Beyond the Stretch #40

JUNE 2025

VOL. 40

A

BEYOND THE STRETCH

T H E R A P Y

P A R T N E R S

G R O U P

N E W S L E T T E R

As the summer sun rises, so do the opportunities at Therapy Partners Group. Whether you're a seasoned Physical Therapist, a passionate student, or a recent graduate ready to make your mark, this season is all about growth, connection, and culture.

We believe in more than just exceptional care—we believe in building careers with purpose. This summer, we're spotlighting the vibrant culture that makes TPG a place where clinical excellence meets community. From mentorship programs and CEU opportunities to leadership pathways and local outreach, there’s no better time to explore where your passion for healing can take you.

And yes—we’re hiring! Across the country, our clinics are looking for talented individuals ready to make an impact. Whether you’re searching for your first job or your next big move, we offer a collaborative environment that nurtures both professional and personal development.

WHAT'S INSIDE? 4 - In the life of a CHT 7 - Real Talk from the Field

In this edition, you'll find stories of success, upcoming events, and a sneak peek at the roles waiting for you!

14 - Pickleball Clinical Pearls

Join our team: Career Opportunities

If you were to tell me 9 months ago that I would be training and competing in triathlons, I probably would not have believed you.

But here I am, 4 races in, and I've fallen in love with the sport. It not only challenges me physically but also mentally. Having to train for three different disciplines; swim, bike and run; it takes up a lot of time in the week. Finding balance between work life, personal life, and training made myself more disciplined as a person and also made me more intentional with all aspects of my life. One of the most rewarding feelings is being able to show up on race day, trust in my training, and just enjoy the course.

Who would have thought in my first year of getting into triathlons I would be competing in my 1st solo Ironman 70.3 race in December. Stay tuned if I go for a full Ironman next year...!

CELEBRATING CELEBRATING HAND HAND THERAPY THERAPY WEEK WEEK What inspired you to become a hand therapist?

f work, I Outside o aint, p like to oil nnis, te hike, play & read Fit, do Cross

When in grad school, and upon completion, hand therapy was the area I was least interested in. When I started working in Moab, Utah, I had a boss who loved hand therapy and sent me to a course that was simple and gave me the confidence to try it. He helped mentor me, and then my curiosity in the specialty grew. I enjoy the dynamic medical nature of hand and upper extremity conditions and the challenge of managing complex conditions.

What's one of your most memorable patient success stories?

I worked with a patient for a year following a potentially devastating proximal Humerus fracture, Brachial Plexus injury and Radial Nerve palsy after a car accident. He was hopeless and in so much pain at the start of his rehab journey however he pushed himself in and outside the clinic. He was at the brink of having to have a nerve surgery but was told by his surgeon that if we pushed more he may avoid it, and he did! His ortho doctor expected him to have an almost 100% recovery once he hit the 6-8 month post accident mark. It was a challenging case and there was a very vague idea of his prognosis from the start however he was so much fun to work with as he trusted me to guide him and was willing to put in the work.

Any wisdom or words of encouragement for someone looking into being a HT? While this area is challenging with lots of anatomical minutiae to understand it can be done. No question is a stupid question if you don’t understand a condition/diagnosis/surgery. I had to take my CHT exam three times to pass it; however, every opportunity to study and/or be mentored by experienced therapists has made me a better therapist.

HAND

EXERCISE

PHYSICAL THERAPIST HEALTH TIP

Start with a straight hand

Bend first joint of digits keeping your finger tips straight

Straighten first joint of hand, bending the tips of your fingers to create a hooked fist

Make a full fist bending all joints of hand

TENDON GLIDES Purpose: An injury to the hand can result in swelling, stiffness, and scar formation resulting in limited tendon excursion and impaired functional grasp. These exercises are beneficial following traumatic injury to promote tendon glide, improve range of motion, enhance coordination and restore functional use of hand.

Stretches from Occupational Therapist, Grace Boxleitner

Top Men’s Top Men’s Health Health Issues Issues

Over the last year, I have been working to integrate knowledge and practical skills gained from both the Advanced Clinical Pathway and my OCS preparation/training. I have noticed my own clinical reasoning and skills improve during this time and I have been able to pass that knowledge on to my students and our wonderful clinical staff at EDPT - Folsom.

