Author: Nate

The Power of Early Intervention in Sports Injuries: A Tale of Two Ankle Sprains

Nate Recovery
The Power of Early Intervention in Sports Injuries: A Tale of Two Ankle Sprains

Ankle sprains are one of the most common sports injuries. While they often get brushed off as “just a sprain,” how an athlete manages the first few days can determine whether they’re back in the game in two weeks—or sitting out for two months.

To show why early intervention matters, let’s look at the stories of two of my recent athletes with the same injury but very different paths: Andrew and Lee.

Andrew’s Story: Early Intervention

  • Day 1: Andrew injures his ankle in a game. Instead of waiting, his parents contact me immediately and I get him into the clinic that same day. After confirming there’s no fracture, I initiated a comprehensive, evidence-based treatment plan which included myofascial release, joint mobilization & manipulation, gentle range-of-motion and mobility drills, application of tape for pain and improved function, recommendations for activity modifications, and guidance on weight-bearing strategies and symptom management.
  • Days 2-7: Pain decreases daily, swelling is controlled, joint mobility is returning to baseline levels, functional activities are becoming less cumbersome—not with rest, but with active recovery.  Andrew initiates advanced rehabilitative work incorporating multi-directional tasks, strength training, and low-level plyometrics to facilitate a return to sport.
  • Days 7-14: With professional guidance, progressive loading, and a well-designed treatment plan, Andrew is reporting nearly 100% overall recovery.  He passes all return-to-play tests and is back at practice.
  • Outcome: Andrew misses only 2 games, returns confidently, and lowers his risk of re-injury.

Lee’s Story: Delayed Care

  • Day 1: Lee injures his ankle in a game too, but decides to “rest it and it will work itself out.” He initially avoids putting weight on it because it hurts, ices and elevates the leg when possible, and takes an advil.
  • Days 2-14: Pain and swelling linger.  He has lost ankle mobility and feels weak & unstable.  Walking, squatting, and stairs remain difficult.  He tries an OTC brace, but still cannot participate in practice at his prior level due to persistent symptoms.
  • Weeks 2-3: Only now does Lee’s parent (and coach) contact me and request to begin physical therapy. Because of the delay, his ankle is stiff, weak, and unstable making it difficult for him to function in everyday and athletic activities. The initial treatment plan is similar to the above scenario, but with a much more tailored approach to restore joint range-of-motion before progressing to sport-specific drills due to significant loss of motion.
  • Weeks 4–6: Lee has finally passed all required return-to-sport testing and is cleared to play (although he still demonstrated ~10% deficits on certain criteria).  He’s missed nearly 1/4 of the season (including two big tournaments), his overall fitness, conditioning, and ball handling skills have dropped, and he still remains at a higher risk of a recurrent sprain.
  • Outcome: Significant time loss from sport, longer rehab timeframe, higher medical costs, and lower confidence.

Why Early Intervention Makes the Difference

The body is built to heal under tailored loads and guided movement—not prolonged rest. Here’s why:

  • Pain & Swelling: Early intervention and individualized load application help the body minimize swelling and reduce pain relatively quickly. Delayed care opens the window for suboptimal scar tissue formation, persistent pain, and apprehension.
  • Range of Motion: Early intervention and individualized load application minimize the development of abnormal stiffness, which allows for functional activity to resume sooner. Delayed care often requires longer time and measures to regain motion and restore function.
  • Strength & Stability: Early intervention and individualized load application restores strength, balance, and control during a time when fear avoidance, apprehension, and muscle inhibition are heightened. A delay in care leads to lingering problems with athletic performance and confidence in sport.
  • Return to Play: Athletes who initiate care early reach functional milestones (jumping, sprinting, cutting) weeks sooner.  That’s the difference between missing 1-2 games and missing out on a significant portion of the season.
  • Cost: A immediate start to rehab often means fewer total visits, fewer imaging studies, and less reliance on medications—saving A LOT of money in the long run.

Practical Checklist: What To Do Within the First 48 Hours of an Ankle Sprain

✅ Get evaluated quickly by a medical professional to rule out fractures or severe injury.

✅ Use compression and elevation to limit swelling.  Ice for pain.

