetes. Even young people are affected by diabetes, with 193,000 Americans under the age of 20 having the disease. The cost to manage and treat […]

Aquatic Therapy: An Alternative to Pain Medication

By John R. Mishock, PT, DPT, DC; Owner of Mishock Physical Therapy & Associates Aquatic therapy is quickly becoming well known for its amazing effects on decreasing pain, speeding recovery and improving function. Aquatic therapy, or pool therapy, consists of an exercise program that is performed in the water. The water provides buoyancy and hydrostatic […]

Eccentric Exercise: An Integral Muscle Contraction Type Used in Physical Therapy

By Dr. John R. Mishock, PT, DPT, DC Physical therapists are doctorate level trained health care providers who are experts in exercise, function movement, and performance. In practice, physical therapists use three main muscle contraction types (concentric, eccentric, and isometric) to improve a patient’s quality of movement. In the last article I reviewed isometric muscle […]

Isometric Exercise: An Integral Muscle Contraction Type Used in Physical Therapy

By Dr. John R. Mishock, PT, DPT, DC Physical therapists are doctorate level trained health care providers who are experts in exercise, function movement, and performance. In practice, physical therapists use a three main muscle contraction types (concentric, eccentric, and isometric) to improve a patient’s quality of movement. Today, we will focus on the isometric […]

Tommy John Elbow Ligament Injuries in Football Quarterbacks: Why are there significantly fewer injuries than in baseball pitchers?

By John R. Mishock, PT, DPT, DC Recently Ben Roethlisberger, quarterback for the Pittsburgh Steelers, sustained an ulnar collateral ligament tear and subsequent surgery, ending his football season. Elbow injuries in football players are uncommon with 92% of the injuries being traumatic (contusions and dislocations), (Ortho J Sports Med 2019). Ulnar collateral ligament injuries in […]

Vibratory Therapy: A Manual Therapy Technique Used in Physical Therapy Treatment to Decrease Pain and Improve Function

by Dr. John R. Mishock, PT, DPT, DC Mishock Physical Therapy & Associates uses a wide variety of manual therapy techniques (myofascial release, joint mobilization/manipulation, Active Release Technique, trigger point therapy, acupressure, proprioceptive neuromuscular facilitation, cupping, Maitland, Mulligan, Cox Flexion Distraction, chiropractic, and others), to help relieve pain, enhance soft tissue healing and improve patient […]

Knee ACL and Lower Extremity Injuries: Can we prevent them in our young athletes? Part II

By Dr. John R. Mishock, PT, DPT, DC In my last article, (Knee ACL and Lower Extremity Injuries: Can we prevent them in our youth athletes? Part I) http://mishock.wpengine.com/knee-acl-and-lower-extremity-injurys-can-we-prevent-them-in-our-young-athletes-part-i/we determined that lower extremity injuries make up 66% of all sports injuries, with the knee being the most commonly injured joint.(Med Sci Sports Exerc. 2002) These […]

Knee ACL and Lower Extremity Injuries: Can we prevent them in our young athletes? Part I

By Dr. John R. Mishock, PT, DPT, DC Lower extremity injuries make up 66% of all sports injuries, the knee being the most commonly injured joint. (Med Sci. Sports Exerc. 2002) The anterior cruciate ligament (ACL) is one of four ligaments in the knee that holds the thigh and leg bones together. The ACL ligament […]

Hydration during Exercise and Competition: Improving Sports Performance and Reducing the Potential for Serious Illness or Death

By John R. Mishock, PT, DPT, DC, Owner, Mishock Physical Therapy & Associates Each year there are numerous deaths of youth and adolescent athletes connected to dehydration related illness, while playing sports, especially pre-season football camps. There was a time when drinking water during practices and games was seen by coaches as a weakness or […]

WHY EVERYONE SHOULD SEE A PHYSICAL THERAPIST

By Ann R. Miller PT, DPT, ATC, CKTP Clinical Director, Pottstown Contrary to what most people believe, physical therapy is not just for rehabilitation. Physical therapists are the experts at evaluating the human movement system and helping to maintain good health. As we go through life our bodies change and sometimes we develop aches, pains, […]

“Bio-banding” of Young Athletes: A way to keep kids playing sports and reduce injury

By Dr. John R. Mishock In the United States, it is estimated that 60 million children and adolescents (ages 5-14 years) play organized sports each year at a cost of over $7 billion dollars, and growing. (Minnesota Amateur Sports Commission). Unfortunately approximately 70% if these kids stop playing sports by age 13. (Journal of Physical […]

Seeing a Physical Therapist First through Direct Access Improves Outcomes and Saves Money

By Dr. John R. Mishock, PT, DPT, DC Studies show that seeing a physical therapist first through direct access can: improve musculoskeletal pain faster; reduce or remove the need for some types of musculoskeletal surgery; reduce opioid use; improve patient satisfaction; reduce expensive medical testing; and help patients get needed treatment faster. (Physical Therapy, 2017) […]

PHYSICAL THERAPY CAN HELP HEADACHES

By Ann R. Miller, PT, DPT, ATC, CKTP Clinical Director, Stowe (Pottstown) Headache pain is the third most common pain complaint worldwide. Some people suffer from the occasional headache, but others suffer from daily, chronic headaches which can be disabling, interfere with one’s ability to work and result in decreased quality of life. Headaches are […]

Growth-Plate Injuries of the Shoulder and Elbow in Baseball Players

By Dr. John R. Mishock Growth-plate injuries of the shoulder and elbow are common injuries in youth and adolescent baseball players. The growth-plate (epiphyseal plate or physis) is an area of cartilage at the end of a bone that is responsible for the bones growth. The growth plates close at the completion of bone growth […]

Baseball pitcher throwing mechanics: Can this help to reduce the near “Epidemic” of Tommy John Elbow Injuries in Baseball Players?

By John R. Mishock, PT, DPT, DC The baseball pitcher is 36 times more likely to developing a shoulder or elbow injury if they throw while the arm or body is tired and fatigued. (American Sports Medicine Institute). We know that limiting pitches thrown per game, per week and per year can reduce the risk […]

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