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Shoulder Pain in Athletes and Active Individuals: What You Need to Know The shoulder is the most mobile joint in the body — and that mobility comes with a trade-off. It is also one of the most frequently injured joints in athletic populations, and one of the most mismanaged. Shoulder pain is not a diagnosis. “Impingement,” “rotator cuff tendinitis,” “bursitis” — these are descriptions of what’s happening in the joint, not explanations of why. And when you’re an athlete who needs to get back to training, understanding why matters. At St. Louis Sports Clinic, we assess shoulder injuries the way sports medicine teams do: systematically, comprehensively, and with an eye on returning you to full function. Common Shoulder Conditions in Athletes Shoulder Impingement Syndrome Impingement describes the mechanical pinching of soft tissue structures — typically the supraspinatus tendon and/or the subacromial bursa — between the humeral head and the acromion. It presents as pain with overhead reaching, throwing, pressing, or lifting. In most cases, impingement is driven by altered shoulder mechanics and muscular imbalances — not a fixed structural problem — which is why conservative care works well. Rotator Cuff Tendinopathy and Tears The rotator cuff is made up of four muscles (supraspinatus, infraspinatus, teres minor, subscapularis) that stabilize the humeral head in the glenoid. Tendinopathy — degenerative change in the tendon — is extremely common in overhead athletes and recreational weightlifters. Partial tears may be managed conservatively; full-thickness tears require assessment to determine whether surgery is warranted. We can help you understand your imaging and your options. Labral Tears (SLAP and Bankart Lesions) The labrum deepens the shoulder socket and anchors the biceps tendon. SLAP tears (superior labrum, anterior to posterior) are common in overhead athletes — throwers, swimmers, CrossFit athletes. Bankart lesions result from shoulder dislocations. Some labral

Shockwave Therapy for Plantar Fasciitis: Does It Work? If you have plantar fasciitis that has been going on for more than three months — or you’ve tried stretching, orthotics, cortisone injections, and rest with limited results — this post is written for you. Shockwave therapy is one of the most evidence-supported treatments for chronic plantar fasciitis, and it’s one of the most underutilized in the St. Louis area. We’ll explain exactly how it works, what the research shows, and what you can expect at St. Louis Sports Clinic. What Is Shockwave Therapy? Shockwave therapy uses high-energy acoustic waves — delivered through a handheld device pressed against the skin — to stimulate healing in damaged tissue. The waves penetrate into the affected area, creating mechanical stress that triggers a cascade of biological responses: increased blood flow, activation of growth factors, breakdown of calcific deposits, and stimulation of the body’s own repair mechanisms. There are two types of shockwave relevant to plantar fasciitis: Radial shockwave (RSWT): Pressure waves that radiate outward from the point of contact. Best for treating broader areas and superficial structures. Focused shockwave (FSWT): Energy concentrated at a precise focal point within the tissue. More targeted, able to penetrate deeper, and typically used for focal chronic tendinopathy. St. Louis Sports Clinic is one of the only clinics in the St. Louis area to offer both. We use the Storz Medical MASTERPULS® ULTRA+ for radial shockwave and the Storz Medical DUOLITH® SD1 ULTRA for focused shockwave — both considered among the gold-standard devices in the field. Why Plantar Fasciitis Becomes Chronic Acute plantar fasciitis — the heel pain that wakes you up in the morning after ramping up your mileage — often resolves with rest, stretching, and time. But when pain persists beyond 3–6 months, something different is happening in

Running Injuries in St. Louis: How to Treat Them Without Stopping Training “Just take two weeks off” is not a treatment plan. If you’re a runner — recreational, competitive, or anywhere in between — you already know that rest alone rarely fixes a running injury. You stop, feel better, go back to running, and the pain returns. The injury hasn’t been addressed; it’s been temporarily quieted. At St. Louis Sports Clinic, we treat running injuries the way sports medicine teams treat professional athletes: identify the root cause, address it directly, and build a plan that keeps you training through recovery as much as possible. The Most Common Running Injuries We Treat IT Band Syndrome (ITBS) Lateral knee pain in runners is most often IT band syndrome — and it’s almost never caused by a “tight IT band.” The real drivers are typically hip abductor weakness (glute med and TFL), hip drop mechanics during the stance phase, and altered foot strike patterns. We assess the whole chain, not just the knee. Plantar Fasciitis Heel pain in runners is among the most common presentations we see. Acute plantar fasciitis responds well to dry needling, soft tissue work, and calf loading programs. For chronic cases — pain lasting more than three months — we add shockwave therapy, which has strong evidence for plantar fasciosis and gets results when other treatments have stalled. Achilles Tendinopathy Mid-portion and insertional Achilles pain are both common in distance runners, particularly those ramping up mileage or transitioning footwear. Progressive loading through a structured tendon rehabilitation program is the cornerstone of care — we combine it with dry needling, soft tissue work, and shockwave when indicated. Shin Splints (Medial Tibial Stress Syndrome) MTSS is an overuse injury to the tibial periosteum, usually caused by rapid increases in volume, inadequate

