Visit One of Our
3 Charleston locations
Give us a Call
Send us a Message
Opening Hours
Mon-Friday: 8AM - 5PM

Why Squatting Will Not Help You Throw Harder From The Mound

Let me take you on a journey through the biomechanics of pitching. Most people understand that power comes from the lower half when throwing a baseball. So, what workouts do you do for the lower half — Squats, deadlifts or leg presses? Many would argue that these exercises are unnecessary if you are trying to gain velocity when throwing a baseball. What if you have chronic neck and back pain? What do you do then? With this being said, these exercises are very important for overall function and hormonal response, however, they are not going to make you throw harder.

Let’s start with the leg kick. The point of a leg kick is to allow time to pass as forward momentum is being built. Arm separation has had time to occur while the leg has come down. As the front leg extends toward home, this is where the most important pitching motion happens. Most of your power comes from how quickly you can rotate your pelvis toward home plate. As your front leg comes down, you create external rotation of both legs. Just before the front foot hits the ground, relative internal rotation occurs in both legs. The front leg uses internal rotation to rotate the pelvis toward home plate, while the back leg maintains internal rotation to translate centripetal force toward home plate.

Let’s move up the chain.

This quick and powerful rotation of the pelvis induces a stretch on the anterior oblique muscular sling. This is comprised of internal obliques on the glove side, and external obliques on the throwing arm side. Pectoralis major, biceps long head and flexor digitorum superficialis on the throwing arm side has induced stretch through the centripetal force as well. Picture a slingshot being cocked back. Just like the sling, the muscles are now being stretched.

The key to understanding biomechanics is that simple leg workouts will not help you or your athlete gain velocity. The questions you need to be asking are: How do I train power and speed behind hip internal rotation? How do I train comfortably in internal rotation on the stance leg? How do I train my core to be able to transfer load from my lower extremity to my upper extremity?

The dissonance between training and games needs to be closed. At Rehab Docs, we take a special interest in biomechanics of athletes because we understand how devastating injuries can be, especially those that could have been avoided.

The Rehab Docs understand how important it is to build strength, power and speed off of foundational movements of each sport. Don’t waste your time and energy training inefficiently. Different sports require different types of training to make sure you are maximizing your potential and limiting your risk of injury.

Give us a call today to discover your tailored chiropractic treatment plan!


What to Look for in a Chiropractor

It’s safe to say that chiropractors as a whole get a bad wrap. The typical perception of a chiropractor is that your going to get your “back-cracked” and have to keep coming back for life. Listen there are good and bad people in every profession. So what makes a chiropractor good at what they do? How do you know you are getting the best conservative chiropractic care possible? And what makes a chiropractor different from a physical therapist?

Let’s start by discussing what to avoid.

When you go to a chiropractor or physical therapist understand that you do not need x-rays to see the curvature of your spine. Of course if you have acute trauma or suspect to progressive nerve compression get imaging. My point is that the curvature of your spine does not need to be seen on an image because at the end of the day, does is matter? Unless you have severe degeneration, fracture or pathology, your curvature of your spine has no influence on spine pain and function (you know Usain Bolt has scoliosis right!?).

You have heard me say this in the past but bones only move when a muscle influences the movement. This is no different in your spine. You usually see an abnormal curvature only if the muscles pulling on the spine are asymmetrical. So what do you do, rely on adjustments? NO. Rely on soft tissue work? NO. Influence symmetrical muscle pull by teaching the brain to control the muscles around the spine correctly? Yes.

Avoid soley band-aid care! Band-aid care is an adjustment, soft tissue work, dry needling and single joint exercises that don’t fix the root cause of the issue. We preach on this all the time. Look for someone that is working on changing the way you move so you do not have to rely on band-aid care the rest of your life. Band-aid care is nice to relieve painful symptoms but does not fix the overall problem. Yes I know, band-aid care feels good, but at some point your going to get tired paying for the same issue over and over.

Avoid being another protocol! Be wary if someone spells out your whole treatment plan from start to finish. I remember doing rehab after my elbow surgery when I was younger and every visit they would go to the computer, type in my “issue”, and out came a list of exercises that we did that day. Every person has different strategies to move AND has a different ideal pattern that they should be moving in. Treatment should vary in response to how your body chooses to adapt to the new movement strategies.

The goal of every practitioner should be to fix a problem long term. The best physical therapists and best chiropractors practice the same — they are going to use the best possible treatment strategies to help their patients. The problem is that the best is hard to find. In your search for chiropractors in charleston, sc, keep in mind that you are looking for someone who takes a look at the whole kinetic chain, someone who tailors treatment to your body and goals and someone who wants to fix the cause of your pain long term.

