HOT SEAT FANTASY PLAYER: COREY DICKERSON

Rising MLB star, Corey Dickerson was recently traded from the Rockies to the Rays. Fantasy players had high hopes for Corey's 2015 season but chronic plantar fasciitis and rib fractures limited him to 224 AB. He still managed to bat .303 with 10 HR in limited duty.

Manager Walt Weiss has been quoted as saying, "this kid could hit underwater." His talent is not being questioned. We're going to look at the long term implications of his 2015 injuries and see if he is worth the gamble in 2016.

Plantar fasciitis is inflammation of a thick band of connective tissue that connects the heel bone to the toes. The plantar fascia supports the arch and absorbs shock to the foot.

Due to the chronic nature of this injury, I suspect Corey may have faulty foot mechanics which along with prolonged standing and walking (needed for his job) have caused repetitive trauma to the fascia.

This is an injury that may need constant maintenance given his job description. Treatment likely includes anti-inflammatory injections, orthotics to support his foot mechanics and unload the plantar fascia along with an aggressive strength/stabilization and stretching program. Given his work ethic, I think this problem will be manageable for him going forward.

Corey also missed considerable time due to fractured ribs he suffered while diving for a fly ball on July 30. This injury should be fully healed now and based on his recent batting cage sessions I don't forsee this injury being an issue in the future.

The challenge to Corey's value will be TB's crowded OF situation. Given every player's learning curve when transitioning to a new league; the question becomes will Corey get enough ABs to merit his selection on your Fantasy team. If he can get off to a hot start he should be a nice pickup.

Labral Tears: THROWING ATHLETES MOST FEARED INJURY (A simplified guide)

Now that the smoke has cleared on the news that Greg Bird has a right labral tear requiring surgery, let's talk about this Boogeyman (known as a labral tear) and what this really means.

The labrum is a ring of soft fibrous tissue located in the shoulder socket. It's job is to help stabilize the shoulder joint. This collagen material cannot be strengthened and there are no reliable techniques to prevent labrum injuries. Oh, and did I mention they are tough to diagnose too!

A type I tear is when a portion of this tissue frays but remains intact. Usually PT can help regain motion, strength and function. In some circumstances arthroscopic surgery is recommended. Most procedures involve removing torn sections of this tissue.

A type II tear is when the labrum actually becomes detached from the bone. To correct this, the labrum is sutured back to the bone through anchors arthroscopically. As you can imagine this is a more involved rehab process than recovery from a type I tear.

These procedures are far more complicated and pose more of a threat to a throwing athlete's career than Tommy John surgery. In two separate studies it was reported that 3% and 14% of pitchers suffering from labrum tears were able to return to their previous level of success. This is far from the nearly 90% reported following Tommy John surgery.

Recovery really depends on a lot of factors such as the location and severity of the tear, how well the repair went, how well the patient heals, if they follow their physician's protocol and is compliant with physical therapy. Return to full essential function is usually between 6 and 8 months however the stress of throwing a baseball requires much more time. (12-14 months)

The good news is Greg Bird is not a pitcher and he plays a position in the field that requires the least arm strength. What makes Bird special is his bat not his arm. Expect him to be ready to compete at 2017 spring training. Ok... now everyone take a deep breath.

Hunter Pence PILATES WORKOUT

http://youtu.be/HdeV-GNDtk0

Check out Hunter Pence as he rehabilitates an abdominal injury from last season. This is the type of injury prevention and performance enhancement program I like to see when recommending players for your fantasy teams. Pilates is an excellent core strength and stability program many Yankees would benefit from; particularly Chase Headley and Dustin Ackley, who have had their share of lower back issues. Let's hope they're friends with Hunter.

CONCUSSION: MLB Policy and Youth Sports Screening.

Since the release of the movie Concussion starring Will Smith, some of the most frequent questions I am asked in my physical therapy practice are related to concussions.

As many of you saw in the movie, a concussion occurs as a result of the brain being physically jostled within the skull. This can cause swelling, bruising and trauma to brain tissue. Symptoms may include headache, problems with balance/coordination, concentration and memory.