✅ Begin gentle movement early (pain-free ROM exercises).

✅ Bear weight as tolerated—with support (brace or tape, crutches) if needed.

✅ See a sports physical therapist to start guided rehab.

✅ Avoid prolonged immobilization unless specifically directed by a provider.

The Bottom Line

Two athletes. Same injury. Two completely different outcomes.

Evidence-based, early intervention strategies are the key to returning athletes to sport quickly and safely following injury.  Because every day matters.

When Perseverance Pays Off: Lessons from Tommy Fleetwood’s First PGA Tour Win

Nate Education, General, Golf, Monthly Newsletters
When Perseverance Pays Off: Lessons from Tommy Fleetwood’s First PGA Tour Win

A Breakthrough Moment Years in the Making

 

Tommy Fleetwood had long been one of golf’s most talented players—a regular presence in tournaments, often on the leaderboard, but without a PGA Tour title to show for it—until his first-ever PGA Tour victory (and FedEx Cup) at the Tour Championship in Atlanta this past Sunday. That breakthrough didn’t come by accident; it was the result of years of hard work, near-misses, and quiet determination.

With that said, here are some simple, practical considerations both player and parent should consider in his or her athletic journey…

 

1. Embrace Defeat as a Stepping-Stone

 

For Fleetwood, coming close but not quite getting there was not a failure—it was preparation.  Each runner-up finish, every close call, sharpened his focus. For a young athlete:

  • Losses are lessons: Rather than feeling crushed, reflect—What did I learn? What can I do differently?
  • Parents, your support matters: Encourage your child to talk about setbacks. Help them see how much they’ve grown—not just where they fell short.

 

2. Seek Challenges—Don’t Avoid Them

 

Elite athletes aren’t defined by comfort zones. Fleetwood stepping into high-pressure environments taught him how to handle tension. For youth athletes:

  • Play up—not down: Facing stronger competition, or pushing your limits, helps you grow.
  • Normalize discomfort: Parents, help your child understand: it’s okay to feel uneasy. That’s when growth happens.

 

3. Keep Chasing Excellence—Every. Single. Day.

 

Even after winning, Fleetwood didn’t rest on his accolade. His win wasn’t a finish line—it was a milestone. For families:

  • Focus on continuous improvement: Set short- and long-term goals: your technique, strength, flexibility, mental resilience.
  • Celebrate progress—not just podiums: Compliment effort, growth, attitude—and remind them that mastery is a marathon.

 

Putting It All Together:  A Real-Life Model

Here’s how you—young athlete and parent—can embody the same spirit that led to Fleetwood’s breakthrough:

Principle What It Looks Like in Action
Overcoming Defeat Review matches/games and pinpoint one area to improve next time.
Accepting Challenges Practice under pressure: simulate game-day conditions in training.
Pursuing Improvement Set measurable targets—performance, technique, mental composure.

 

A Personal Note to Young Athletes & Parents

 

Dear young athletes, remember: setbacks are not the end—they’re signposts pointing toward what needs work. Let Tommy Fleetwood’s first PGA Tour victory remind you that brilliance often happens after the grind, not before it.

Dear parents, your belief fuels your child’s perseverance. Help them reframe “I lost” into “I learned,” and celebrate the small wins along the way—because those pave the path to greater triumphs.

 

Takeaway: Whether it’s golf, soccer, basketball, or dance—talent is just the start.  It’s the daily commitment to get better, the courage to face failure, and the grit to chase excellence relentlessly that turns potential into achievement.  Let Fleetwood’s example be your inspiration: it’s never too early (or too late) to breakthrough.

When should my child begin to lift weights?

Nate Injury Prevention
When should my child begin to lift weights?

There are many health and fitness benefits to resistance training.  Not only does it enhance muscular strength, it improves fundamental movement skills, increases bone mineral density, improves cardiorespiratory function, helps in weight management and body composition, and reduces injury risk in sport.  

Despite the established benefits of resistance training, many health care professionals, teachers, coaches and parents have been led to believe that it is inappropriate to implement at the youth level.  Probably the most common myth and unfound belief is that it is unsafe.  

This is just not true.