Here at The Rehab Docs, we understand how confusing it is when choosing a healthcare professional. We would love to help you make that decision by answering any questions you may have and to help you find the best chiropractic care possible.

Common Faulty Movement Patterns Involving the Shoulder and Neck

Some of the most common problems that we see are due to poor motor control, especially of the scapula. Just an anatomy and biomechanical review: The shoulder complex is comprised of 3 very important joints that all need independent motion. These joints are the Glenohumeral Joint (the joint that you mostly hear about with injuries), the Acromioclavicular Joint (the bony connection to the rest of the body), and the Scapulothoracic Joint (the problem child). Problems arise when we do not know how to control the muscles influencing movement of these joints. The lack of control is due to compensation or poor motor strategies over time. The most common compensatory presentation that is seen is best described by Janda. He terms the condition Upper Cross Syndrome. Simply explained, the Pecs, Upper Traps, and Levator Scapulae are all tight (or neurologically facilitated), while the Deep Neck Flexors, Middle/Lower Trap, and Serratus Anterior are all weak (or neurologically inhibited). View picture below for reference.



Here is a question to ponder for the colleges: How do you think constant use of secondary respiration muscles influences the neurological tone in Janda’s facilitated muscles? Are we creating a lower threshold for activation of these muscles in other daily activities?

The painful source of this type of presentation can be anterior shoulder pain, upper trap pain, neck pain, headaches, TMJ dysfunction, etc. The painful source is determined by which structure is compensating the most and what daily activities you find yourself doing most. We preach this often, but Band-Aid care will not fix this issue. Adjustments, soft tissue work, single joint exercises and dry needling is not what you should be seeking for care. This, like many other conditions, is due to how you use your body. Stability of the scapula through an overhead range of motion is easier said than done! The goal is to change your movement strategy. By default, tone and trigger points will dissipate… for good, unless poor movement strategies are resumed.

The goal of treatment should always be fixing the problem long term. This can only be done by changing the way your brain chooses to move your body through space. It is our goal to make sure you can continue to swing a golf club for the rest of your life, to not be in fear of picking up children and grandchildren, and to be the weekend warrior you’ve always dreamed of being.



This site does not represent individualized professional medical advice. Please seek medical attention for any concerns regarding your personal health. Do not avoid, delay, disregard professional medical advice, or delay seeking it because of something you read on this site. If you want to be evaluated and receive personalized treatment, please call the office or send us an email.

Learn More

Common Faulty Movement Patterns Involving The Low Back

As we have said in multiple other posts, pain is a warning sign. Low back pain is no exception. It tells us that something is not quite right. Many have likened the prevalence of low back pain to an epidemic. Why the sudden increase in low back pain?? There are many speculations as to the reason and ways to prevent. Here is my take:

We all know that America is only getting more technologically advanced. This is great except for the people who have jobs working primarily with technology. Technology has advanced the human experience dramatically in terms of mental stimulation. Physically the opposite is true, for the most part.

The sedentary lifestyle that has evolved is inevitable. Being in any position for a prolonged period of time forces adaptation to the position. One of life’s greatest gifts, adaptation, can also be a huge downfall for a human body. The process of adaptation usually only has efficiency in mind. This may be efficiency of mating, day-to-day operations, catching prey, survival, etc. Immediate efficiency does not take into account long term effects.

Technology has allowed for a more sedentary lifestyle. This has forced advantageous adaptations to facilitate this sedentary lifestyle. We are then very efficient at sitting at a desk, but then do not perform as well when we enter weekend warrior mode.

The adaptation that, in my opinion, caused this epidemic of low back pain is the lack of a stable core. A sedentary lifestyle influences increased tone in the same muscles that act as accessory inspiratory muscles. These muscles include pectoralis major and minor, sternocleidomastoid, serratus anterior and scalenes. Because of the increased tone and neurological sensitivity to these muscles, they are much more active in inspiration at rest. If our secondary respiration muscles become dominate (because of adaptation) we do not have to rely on our primary inspiration muscles to handle its full load. This means less contraction of the diaphragm and intercostals. If we cannot get into full contraction of our diaphragm, we cannot create the necessary intra-abdominal pressure to stabilize our core. Let’s talk about what a stable core means.

