Think Outside the Box: Part 1

Imagine that every person has a 3d box surrounding him/her. It’s a 3D box that is tight fitting.  


If athletes stay within that box, they’re pretty stable and strong and they can generate a good amount of force in their box.  If an outside force is closer to their bodies, they should be able to stabilize well.


The more the athlete reaches out of that box, the less stable and strong they are. The farther an outside force is away from their bodies, the more unstable they can become.




Well, it means that we need to engage our core stability.  And, if we’re reaching out and trying to generate forces, we’d better make sure that our core strength is enough to support our bodies through the force. It doesn’t mean that we should never leave our boxes, but we have to strengthen and control our positioning outside of the box…


If we can manage to do that, we can probably avoid some injuries.  Let’s think about that with a couple of examples.  


·     Swimmers are often diagnosed with shoulder injuries as a result of reaching overhead and not being able to stabilize their shoulder blades.  They could avoid injury if they were stabilizing their shoulder blades consistently and keeping them in good position.

·     Soccer players are often injuring their ACLs, PCLs, menisci, LCLs and MCLs.  It’s usually in a play where they are reaching with their legs to trap or tackle.  If they weren’t reaching so far out of their boxes, they could probably avoid injury.


So…take a look at your core strength and stability and your positioning in sport!


If you have any questions or comments, please contact me at  I’d love to hear what you think!




Dynamic Warm Up

Studies have shown that a dynamic warm up before competition is more beneficial to athletes than static stretching… WHAT????

Dynamic warm up (aka dynamic stretching) is moving joints through range of motions that will be used in your sporting activities, like: high knees, butt kicks, side shuffles, carioca, skipping and bounding.  

Static stretching is stretching in a range of motion that would likely exceed the range usually used in your sport, like: quad stretches, hamstring stretches, etc. Static stretching is for increasing range of motion and creating actual changes to your muscle fibers.

So, what’s my point???

If you and your offspring athlete are warming up before competition, move!  Break a sweat and warm up your body! Try the things listed above! If you’re just stretching, you are not going to prepare your muscles, ligaments, tendons, etc. for anything!  In fact, if you are only statically stretching, there’s a chance you may actually slow yourself down (due to inhibition of sensors (Golgi tendon organs) in our tendons that provide explosive response to quick stretch.

Questions or comments?  Contact Karen at or 973-738-2400.

Return to Sport Post Concussion

When can my kiddo return to play after a concussion?  When is it safe? How much will he/she miss?

Here’s the science (according to the CDC):  

A concussion is A BRAIN INJURY.  It’s when the brain, which floats about in the skull, makes contact with the skull due to an external force, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

Here’s What To Look Out For:

Concussion symptoms can be (but are not limited to): Headaches, dizziness, confusion, clumsiness, loss of memory, nausea/vomiting, loss of consciousness, mood or behavior changes.  Continue to check for signs of concussion right after the injury and a few days after. If concussion signs or symptoms get worse, you should take him or her to the emergency department right away.

Ok, my kid has a concussion.  NOW WHAT???

First, take your kiddo to the doctor.  Based on his/her recommendation, you’ll be able to find out if you need to go to a concussion specialist. Make some short-term changes to your child’s daily activities.  Anything that triggers symptoms should be avoided. Anything that doesn’t is ok to do. Your child’s symptoms will dictate their recovery. It’s UBER important that you explain to your kiddo that honesty is the best policy here.  If they don’t report symptoms, their concussion can last a lot longer, or get worse. EACH CHILD IS UNIQUE, THEREFORE CONCUSSIVE SYMPTOMS CAN LAST FROM WEEKS TO MONTHS.

My kiddo has been symptom free for 24 hours:)  What now?

Now that concussion symptoms have been gone for 24 hours, your little person can start a Return to Play Protocol with a healthcare professional.  It’s a 5 or 6 stage progressive protocol (depending on who you ask) that’s based on your child’s symptoms. The stages are: Return to regular activity (like school), light aerobic activity, moderate aerobic activity, heavy non-contact activity, practice and full contact and return to competition. Once through the protocol, your kiddo is ready to go!!!