MLB has made great strides to protect it's players and umpires from brain injury by implementing rules changes to reduce hits on a defense-less catcher, mandatory baseline neurological testing, new protocols for evaluating and clearing players for return to play and creation of a seven day disabled list.

It is very important that someone that has been concussed not be allowed to return to contact sport participation until these symptoms have resolved. If one returns to sport too soon they run a greater risk for a second concussion and additional damage to the brain. This can lead to permanent brain damage, long term disability or even death. Yes, this is scary stuff.

If concussion is suspected one should see a physician immediately to determine the severity and implement the proper treatment. Treatment for a mild to moderate concussion includes rest to allow swelling or contusion to reduce. This means rest from cognitive tasks, concentration and physical exertion. Aspirin free medication may also be prescribed as ibuprofen, Motrin and Advil may increase risk for further bleeding. Yes, physical therapy including vestibular rehab may be appropriate once a physician has deemed it safe to resume light/ moderate activity.

80-90% of concussions heal spontaneously within 7-10 days, however developing brains of children and adolescents may take longer. This is why Major League Baseball adopted the 7 day disabled list for players with concussion to prevent them from returning too early. This also takes the onus off the player feeling the pressure to return. He must fulfill the criteria in a series of neurological exams in order to be cleared for return to play.

The problem in youth sports is many coaches, parents and trainers don't have the experience or training to determine if in fact their athlete has been concussed and are allowed to resume participation risking further injury as I described above.

One quick and easy test for determination of concussion is the King-Devick test. There are over 50 peer reviewed studies supporting this objective visual screen as an excellent tool that can be administered by a lay person right on the field to assess whether an athlete has sub-optimal brain function and needs to be taken out of the game and sent to a physician immediately or allowed to return to play. Here is a link about the test from the Today Show. There's even a smart device app for it.

youtu.be/URjMCuRJrrE

Starlin Castro WORKOUT

www.pikore.com/starlincastro1324

Here is Starlin's latest post of himself getting ready for the season. Not sure I love his choice of bicep curls. I'd have him hold an isometric curl at 90 deg of elbow bend on one arm while the other arm curls through full range at the same time single leg bearfoot balancing on foam but tomato, to-mah-to. In any event keep it up and thanks for sharing Starlin!

Kristaps Porzingis TO BULK OR NOT TO BULK

Since the day he was drafted many have said Kristaps Porzingis needs to bulk up in order to compete in the paint for the Knicks. At 7'3" 240 lbs his ectomorphic body type reminds us more of Manute Bol, Shawn Bradley or Kevin Durant rather than Shaquille O'Neill or Ben Wallace. If the Knicks and Porzingis can resist the temptation to turn him into something he's not, Porzingis has the potential to have a long All-Star filled career.


STRESS

It has been reported that last year KP played 1,072 minutes in 50 games. This year he is on pace to compete for 2,238 minutes. This means KP will be taking his joints, ligaments and tendons far beyond the level of stress they have ever been before. Adding an additional 20 lbs to his frame over the course of one season could have serious consequences to his career.


REHABILITATION

Rehab is not just about restoring function following an injury. It also includes the process of helping an individual achieve the highest level of function possible or PERFORMANCE ENHANCEMENT.

KP REHAB PROGRAM

If I were in charge of KP's Rehab or Performance program I would have him perform stability exercises 3x/wk and mobility exercises 2x/wk.

STABILITY: Just because we don't want to excessively load his frame with bulk doesn't mean KP shouldn't strength train with weights. Resistance training would emphasize more functional fitness rather than isolated muscle strengthening. For example, standing on one leg while on foam and performing dumbbell bicep curls vs. using a preacher curl machine.

KP would perform Pilates and Yoga based exercises to promote core strength and balance/stability throughout his body. These would also help to improve the slumped posture he's adapted to deal with a world unsuited for such a large man.

Mobility: These activities would include speed and agility training with emphasis on footwork using tools like an agility ladder and step hurdles. KP would also perform plyometric or "jump training," activities to improve his power and speed-strength.

If KP is able to train within the scope of his body type he could be the first Camby, Nowitzki, Olajuwon hybrid the world has ever seen!