 If you've had an injury and then you've had a surgery after that there's physical therapy and that's changing to be Before now you have your surgery Luke O'Brien is with the Howard Head Center that deals with physical therapy here at the Stebbin Clinic and the Stebbin Philippine Research Institute Tell me what's changing in your field based on injury prevention. Yeah, so I Think that there's a lot of elements that go into creating an injury So the first is being able to define what are those components? So what role is the environment playing on injury development? What role is biomechanics playing on injury development and what role is training load and beginning to understand that Nothing happens in isolation and that it's usually the interplay between all of these three factors that lead to the to an injury Curing in an athlete or just a recreational warrior like myself at what level can we start paying attention to this? I mean you have to be a high school athlete, or can you be an eight-year-old who's in your first year little league sports? I think as soon as you enter organized sport that has a training schedule, then you need to be aware of it and you need to be Having good advice and guidance to make sure that the training practices and and your competition Competition schedule is appropriate for you at that period of your development Part of this then is dealing with parents and coaches. There's some coaches out there at the little league level that are pretty aggressive You have to change a culture here absolutely that the thing that usually gets through with coaches is that team success is reliant on having all of their players available and healthy to play and Very few teams are highly successful when their best stars are injured whether that be at little league level Whether it be minor leagues or the big leagues and so keeping people fit and healthy and in the game is integral Not only to the individual success, but to the team success coaches and almost always understand that language Part of this I'm going to tell you a story about my own son who played on a US national hockey team And in the last years of college hockey had a very serious back problem But he refused to tell anyone because if he sat on the bench he was going to lose his position to somebody else and Athletes are scared about that. Do you deal with that you run into that problem? Yeah, absolutely so so fear of So it really is the culture of the team in the sport and so some teams and sports More apt to have this problem But one of the the tools that I've used to help athletes is they're never able to compete at the level that they want to at the performance and Level that they want to when they're injured and so when they and when you're able to create a Healthy athlete then they're able to achieve their athletic goals and potential, but an injured athlete is always Battling something that limits their ability to achieve those goals And so it's so important to have a rational educational process to help change the culture surrounding that injury So you're participating in this symposium about injury prevention. What are a couple of takeaways that you've got already? Little kids are not big adults. And so what is appropriate for? Miners and what is appropriate for adults is entirely different and they shouldn't we shouldn't just apply the Evidence and the science that we have from the adult population to a little league level and expect the same results I'm gonna go a little longer here with you because you're very interesting and you have a great perspective When I played sports, which is a long time ago now Well, I still ski into other things, but kids played three high school sports or two college sports When my son came up to the hockey ranks by the time he was 13 if he didn't play hockey almost year-round Those he was competing for positions against would get better and take those positions But there's disadvantages to this right you have muscle development or skeletal development issues. Am I correct with that? yeah, so Being a one-sport athlete leads to musculoskeletal developments that predispose you to be successful in that sport So for instance is something that happens in the arm to all pitches That helps them be a better picture, but it doesn't necessarily make them a better golfer or a better tennis player Can you have overuse if you're if you're a pitcher and you're starting pitching for your little league team at age 10 By the time you're 18 If things haven't been done correctly, couldn't you've already ruined your arm? Yeah, absolutely, and I think particularly in the youth levels. It comes down to load So we have a lot of work surrounding pitch counts So you might be able to do 80 pitches in a game now for one athlete They might be used to doing 70 pitches in a game 80 pitches is no problem But if there's another athlete who is entering into that game with an 80 pitch count and they're only used to doing 20 That's a four-fold increase in their volume They're gonna set that person up for an injury and if not managed correctly, it'll have long-term implications What you're doing is extremely important, and I wish you well