In fact, research findings indicate a relatively low risk of injury in children and adolescents who follow age-appropriate resistance training guidelines with qualified supervision and instruction (see here).

Even the National Strength and Conditioning Association (NCSA) provides a position statement (see here) that encourages resistance training in youth populations given the myriad of health benefits.

Did you know that regular physical activity during childhood and adolescence not only promote growth and development, but has been shown to reduce the risk of developing chronic disease later in life?  (see here)

At Uncommon Physical Therapy, not only do we help train your child how to properly move, we develop a comprehensive and individualized performance plan, and guide you along the way.

There is nothing wrong with getting strong.  

Visit UncommonPT.com to schedule your visit today!

Cash Pay Physical Therapy

Nate General
health insurance wooden letters
Over the last several weeks I have received a number of inquiries pertaining to cash-based physical therapy, given that our clinic functions under this payment model.  For those that have asked, and for others that may be curious, let me clarify what this payment system is and what it means for you.
In the most simplistic terms, a cash-based practice is one in which the clinicians do not accept insurance payments, accepting only direct payments from the patient, client or customer.  This can occur through fees per visit, fees per package, or through monthly membership or subscription plans.  Payment methods may include cash, checks, debit/credit cards, health savings accounts, or flexible spending accounts.  Payment is due at the time of service, and is always at a stated price (at least it is here).
So you’re probably thinking, “but I have insurance, why wouldn’t I just go to a clinic that accepts my insurance?”
Let me further explain.
Most health insurance policies don’t cover the entire cost of physical therapy.  Many patients are still responsible for copays and deductibles, so regardless, you will likely pay a fair amount out of pocket for physical therapy services.  In fact, many in-network physical therapy clinics are charging $250/visit to your insurance company.  If you haven’t met your deductible yet, not only are you responsible for your copay, but you would be responsible for the full cost of that visit.
Furthermore, at a traditional (insurance-based) physical therapy practice, in order to be in-network with insurance companies, clinicians agree to accept the insurance company’s rates, which are often low.  As a result, providers will offset the reduced rates by increasing volume of patients they see.  What this means is that patients might be booked alongside several others simultaneously, or, it will be recommended that you are seen 2-3x/week for 4-6 weeks.
In addition, most health insurance policies restrict the total number of visits you are allowed to seek physical therapy services.  For those undergoing surgical intervention, this can be a major barrier to your full recovery.
Does this sound familiar?
At Uncommon Physical Therapy, we decided from the beginning to operate as a cash-based practice to eliminate these problems.  Our emphasis is on quality over quantity to provide you with the most value.
Each visit with us is strictly 1:1, and can last anywhere from 30-60 minutes depending on your preference of services and specific needs.  Our costs are publicly listed, as we believe in full transparency with our patients, clients and customers.  And we will never limit your visits; if you need care, we are here for you.  But remember, you still have options for seeking reimbursement for your physical therapy care.  Speak with your health insurance company and see if your plan offers out-of-network benefits.  If so, you may be able to submit the billing claim (what we call a superbill) to the insurance company for possible reimbursement.
As a final note, a recent study (see here) comparing cash pay to insurance-based physical therapy found that cash-based services…
1.  Decreased the total number of visits
2.  Reduced the cost per visit
3.  Decreased the overall cost for the entire treatment plan
As an example:
Traditional (Insurance-Based) Physical Therapy
  • Cost Per Visit = $50 (co-pay)
  • Total Visits = 12
  • Total Cost = $600+ (does not include bills from services)
  • Time Spent 1:1 with PT = 15 minutes/visit
  • Total Time in Clinic = 180 minutes
  • Cost Per Minute = $3.33
Cash-Based Physical Therapy
  • Cost Per Visit = $125
  • Total Visits = 5
  • Total Cost = $625 (no additional bills)
  • Time Spent 1:1 with PT = 60 minutes/visit
  • Total Time in Clinic = 300 minutes
  • Cost Per Minute = $2.08
I hope this information has been helpful.  At Uncommon Physical Therapy, our goal has always been to empower our patients to make the best healthcare decisions.  That is what the uncommon healthcare experience is all about.
For more information, visit uncommonpt.com and schedule with us today!