Most of us do not have a stable core, not only because of this adaptation to our prolonged positions, but because we don’t know what a stable core means anymore. A stable core is not a six pack. A stable core looks more like a baby’s belly. Can you picture that cute gut hanging over the diaper? We've added a picture above for reference. A baby is able to use descension of the diaphragm and eccentric tone of transversus abdominis and obliques to create intra-abdominal pressure to stabilize in a variety of positions. Ideal stabilization of your core should look more like the inflation of a balloon within your stomach. Rectus abdominis (our six pack muscles) and erectors (big muscles on either side of the spine running all the way up) on the other hand, only stabilizes us in the sagittal plane of motion, or front to back. If this compensation resides, we are then at a loss of stabilization in rotation, lateral flexion, and anywhere in between. Not only are we at a lack of stabilization with this compensation, we are in a strategy that increases compression on the lumbar spine, which means the discs and other associated joints.

Being able to stabilize the low back with use of intra-abdominal pressure allows us to create a sphere of stabilization. This allows us to not only use our limbs off of stability, but also transfer load from lower extremity to upper extremity. For this reason, creation of intra-abdominal pressure is massively important to weekend warriors and athletes alike.

Everyone hears about how important the core is to a healthy back and function. How many of you knew the correct way to stabilize your core? Lets try a test. Put one hand on your chest and one on your belly button. Take a big, deep breath in. What did you notice? Want to know ideal? Ideally, the top hand should not move at all and the bottom hand should be moving out with each deep breath in. Being able to create intra-abdominal pressure is the key. Being able to do this during functional movements takes stress and abuse off of the low back by relieving the compensating structures.

If you want to exit low back pain, limit future risk of low back pain, or maximize potential, this is a great place to start.

This site does not represent individualized professional medical advice. Please seek medical attention for any concerns regarding your personal health. Do not avoid, delay, disregard professional medical advice, or delay seeking it because of something you read on this site. If you want to be evaluated and receive personalized treatment, please call the office or send us an email.

Learn More

Knee Pain

Common Faulty Movement Patterns Involving the Knee

Everyone at some point in their life has had knee pain. Most commonly this pain is at the front of the knee and may hurt walking up and down stairs. Knee pain comes and goes but it is a huge sign that biomechanically something isn't right. The knee is considered a stable joint because its plane of motion is mostly in one direction. Muscles that surround “stable” joints have a unique ability to produce tremendous torque. Torque at a joint is simply movement in one direction in a period of time. The knee, for example, is able to extend very quickly and forcefully due to its “stable” joint position. Another way of saying this is that there is less variance of joint position so the muscles can fire maximally with one purpose. The only problem with this joint stability is that our muscles surrounding our knee are not very good at stabilizing joint position. This is usually because we are not often in “unstable” joint positions at the knee where the muscles are forced to stabilize.

The opposite is true at the hip and ankle. These joints have many planes of motion which force the muscles surrounding to stabilize at each joint position. The muscles surrounding these mobile joints are not as capable in providing torque, but rather are great at providing stiffness. This is because the muscles at these joints are forced to act as stabilizers more often on a daily basis. Stiffness is achieved when muscles from either the side of the joint (the antagonists) contract in synergy to provide less movement at the joint. Now don’t get confused, the muscles around the hip and ankle are not there to limit movement but rather stabilize the joint through a large range of motion. With this being said, there are many instances where different levels of torque and stiffness at each joint are needed simultaneously and independently. A problem occurs when range of motion or muscle control is lost. Let's say we have someone with anterior knee pain. Yes, most likely rectus femoris or your quad is tight. At this point you must ask, “Why is my quad tight?” This could be because of a lack of hip extension, a lack of dorsiflexion in the big toe (not kidding), or multiple other reasons. After this you must ask yourself, is this a joint problem or a motor control problem. Do you have the joint range of motion but not able to use the range of motion through a functional movement? Are you not able to get into glute extension because of a lack of a stable core and subsequent lumbar extension and anterior pelvic tilt? The point is that something simple such as knee pain cannot be simply looked at as overuse. Getting a massage, dry needling, stretching, or simple single joint exercises are not going to fix the cause of your problem. A biomechanical problem needs to be addressed by analyzing biomechanics, not chasing pain. The key to getting out of pain and staying out of pain is realizing the difference between the cause and source of pain. No one has to live with knee pain. Make sure you are getting the care you deserve and get back to doing the things you love to do.

This site does not represent individualized professional medical advice. Please seek medical attention for any concerns regarding your personal health. Do not avoid, delay, disregard professional medical advice, or delay seeking it because of something you read on this site. If you want to be evaluated and receive personalized treatment, please call the office or send us an email.