For example, on the thoracic ACP module, I learned how assessing subcostal angle can assist in differentiating between stiffness of the anterior thoracic musculature and weakness of the abdominal/oblique muscles. As weakness in these muscles is quite common in the outpatient setting, I have been able to use this assessment and the corrective techniques as additional tools to address the problem.

Moreover, the clinical reasoning skills gained over the last year have been useful in answering patient questions with evidence-based backing and increasing my own confidence in addressing the wide variety of clinical cases we encounter on a daily basis.

PHYSICAL THERAPIST PHYSICAL THERAPIST

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Physical Therapist: Two Trees PT: Ventura, CA Physical Therapist: Two Trees PT: Simi Valley, CA Physical Therapist: Two Trees PT: Santa Paula, CA Physical Therapist: Two Trees PT: Camarillo, CA Physical Therapist: Two Trees PT: Oxnard, CA Physical Therapist: Pair & Marotta: Bakersfield, CA

Specialty outpatient rotations available including outpatient neurology, pelvic health, pediatrics, sports rehabilitation, orthopedic specialists. All rotations from early ICE to terminal clinical experiences with hiring opportunities are welcome.

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EMERGING LEADERS & CLINICAL LEADERSHIP PROGRAM The Emerging Leaders Program is designed for clinicians beginning their leadership journey. It focuses on developing foundational leadership skills, communication, and effective team management.

The Clinical Leadership Program is specifically tailored for clinic directors within TPG. This program enhances leadership abilities, clinical expertise, and operational management skills.

12 months to complete a program 75% pass rate of all courses & completion of program requirements Case study write-up & presentation Anyone in an Advanced Clinical Program will be included in the Formal Residency Live Virtual Modules

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LOCATIONS & DATES July 19-20

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Summer Moves

INDUSTRY NEWS NEWS

INDUSTRY

GUEST BLOG

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n w o y r e v our

By Brady Whetten PT, DPT Multi-Site Clinical Director at Therapy Partners Group Board-Certified Clinical Specialist in Geriatric Physical Therapy

L L A B E L K C PI l Pearls

a c i n i Cl

Pickleball is booming across the United States, with participation increasing by 223% over the last three years to nearly 9 million players, making it the fastest-growing sport in the country. However, this rapid rise in popularity has been accompanied by a proportional surge in injuries. Recent reports show a 60% increase in pickleball-related injuries over the past two summers, particularly among recreational players aged 60 years and older. The most common injuries include falls, Achilles tendon tears or strains, as well as wrist and shoulder overuse injuries.

A study by Myers et al. (2024) revealed that 42% of recreational pickleball players reported experiencing falls, and 30% at least one fall while playing, often during lunging, backpedaling, or rapid directional changes.

Importantly, the study identified a correlation between reduced hip abduction strength and slower changeof-direction performance, both modifiable risk factors that physical therapy can address.

This is where you play a pivotal role. Physical therapists perform movement assessments to identify deficits in strength, agility, and joint mobility that contribute to injury risk. Individualized strengthening programs focusing on the hips, ankles, and core, along with acceleration and deceleration training, can enhance dynamic balance and reduce fall risk. Return to play decisions are guided by standardized functional tests, ensuring a safe and confident return to the court.

Additionally, you can educate players on proper footwear, warm-up routines, and safe movement mechanics to reduce the likelihood of overuse injuries such as Achilles tendinopathy or rotator cuff strains.

By Sujay Nair PT, DPT

References

Treating the Pickleball Player — A Growing Opportunity for Rehab Clinicians What We're Seeing in the Clinic As the game grows, so does the injury list. The most common issues showing up in outpatient rehab settings include: Lower leg strains and sprains — particularly calf, Achilles, and hamstring injuries, often from quick lateral movements or deconditioning. Rotator cuff tendinopathy and impingement — repetitive overhead strokes, poor scapular mechanics, and fatigue play a role.

Lateral epicondylitis ("Pickleball Elbow") — caused by poor grip technique or too much paddle time. Wrist fractures and contusions — most often due to falls, particularly in women over 60. Low back pain — a result of limited mobility, poor trunk control, or lack of pre-game prep.

How We Can Help These injuries respond well to what we do best: thorough assessment, movement retraining, and personalized rehab programs. A few clinical tips: Don’t just treat the pain.