Heat-Related Illnesses in Sport

Nate Injury Prevention
Heat-Related Illnesses in Sport

Let me state the obvious:  It is HOT outside!  REALLY HOT!

This week I’ve been providing medical coverage for a local youth soccer camp.  While I do not anticipate (and certainly do not wish to see) any significant injuries, my biggest concern has been the development of a heat-related illness in an athlete.

The prevention, recognition and treatment of exertional heat illnesses are major focuses of the on-field sports medicine team at all levels of sport.  This week, and through the entirety of what always seems as the never-ending summer in Alabama, the risk of an exertional heat illness is ever present.  

So how do you recognize a heat-related illness?

Common symptoms may include….

-Headache

-Dizziness

-Nausea

-Vomiting

-Diarrhea

-Muscle cramps

-Weakness

-Confusion

-Chills

-Cold, pale, clammy skin (heat exhaustion)

-Hot, red, dry skin (heat stroke)

-Quick pulse

What should be done if heat-related illness is suspected?

In most situations, removing the athlete from play, resting in a cool location, and slowly replenishing fluids is sufficient.  However, if more severe symptoms are present, if symptoms worsen, or if symptoms last for longer than one hour, immediate medical attention is required.

For further clarification on recognizing signs/symptoms and the recommended response, see the CDC’s guidelines here.

In best minimizing heat-related illnesses, proper hydration is a key component.

A few easy ways to determine an athlete’s hydration status are to (1) check the color of urine, (2) pay attention to thirst sensation, and (3) measure body mass both pre- and post-exercise.  Each of these items can help determine hydration needs both prior to and following activity or competition.

The National Athletic Trainers’ Association (NATA) has published several position statements related to both fluid replacement (see here) and exertional heat illnesses (see here) which I would encourage you to read for further information.

In the meantime, stay cool, and should you have any additional questions about how we can best help you, visit UncommonPT.com.

Blood Flow Restriction Training after ACL Reconstruction

Nate ACL Rehab
Blood Flow Restriction Training after ACL Reconstruction

One of the main priorities of rehabilitation after anterior cruciate ligament (ACL) reconstruction is the restoration of quadriceps strength.  While there is certainly considerable pain, swelling, temporary loss of motion and reduced function associated with the surgical procedure, it has been estimated that approximately 30% of patients demonstrate quadriceps strength deficits up to 12 months after surgery, and those deficits can be as high as 30% years after the procedure.  This is important, as these collective problems have been linked to reduced knee function, lower functional performance, faulty biomechanics, delayed return to sport, increased osteoarthritis risk, sub-satisfactory outcomes, and heightened risk of re-injury.  (See here)

Current strength training guidelines recommend the use of higher loading mechanisms (i.e. 60-80% of 1-repetition maximum) to achieve adequate strength gains.  However, training at this intensity following injury or surgery may not be feasible given symptoms of pain, swelling, loss of motion, or weight-bearing restrictions, not to mention the concern for adversely stressing healing tissues.  

In recent years, the use of blood flow restriction (BFR) training has gained considerable interest.  BFR training, by definition, is the combination of low-load exercises (20-40% of 1-repetition maximum) with the simultaneous application of a strap or pneumatic tourniquet/cuff to the limb(s) that occludes venous outflow while maintaining arterial inflow. This method is believed to induce muscle hypertrophy (mass and strength gains) through a series of physiologic events that leads to tissue hypoxia, cellular swelling, elevated systemic growth hormone production, among other metabolic processes.

In a recent systematic review (see here), the authors found that low-load blood flow restriction training (LL-BFR) after ACL reconstruction may be beneficial on both quadriceps strength and mass compared to non-BFR training.  In addition, they found that LL-BFR may be an effective alternative to non-BFR as it relates to knee joint pain and ACL laxity.

For a more advanced explanation of BFR principles, safety, and recommendations refer to this article.  

At Uncommon Physical Therapy, we offer BFR training as part of a comprehensive rehabilitation program following ACL reconstruction.  

Schedule with us today to learn more.

UncommonPT.com

For Baseball Players, the Off-Season is Key for Success

Nate Baseball, Injury Prevention
For Baseball Players, the Off-Season is Key for Success

The off-season is a critical time for any athlete, particularly those participating in overhead or throwing sports.  Given the progressive loads to both the neuromuscular and cognitive systems throughout the regular season, it is imperative that restoration takes place.  