Don’t Fall Victim To Unnecessary Sports Injuries

Unnecessary sports injuries are an absolute tragedy for young athletes. These type of injuries are noncontact in nature and are more common than you may think. Over ⅓ of knee injuries in women’s soccer are noncontact in nature (1). The sad part is that most of these injuries can be prevented!

This topic hits home for me. I tore my UCL, a ligament in my elbow, when I was a young athlete. Tommy John Surgery and a long rehab process was a necessity if I wanted to continue in my sport. This was not simply an overuse injury as my pitch count was strictly monitored. This was a pitching form problem that could have, and should have been fixed. If only I knew then what I know now! It is a passion for me to help young athletes from all athletic backgrounds prevent unnecessary injuries such as this.

My high-school friend, Matthew Young, and myself recovering together post-surgery. Not the way anyone wants to spend the summer before college.

One of the most common injuries in high school and collegiate sports is ACL tears. A non-contact ACL tear can be the resultant of many biomechanical faults. According to the British Journal of Sports Medicine, athletes with the highest risk of ACL injury are between the ages of 14-18 and are twice as likely to happen to females than males (2). According to another study by the North American Journal of Sports Physical Therapy, athletes that have a low score on their functional movement screen have a four-fold risk increase of lower extremity injury (3).

A functional movement screen is a series of tests to evaluate the way an individual moves. These exercises can range from the ability to balance to the ability to withstand stress. The goal is to pick out flaws in an individual’s movement pattern that can leave them susceptible to injury. If we can fix these flaws, then we can prevent injury with the added benefit of actually improving performance at their sport!

Let’s make it a priority to have young athletes screened for the risk factors associated with noncontact knee injuries! Better yet, let’s make it a priority to have all young athletes screened in order to prevent life altering injuries that can be prevented!

1. Fulstone, D., et al. “Continued Sex-Differences in the Rate and Severity of Knee Injuries among Collegiate Soccer Players: The NCAA Injury Surveillance System, 2004–2009.” International journal of sports medicine 37.14 (2016): 1150-1153.
2. Renstrom, P et al. “Non-Contact ACL Injuries in Female Athletes: An International Olympic Committee Current Concepts Statement.” British journal of sports medicine 42.6 (2008): 394–412. PMC. Web. 3 Nov. 2017.
3. Chorba, Rita S. et al. “Use of a Functional Movement Screening Tool to Determine Injury Risk in Female Collegiate Athletes.” North American Journal of Sports Physical Therapy : NAJSPT 5.2 (2010): 47–54. Print.

This site does not represent individualized professional medical advice. Please seek medical attention for any concerns regarding your personal health. Do not avoid, delay, disregard professional medical advice, or delay seeking it because of something you read on this site. If you want to be evaluated and receive personalized treatment, please call the office or send us an email.

Taking Squat Tips From A Baby

This is my little girl Callan Kay who is obviously the cutest thing in the world (I’m not at all biased). What is not so obvious is how perfect her squat is or how the heck she got there. Why do babies squat with such ease but when us adults are asked to squat, we act like we’ve been asked to play darts with spaghetti?! I mean, I thought we got smarter as we aged! Let’s discuss some of the reasons squatting is so difficult and why babies are really just out to piss us off with their amazing squat form.

First things first. How did a baby get this perfect form? Put yourself in a baby onesie and let’s think. When a baby learns to move, he/she has limited muscle strength and coordination to perform a task. When a baby rolls over for the first time, all of the muscles that made this happen worked PERFECTLY. There was no other way for the baby to roll over except for this one way. Thus, a movement pattern is born. There are windows in babies lives that are ideal for these movement patterns to be built. Otherwise, the baby will get stronger, miss the window, and forever compensate around this ideal movement. Missing this window may lead to malformation of joint surfaces, less coordination during movement, or even early arthritis. Don’t freak yourself out about missing these windows. Simply follow one rule and these windows won’t be missed: Never put your baby in a position that they cannot themselves get in. For example, putting a baby in a walker before they can walk themselves will only cause problems (this is why they are banned in Canada)!

Now on to the adults… The reasons not every squat will be the same include: a bunch of science and terms that confuse people. The bottom line is that every body type is different and this has a profound effect on how you move. For example, someone with a longer torso and shorter legs will squat much differently than someone with a short torso and longer legs. Don’t get me wrong, everyone has a unique ideal squat that should be strived for. The hard part is picking out what needs to be changed from what needs to be compensated around.