Zoom out and assess the full kinetic chain—foot and ankle mobility, hip strength, and thoracic rotation all matter in Pickleball. Incorporate vestibular and balance training for older athletes to reduce fall risk. Use eccentric loading for tendon issues, and consider paddle grip ergonomics during your evaluation. Introduce Pickleball-specific return-to-play drills that mimic game movement and demand.

Building Local Connections One of the best ways to grow your practice and make a meaningful impact is by connecting with local Pickleball communities. These groups are highly engaged and often eager to partner with trusted healthcare providers. Consider offering: On-site injury screenings at local courts Pre-season warm-up clinics Workshops on safe movement and fall prevention Getting involved doesn’t just help build your caseload—it helps keep your community active, healthy, and out of urgent care!

By CCO, Jennifer Allen

References

801 Via Suerte Suite 103 San Clemente, CA 92673

SAN CLEMENTE

Phone: (949) 485-5567

NEW NEW NEW NEW

Brittany graduated from the University of Dayton in 2017 as a Doctor of Physical Therapy. She empowers her patients to "fix their body with their body" by addressing muscle imbalances and movement dysfunctions to help return them to the activities they love.

As a former collegiate volleyball player, she particularly enjoys treating the overhead athlete, biomechanical lower back pain, ACL reconstructions, and labral pathologies of the shoulder and hip. Although she has a sweet tooth for cookies, nothing about her approach is cookie-cutter. She loves spending time tailoring a patient's treatment plan to his or her specific needs.

In her free time, she enjoys spending time at the beach with her dog Benny, traveling the world with her husband Mitch, searching for the best taco in Orange County, and regularly being heartbroken by the Cleveland Browns.

Hey Grads — Let’s Talk About Your Future in Physical Therapy! Explore open roles across 7 states and 24 brands, meet our team, and discover how your passion meets purpose with Therapy Partners Group!

TUESDAY, JUNE 24TH 12:00-12:45 PM PST / 3:00-3:45 PM ET

Job opportunities for PTs, PTAs, & OTs across the TPG network What TPG offers: Benefits TPG University Leadership Training Residency & Fellowship Bonuses & more

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Click HERE or Text "tpg3" to (402) 922-8037

Available at select GBPT clinics

Written by James Taylor, Physical Therapist at

YOUTH BASEBALL PITCHERS Despite advances in baseball rehabilitative science, the number of throwing injuries in baseball continues to rise. Nowhere is this increase more evident than in the growing population of youth baseball athletes. In a 10-year study examining a cohort of 261 pitchers, Shanley et al.

(2023) observed an injury rate of 25.6% in youth athletes and a 5.4% surgical rate.

This problem threatens the health of these athletes looking to play at a higher level (a finding supported by an increase in surgical rate of 4.3 times in the Shanley study for those pitchers who competed at the collegiate or professional level) and adversely impacts the quality of play at those levels as well.

Applying these injury rates to the 2 million boys and girls that participate in Little League baseball each year, along with approximately 250,000 athletes that participate with Perfect Game showcase tournaments each year, the need for greater homogeneity in skilled care with this population is crucial.

When performing the subjective portion of our examination for these throwing athletes, we must make sure to establish the context of where they may be in the case of their competitive season (off-, pre-, mid-, post-).

We need to establish what role they play as a pitcher (starter or reliever), and what positions they play when they are not pitching (catchers, for example, are at the second highest risk for elbow injuries among the position groups), and how many teams (baseball or otherwise) they may have been playing for recently.

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Taking the time to document the strength or arm care program they are going through as well as any recent work with a pitching coach or nutritionist will also provide insight on their preparation to minimize their injury risk. Even if most of these items are not in place, the knowledge will be useful in your plan educating patients as they begin to transition back to their sport later in their plan of care.

Many therapists are adept at creating a comprehensive treatment program that thoroughly addresses strengthening of the rotator cuff, the scapular stabilizers, and mobility of the cervicothoracic spine. However, in order to ensure that we are readying our athletes for the demands of competitive sport, we need to do more than provide an educated guess on what appropriate strength is. As the literature highlighting the inadequacies of manual muscle testing continues to increase, the need for objective measurements using handheld dynamometers or crane scales becomes greater. Nakaji et al. (2021) performed a study providing descriptive statistics on ROM and isometric strength that is useful for throwers below the age of 12, and Hurd et al. (2011) provided a thorough guide on assessing strength within this population as well. Given the rapid speed at which pitchers are delivered (~7000 deg of IR per second during the acceleration phase), developing capacity to generate force quickly is key prior to initiation of a throwing program. Though the body of literature for upper body plyometrics relative to throwing athletes, a few useful resources such as the work of Steven Collins (2021) and Carter et al. (2007) and are available that provide an appropriate timeframe to measure our progression, though Carter’s work was more specific to collegiate throwers.