Specifically for baseball players, the cumulative stress on the dynamic (muscle) and static (ligament/tendon) stabilizers of both the upper and lower extremities leads to a variety of changes over the course of a competitive season.  This includes a loss of shoulder and elbow range of motion, decreased strength, loss of velocity, and increased pain (see here).  Therefore, an individualized off-season program should provide the athlete, and the body tissue, ample time for recovery followed by a preparatory/transitional period leading back into the competitive season.  This is what we call the off-season.

In a recent study, it was found that an off-season of adequate length was beneficial in the prevention of throwing injuries due to overuse (see here), specifically at the elementary school-aged level.

In another study, it was found that nearly 25% of youth baseball players reported an overuse injury or fatigue during a given season (see here).  In this same study, 30% reported that arm pain sometimes led to them having less fun participating in the sport.  In addition, 46% reported being encouraged to keep playing despite pain or fatigue.

The baseball player’s offseason should consist of time dedicated to rest, active recovery, and rejuvenation both physically and mentally.  The two goals of an offseason training program are simply this: 

  1. TO OPTIMIZE PERFORMANCE
  1. TO REDUCE INJURY RISK   

(FYI: Did you know the most common injuries in baseball include hamstring strains, throwing arm injuries, lumbar muscle strains, hip adductor strains, and oblique muscle strains?)

Principles of the Off-Season Training Program

1. Regular Functional Assessments

2. Optimize Mobility

3. Develop Strength

4. Maximize Speed & Power

5. Enhance Core Control

6. Frequent Arm Care

In addition to the above, appropriate workload progressions for baseball-specific activities such as sprinting, hitting and throwing need to be continually monitored.

As an example of what we offer, this is a basic outline to our offseason baseball program:

Phase 1: Recovery

-Restore range of motion 

-Soft tissue mobilization

-Joint mobilization/manipulation

-Active and passive stretching

-Maintain muscle function

-Address pain and tenderness

Phase 2: Reconditioning

-Low-load resistance training

-Emphasis on form/technique

-Continued arm care

Phase 3:  Strength & Speed

-Increase work capacity

-Progressive resistance training

-High intensity functional and multi-directional movements

-Velocity enhancement 

Phase 4: Pre-competition

-Sport-specific movements

-Low training volume, but high intensity training

-Resume arm care program

The bottom line is this:  A lack of adequate training in the offseason may be reflected by higher injury rates in the early months of the season as acute workload quickly increases.  Proper off-season programming should be designed to progressively build the athlete’s workload to best prepare for in-season demands and minimize the risk for injury.  

This is what we are here to help with.  This is what makes us Uncommon.

Check out the clinic!

Nate Uncategorized
Clinic and Rogue Fitness Equipment

Check out some photos of our clinic, taken by the amazingly talented Amy Dummier! Please feel free to stop in for a visit and/or to schedule an appointment for any of our services…

Front Entrance and Waiting Area
Clinic and Golf Simulator
Clinic Overview
Clinic and Rogue Fitness Equipment
Back of Recovery Room
Front of Recovery Room

Attention Alabama Runners!

Nate Injury Prevention, Recovery
Running Analysis

Running is one of the most popular and accessible activities enjoyed by millions worldwide, and for good reason.

Numerous studies have shown that running regularly can do wonders for your overall health.

Running can:

-Reduce stress and anxiety
-Improve mood
-Enhance sleep
-Reduce the risk of cardiovascular disease
-Improve bone and joint health

-Help you look younger and live longer…and more…

Despite these health benefits, running-related injuries are common.

Did you know that nearly 50% of runners will sustain an injury over a 1 year period? (See here)

Did you know that 70% of running injuries are due to overuse? (See here)

Did you know that the number one barrier to implementing an injury prevention program, is simply that people “don’t know what to do?” (See here)

WE CAN HELP!!

We offer prevention, performance and recovery programs to keep you moving forward.

Visit Uncommonpt.com to schedule your Running Analysis, Program Development, Training or Recovery session with us today!
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