Golf Injury Treatment in West County & Chesterfield, MO: Stay on the Course Longer By Dr. Tony Katakis, DC, MS, CSCS | Founder, St. Louis Sports Clinic Golf is a sport of repetition — the same complex movement pattern performed thousands of times across a season. That repetition, combined with the rotational demands of the swing, creates predictable injury patterns. And most of those injuries are not random. They’re the result of specific movement deficits that create compensations in the swing. At St. Louis Sports Clinic, we treat a lot of golfers from Chesterfield, Frontenac, Clayton, Ladue, Town and Country, and throughout West County St. Louis. Our focus is golf performance rehabilitation — not just getting you out of pain, but improving the movement patterns that caused the injury in the first place. The Most Common Golf Injuries We Treat Low Back Pain Low back pain is the most common golf injury, affecting approximately 30% of recreational golfers and up to 55% of professional golfers at some point in their career. The rotational demands of the backswing and follow-through place significant torsional load on the lumbar spine, particularly if hip and thoracic mobility are limited. The most common mechanism: a golfer without adequate lead hip internal rotation or thoracic rotation has to generate that rotation from somewhere — and the lumbar spine takes the compensation. Repetitive swings under this pattern create disc stress, facet irritation, and muscle strain. Treatment focused only on the back — without addressing hip and thoracic mobility — consistently fails to produce lasting results. Lead Hip Pain and Impingement Hip impingement (FAI — femoroacetabular impingement) and hip flexor irritation are common in golfers who restrict their hip rotation through impact. The lead hip in right-handed golfers goes through significant internal rotation at impact; if the hip

Dry Needling for Athletes in St. Louis: What to Expect If you’ve heard that dry needling is just acupuncture with a different name, you’ve heard wrong. And if you’ve avoided it because you’re not sure what it actually does — or you’re worried it’s going to hurt — this post is for you. Dry needling is one of the most effective tools in sports chiropractic, and at St. Louis Sports Clinic, it’s integrated into the care of nearly every athlete we treat. Here’s what you need to know. What Is Dry Needling? Dry needling uses thin, solid monofilament needles — the same type used in acupuncture — inserted directly into trigger points within muscles. A trigger point is a tight, irritable band of muscle tissue that has lost its normal function. It can cause local pain, referred pain to other areas of the body, restricted movement, and inhibition of surrounding muscles. The “dry” in dry needling refers to the fact that no substance is injected through the needle. The needle itself is the treatment. When the needle reaches a trigger point, you typically feel a local twitch response — a brief, involuntary contraction of the muscle. That twitch is feedback that you’ve hit the right spot. It lasts one to two seconds, and for many patients, it’s followed almost immediately by a feeling of release and relief in the muscle. Dry needling is not acupuncture. Acupuncture is a traditional Chinese medicine practice based on energy meridians. Dry needling is based on Western anatomy and neuroscience — specifically on the understanding of how trigger points develop, how they cause pain and dysfunction, and how mechanical stimulation through a needle disrupts that pattern. How Dry Needling Works for Athletes Athletes develop trigger points for a lot of reasons: repetitive training loads, compensatory

CrossFit Injury Rehab in St. Louis: Get Back to the Box Faster By Dr. Nicholas Patullo, DC, CF-L2 | CrossFit Games Semifinals Competitor 2022 & 2023 Most sports medicine providers can tell you that you have a shoulder injury. Not many can tell you that it happened because your bar path on the snatch is pulling forward in the catch, and that the combined demand of high-rep overhead work at submaximal load with a compromised receiving position created a SLAP irritation at the biceps anchor. I can tell you that. Because I’ve been on both sides. I’m a CrossFit Level 2 Trainer, I previously coached at CrossFit Wildwood, and I’ve competed at the CrossFit Games Semifinals. I treat CrossFit athletes every day at St. Louis Sports Clinic — and I understand CrossFit injuries differently than a provider who has never stepped inside a box. The Most Common CrossFit Injuries We Treat Shoulder Shoulder injuries are the most common CrossFit complaint we see. The combination of high-volume overhead work (snatches, jerks, wall balls, kipping pull-ups, handstand push-ups), gymnastics demands, and often-suboptimal technique creates a perfect environment for: Shoulder impingement from poor scapular mechanics or limited thoracic rotation Rotator cuff tendinopathy from chronic overhead loading SLAP tears from aggressive kipping or snatch mechanics AC joint sprains from falls on outstretched hands Biceps tendinopathy from repeated pull-up and barbell work Low Back Low back pain in CrossFit athletes is extremely common and usually connected to one of three things: hip mobility limitations that cause the lumbar spine to compensate during squatting and hinging, poor spinal position under load, or simple volume/intensity overcreaching. We assess the hip-spine relationship every time. Knee Patellar tendinopathy — “jumper’s knee” — is epidemic in CrossFit athletes who do high volumes of box jumps, jump rope, and heavy squat