Lastly, yet most importantly, is the integration of the interval throwing program. Until recently, interval throwing programs have been developed almost exclusively based on an amalgamation of expert opinion on the topic. While the concept of an individualized an exercise program based on patient data may seem to be common sense, Mike Reinold’s revised ITP (Reinold et al. 2024) appears to be the first of its kind that utilizes an understanding of an individual’s workload data as a means for progression and subsequent completion of the ITP. Though further work will need to be conducted to make clinical progressions and supervision of this more feasible, this work represents an important step and also highlights the importance of utilizing appropriate time intervals to develop the appropriate capacity in athletes.

Citations: Carter, A. B., Kaminski, T. W., Douex, A. T., Knight, C. A., & Richards, J. G. (2007). Effects of high‑volume upper‑extremity plyometric training on throwing velocity and functional strength ratios of the shoulder rotators in collegiate baseball players. Journal of Strength and Conditioning Research, 21(1), 208–215. https://doi.org/10.1519/00124278‑200702000‑00038 sciencedirect.com+11 Collins, S. (2021, January 12). How to prescribe upper limb plyometrics. Physio Network. httAWQps://www.physio-network.com/blog/upper-limb-plyometrics/ Little League International. (n.d.). Little League® fast facts. https://www.littleleague.org/little- league-fast-facts/ Hurd, W. J., Kaplan, K. M., ElAttrache, N. S., Jobe, F. W., Morrey, B. F., & Kaufman, K. R. (2011). A profile of glenohumeral internal and external rotation motion in the uninjured high school baseball pitcher, part II: strength. Journal of athletic training, 46(3), 289– 295. https://doi.org/10.4085/1062-6050-46.3.289 Nakaji, R. M., Ellenbecker, T. S., McClenahan, K. M., Roberts, L. M., Perez, C., & Dickenson, S. B. (2021). Descriptive Strength and Range of Motion in Youth Baseball Players. International journal of sports physical therapy, 16(1), 195–206. https://doi.org/10.26603/001c.18815 Perfect Game Staff. (2021, December 17). FAQ showcase questions: Part 3. Perfect Game. https://www.perfectgame.org/articles/view.aspx?article=18181 Reinold, M. M., Dowling, B., Fleisig, G. S., Macrina, L. C., Wilk, K. E., Streepy, J. T., & Andrews, J. R. (2024). An Interval Throwing Program for Baseball Pitchers Based upon Workload Data.

International journal of sports physical therapy, 19(3), 326–336. https://doi.org/10.26603/001c.94146 Shanley, E., Thigpen, C. A., Boes, N., Bailey, L., Arnold, A., Bullock, G., & Kissenberth, M. J. (2023). Arm injury in youth baseball players: a 10-year cohort study. Journal of shoulder and elbow surgery, 32(6S), S106–S111. https://doi.org/10.1016/j.jse.2023.02.009

Check out these social media profiles for a genuine glimpse into working at a TPG clinic, straight from the PTs themselves!

Jasmine Green

@just_jassssy

PT, DPT, SCS

UA D1 Fellowship Director UA Fellow Graduate Sports Residency Trained

@tyler_sports.med

Tyler Goslinga

PT, DPT, SCS, USAW

Clinic Director, Golden Bear PT All things knee rehab Board Certified Sport Specialist PT, Sports Rehab, Sports Science

Dr. Xavier “X” Holt PT, DPT, SCS

@dr.x_performanceandrehab Clinic Director, Bodycentral Sports Certified Specialist @bodycentralphysicaltherapy Getting people stronger & faster

@orion.dpt Clinic Director @el_dorado_pt Orthopedics & Sports Medicine

Danielle Bressoud PT, DPT

@dmbressoud @prosportpt Fitness Trainer Reformer Pilates Instructor

Orion Tomada PT, DPT