Early Sports Specialization Short and Long Term Risk

Early sports specialization has become increasingly more popular, with 17% and 41% of youth athletes are now considered ‘highly specialized’ in sports.

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Much of this has been driven by parents and coaches hoping to help their kid get ahead and allow them to make varsity or get a scholarship for college. This has been amplified by many High School athletes making their college commitments when they are freshman or Sophomores. Although the data suggest that highly specialized youth athletes make up slightly more of the the scholarship athletes in the NCAA, most kids who are specializing aren’t getting scholarships. Most Elite high level athletes have also acknowledged the importance of playing multiple sports as a kid. My push for delaying sports specialization becomes amplified when we look at the factors outside of performance. Highly Specialized youth athletes are more likely to become injured, experience depression and burnout. The sad truth is most everyone who “makes it”, made it because they were a great athlete and not because they specialized when they were 12 instead of 16. Allow the kids to enjoy multiple sports and develop as a holistic athlete.


Early Sports Specialization on Movement Patterns


Reviewing my $45 dollar Blood Flow Restriction Cuffs

I finally received my $45 Blood Flow Restriction Cuffs that I ordered from Alibaba . In the past I have used BFR cuffs extensively in the clinic to treat patients following ACL injuries as well as a way to modulate loads. The Blood flow restriction cuffs I have used have been from Smart cuffs and Be Strong. There continues to be strong research for Blood Flow Restriction, but one of the limiting factors to get BFR implemented in more clinics is the cost of BFR Cuffs. Typical BFR Cuffs cost around ~$400. A few months ago, I was searching on Alibaba and found BFR cuffs for $45. So I knew I needed to try them out.

Quality of Product

I was extremely surprised by the quality of the BFR cuffs and and packaging that it came in. It had a nice hard cover carrying case that has plenty of room to fit 2 arm cuffs, 2 leg cuffs and a pump. The quality of the cuffs were good(atleast at initial use…. I will be tracking how well they will hold up over time).


Shipment Time

This is always the kicker when ordering from websites like Alibaba and Dhgate. This is especially true in the time of Covid. Sadly, when I ordered these, China was going through one of their major lockdowns and many of the ports were delayed. With this is took about 1.5 months to receive the BFR cuffs. Although this was not ideal, I would still say it was worth the incredible cost of these cuffs.


What I plan to use these for?

In the long term I plan to start my own small cash based clinic, and these will an extremely valuable tool. On a more personal level, over the next few months I am going to have a lot of transition in my life. I will be moving to a new city, new apartment and will not have consistant access to my traditional gym with heavy weights. In the meantime I will have to settle for the adjustable dumbbell and lighter weights that I currently own. The BFR cuffs will help create a stimulus that will not only allow me to maintain my muscle mass with this decrease in ability to overload, but also may let me continue make gains. I will also be experimenting with new protocols with the BFR.


What excites me about the idea of BFR being so affordable?

I was discussing this with a mentor of mine who is currently in the process of starting his own cash based practice. What I was discussing was currently BFR sets are way to expensive to be able to loan out to patients during their rehab. However, if they were affordable, we may be able to loan them out especially in early stage rehab of injuries like ACL. Not only would it improve patient outcomes due to being able to generate this positive more often, but also it would be able to significantly decrease health care cost and allow our patients to save their visits for later in the rehab process. I would love to hear your thoughts, but this is something that I think could be incredibly exciting. *** I understand prior to prescribing BFR especially at home without supervision by clinician, a tremendous amount of patient education and screening would be needed.***


How I Studied and Passed The NPTE Within 3 Weeks

Studying and preparing for the NPTE is incredibly stressful and overwhelming. Luckily my last clinical finished 3.5 weeks before the April NPTE. With this I saved much of my studying for this time and treated it as a full time job. Here are my favorite resources that allowed me to significantly improve my scores and pass the NPTE.


Therapy Ed Physical Therapy Course Manual:

I loved this book because it was straight to the point, giving you the most pertinent information with no fluff. It was only ~275 pages and was mainly bullet pointed. I read through this book multiple times making sure to know everything I could from it. I was able to get this book as my program had therapy come in and teach a weekend course. However, you can buy these on Ebay +/- $30. This is one of the best investments you could make.

True Learn

I LOVED this website. You are able to take an initial practice exam, which true learn will let you know what areas you need to focus on. From there, True Learn has a question bank of over 1200 questions. You are able to create small practice test to mix in within your studying. True learn tracks progress, your strengths and weaknesses in each area of the test. When reviewing the questions, true learn gives you the explanation for each answer choice and why it was right or wrong. This feedback along with the immense amount of practice questions allowed me to pick up patterns within the test.

I am happy to say that you are able to get 20% off True Learn NPTE SmartBank subscriptions of 90 days or more using discount code “TommyPT” .


Scorebuilders Textbook

I actually used this very sparingly and only on topics that I found myself struggling and needing more understanding of


Practice Exams(PEAT, Retired NPTE, Scorebuilders, Therapy Ed):

The hardest part of the test is honestly having the endurance to maintain concentration for 4-5 hours. Taking practice test does not only give you feedback on what you know and what you dont know, but also preps you for the endurance of the test. I found the therapy ed and score builders exams to be significantly more difficult than the PEAT or retired NPTE.

I have a theory they do this to scare you to buy more of their products


During the course of my studying I took over 2500 practice questions. I found this to be the most important part of my studying because it allowed me to pick up on patterns that certain answer choices were associated with. Ie if question mentions swelling of first MTP joint Im automatically thinking gout is my main answer. Or teenage boy with a weird hip presentation I would start to think slipped capital femoral epiphysis


Fatigue Is Not a Risk Factor for ACL Injuries: Myth Buster Monday

Fatigue is Not a Risk Factor for ACL Injuries:Mythbuster Monday

Although I have torn my ACL twice, researched ACL injuries for 7 years and presented internationally regonized research on ACL risk reduction. Yet I still know very little about why ACL injuries occur.  However, every day we come a little closer and gain a better understanding the mechanism of this injury.

Although we don’t understand, the exact causes, we are able to identify risk factors for injury that predispose people to be at a. higher risk.  Although many risk factors are backed by research, some are complete misconceptions.  One of the most commonly argued risk factor is that fatigue puts us at greater risk for ACL injuries.  The argument is based around the idea that fatigue will alter our biomechanics in a negative manner. However, the research has shown that the changes we see in a fatigue state actually puts us at a lower risk.  In fact Hewett and Webster(two of the top ACL researchers in the world) foun d that fatigue cared us to demonstrate decreased forces, increased knee and hip flexion.  Each of these puts us at lower risk for injury.

Real world data also supports that fatigue is not a risk factor for ACL injuries.  There is no association between time of season or game qith increased risk of ACL injuries.  Infact a recent systematic review even showed 64% of  soccer ACL injuries happen in the first half of the game


Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Female Soccer Players


Is Fatigue a Risk Factor for Anterior Cruciate Ligament Rupture?