Had a college baseball player come and see me because he experienced some decreased VO as he was pitching. He was sitting around 83 mph before he saw me. His first outing after he saw me he hit 87. One of the biggest things we’ve been working on is increasing his thoracic extension. Here’s a five minute before, and after of our work.

When working with MTSS patients, I’ve consistently seen something interesting. If we are ELITE in 5 specific areas, symptoms drop dramatically. When these boxes are checked, the athlete can achieve a neutral foot push off and is far less likely to fall into excessive navicular drop, especially during terminal hip extension. Here are the 5: 1️⃣ Dorsiflexion: 45 degrees of neutral foot dorsiflexion in a weight bearing lunge test. 2️⃣ Tibial Internal: Rotation Greater than 30 degrees bilaterally .If the tibia cannot internally rotate, the foot will compensate. 3️⃣ Hip Rotation: (90 degrees external rotation, 45 degrees internal rotation) If the hip cannot rotate, force gets dumped distally. 4️⃣ Hip Extension: 30 degrees passive hip extension. Without it, athletes push off early and collapse medially. 5️⃣ Hallux Extension: 90 degrees of big toe extension. This allows proper arch recoil and neutral push off. When these are present, stride mechanics clean up fast. The foot can stay neutral in late stance, and we dramatically reduce stress on the deep posterior compartment musculature. MTSS is not just shin issue. It is a stride mechanics issue. Curious what standards you all are using in your assessments.

Anybody seen patient success this week? Return to play from injuries, new treatments you’re trying that have been effective, etc. I’m excited to hear all the wins we are having

Had a patient come in today complaining of medial shin pain. She had limited tibial IR on tha side. We also found weakness in inversion, but a significant amount of trigger point activity through the FDL. Mobilizing fibular head anteriorly, trigger point therapy through the FDL, muscle activation through the tibial posterior made all of her pain disappear, full strength and full ROM.

So cool to see these successes with my patients lately—hope to continue to see more success with their treatments. • Improved ankle dorsiflexion from 38° to 45° in one session, restoring full symmetry • Increased shoulder external rotation by ~20° in one session, reducing throwing effort immediately • Improved shoulder flexion by ~20° with scapular control, restoring overhead range for a pitcher • Reduced calf tightness during running by restoring hip external rotation and extension strength in one visit • Restored big toe flexion strength and control, improving push-off and gait mechanics instantly • Improved inversion strength deficit at the ankle, reducing medial shin stress during loading • Reduced posterior shoulder pain in deceleration phase by improving lat + cuff control in one session