One thing that I hate to hear is someone in the gym describing what they think is ideal squat form. Telling someone to get their “butt back” is not always the best cue! There is a reason why not every pitcher in the major leagues throws the same way. In fact, it is near impossible to find the same exact form! Of course, squatting is much less complex than pitching form, but the point is that not everyone’s squat will be the same, nor does it need to be.

With this being said, there are certain key points that must be addressed to maintain good squat form.

1. Intra-abdominal pressure, created by your core musculature, is the foundation of any dynamic movement including a squat. Great intra-abdominal pressure keeps you upright in your squat, limits spinal flexion, and actually decreases the pressure in your discs! Training intra-abdominal pressure will not be accomplished by doing sit ups and crunches. A good place to start training this motor pattern is to think of filling up your stomach like a balloon having equal pressure 360 degrees around your core.

2. Equal loading of the “tripod” of the foot allows for ideal stability and function of the knee. The tripod of the foot consists of the heel, the ball of the foot, and the knuckle of the pinkie toe. Finding the tripod of the foot and being able to actively load the arches before squatting will save your knees! Make sure you do this before every squat under load.

3. Hip hinging at the correct angle with the correct rotation of your thigh allows you to use your glutes and hamstrings. This is a common problem seen in squat form which is why you always hear “Get your butt back!” The problem is that this angle is not the same for every person. Make sure you know what angle is correct for you in order to limit future low back pain and knee pain.

4. Ankle mobility is a necessary component that must be addressed to have good squat form. It is very difficult to get full range of motion in your squat if you have poor ankle mobility. Decreased ankle mobility can be because of many reasons but the most common reason is because of tight or shortened calves. And no, simply stretching your calves will not fix the problem. To see if you have an ankle mobility problem, try placing weights underneath your heels during a squat, 1 or 2 inches in height. If you are able to get lower into your squat with better form, then “Ding! Ding! Ding! We have a winner!”

Don’t let the vagueness stress you out, everyone is different and they need to be analyzed as such. Let an expert examine you to find YOUR perfect squat.

This site does not represent individualized professional medical advice. Please seek medical attention for any concerns regarding your personal health. Do not avoid, delay, disregard professional medical advice, or delay seeking it because of something you read on this site. If you want to be evaluated and receive personalized treatment, please call the office or send us an email.

Dry Needling? No Way, I Hate Needles!

What is Dry Needling?

To put it simply, dry needling is another way to manage pain (remember managing pain does not fix the problem). It focuses on addressing trigger points. Trigger points are those “knots” you feel that cause pain. Sometimes the pain is localized to the area of the “knot” while other times the pain can be referred to other areas, ie. headaches.

What is a trigger point?

Think of it as a good thing in a poor functioning system. It is a neurological way of protecting a certain part of the body. If certain muscles around a joint are not moving and coordinating correctly, trigger points can be seen in muscles surrounding that joint.

Why are we getting rid of trigger points if they are a protective mechanism?

For one, getting rid of trigger points gets rid of pain, and people don’t like pain. If a trigger point is dissipated by dry needling but the function around the joint is not fixed, the trigger point will return most likely the same day. This is the problem with band-aid care. An adjustment and soft tissue work is great but if the function is not fixed the problem will not resolve (this is a soapbox for another time). The treatment should be creating ideal function around the joint which in turn gets rid of trigger points and pain. Dry needling and other manual therapies should be used as an adjunct to creating proper function. Using manual therapies alone may feel good but is a waste of time for the patient in the long run as their problems will not be fixed.

Why dry needling?

Dry needling is the easiest way to address stubborn trigger points. Dry needling combined with adjustments is the best way to get these muscles to immediately relax. To get the most out of a treatment sometimes it is wise to get rid of the trigger points before changing motor patterns, or the way you move. This all depends on patient presentation including pain presentation and ability. Once again, needling of any kind does not fix the problem but should be used as an adjunct to fixing biomechanical fault.

How does dry needling work?

Dry needling works by disrupting the constant neurological signaling causing the trigger point. This disruption of signaling is because of multiple factors including increasing mechanoreception, damaging the motor end plate, manipulating fascia, increasing blood flow, increasing cortical awareness of the structure, or a combination of these.

Is dry needling for you?

If you have muscular pain (which a lot of times is because of trigger points), then yes!- but only in the correct context! At The Rehab Docs we use dry needling to facilitate the treatment process. It is a great tool if you use it correctly!

This site does not represent individualized professional medical advice. Please seek medical attention for any concerns regarding your personal health. Do not avoid, delay, disregard professional medical advice, or delay seeking it because of something you read on this site. If you want to be evaluated and receive personalized treatment, please call the office or send us an email.