Bottom Line:)

If you think your kiddo is concussed, please take them to a doctor as soon as you can. When he/she is symptom free for at least 24 hours, they can start the Return to Play Protocol. Let’s make sure they are fully recovered and ready to go so that they can return to play successfully!


Contact Karen for Return to Play at or 973-738-2400.

Early Sports Specialization

Early sports specialization is a current hot topic in the fitness and strength and conditioning

world. How much do we push a sport for our kids? How much is too much? What goals are we

trying to to have our kids achieve? WHAT SHOULD WE DO???

Well, from a physical therapy perspective, I’ll tell you that I see more kids in physical therapy

than ever. Sports specialization can lead to chronic and overuse injuries because our kids are

playing one sport, using the same muscles, stressing the same structures repetitively, while

developing weakness elsewhere. They’re also not getting any much needed rest or any off

season from their sports. Early sports specialization is not necessary for awesome success in a

sport! In fact, many pro athletes are multi-sport athletes and will attest that their success stems

from the fact that they are well-rounded athletes.

According to New York Rangers performance analyst Adam Virgile and the NCAA, here are three stats parents should consider:

Last year, only 5.8% of high school athletes played at ANY level in the NCAA.

● Only 2% of these athletes will receive ANY type of college athletic scholarship.

● 0.04% of high school athletes were drafted to the pros. That translates to


P.S. Getting drafted does not guarantee that the athlete will play in a single

professional game, minor league game or even make the team.

Having said all of that, the above is simply a share of info to help parents and kids make

informed decisions about their participation in youth sports. Remember this: The number one

reason kids play sports is to have fun.

Heat vs. Ice? The Great Debate...

The great heat vs. ice debate has been going on for a LONG...LONG...TIME.

So, what’s the deal?

Generally, you should use ice for injuries that just happened. Use heat for muscles, stress and pain that you’ve had for awhile.  

Ice for things like: sprains, tweaks, pulls, bruising-things that are painful, hot and swollen.  Ice is a great way to help you get through the inflammatory process.

Use heat for things like painful, sore and stiff muscles.  Use heat for chronic pain. It might help with anxiety, stress and sensitization.

What about that contrast thing???

Contrast is when you alternate hot with cold.  Some health professionals think it helps to increase blood flow and promote healing but there’s very little research that backs that up.

When you just shouldn’t use either…

DON’T add heat to an inflammation situation, like a fresh injury.  

DON’T add ice to a chronic situation, like a sore neck or trigger point  that that you’ve had for awhile.

Bottom Line:)

Do whatever you think is best, keeping in mind the “freshness” of the injury.  Ice is generally good for the first 48-72 hours post injury, then heat after that.  You know yourself best, so do what’s best for you!


Contact Karen at or 973-738-2400.

Hanging in the Balance

Balance...many of us take it for granted and don’t really realize the importance of it.  For the elderly, balance is related to confidence while out in the world, the ability to walk and perform everyday activities and the prevention of falls.  For the middle aged, balance is about keeping active with confidence, weekend warrioring and keeping up to our kids. For the kids, it’s about high performance in athletics and/or just playing basketball with the girls (or guys).

Let’s talk briefly about the 3 things that can affect balance.  First, the inner ear and its workings: if the inner ear is damaged or obstructed, balance can be affected.  Second is sight: if you can’t see, it’s super hard to balance. Third is our proprioceptors (yes, I just used a 5 syllable word): tiny receptors in our tendons which send and receive messages to and from our brains to tell us where our body is positioned in space.

While keeping all of that in mind, there is a way to maintain and even IMPROVE your balance!!!  It’s called practice:) Here are some ways to do that:

  1. Stand with your feet right together, hold for 30 seconds.

  2. Stand on one leg, hold it for 30 seconds or more.  

  3. Walk on an imaginary tightrope, forward and backward.

If 1 & 2 are too easy, close your eyes.  You can make any balance exercise more difficult by doing that.  You can also make it more difficult by creating an unstable surface, like standing on a Bosu ball, foam pad, or rocker board.

Consistent practice is necessary for improvement.  Keep at it! You’ll notice a difference in no time!

Questions?  Call Karen at 973-738-2400 or email at