Stretch Summer

By Robert Lim, PTA

JOI talks about Summer Heat Illness and Hydration in Stretch Summer Edition


By: Robert Lim, PTA

Heat-related illness and death are on the rise. Heat stroke, a severe form of heat-related illness, is one of the three leading causes of death in athletes and likely the leading cause among athletes in July and August.


When an athlete exercises, the body’s temperature is elevated and the body sweats to cool itself down. During this process, body fluid as well as critical electrolytes are lost. If the body isn’t replenished with fluids and electrolytes, dehydration may occur and increase the risk of a heat illness such as heat stroke.


image of sports equipment

Heat Illness

The most effective treatment for heat-related illnesses is prevention, including: Proper training for the heat, Fluid replacement before, during and after exertion, appropriate clothing—light colored, loose fitting and limited to one layer, Monitoring the intensity of physical activity appropriate for fitness and the athlete’s acclimatization status.

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When you see any signs of heat illness or heat stroke, you may be dealing with a life-threatening emergency. Have someone call for immediate medical assistance while you begin cooling the individual at risk. Treatment tips include: Getting the athlete to a shaded area. If it is heat stroke, cool the athlete rapidly using cold water immersion. If immersion is not available you may use spray from a hose, cold water sponging or placing cold towels over the entire body. Monitoring body temperature. Providing cool beverages if possible (i.e., if the athlete does not have altered consciousness). Getting medical assistance as soon as possible. Heat exhaustion is a form of heat illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids.

Feeling Thirsty? Ways to Prevent Dehydration

By: Theresa Adams, LAT, ATC

Do you often feel thirsty? Or have the need to drink excessive amounts of water? That may be your body’s way of letting you know it’s dehydrated. Other signs of dehydration include headaches, dry mouth, fatigue, and muscle cramps. If your body does not have enough water, it may not function properly and may put you at a higher risk for health problems. Below are ways to reduce dehydration and stay healthy by maintaining proper fluid balance.

Each day, your body loses water through regular bodily functions, including normal cellular metabolism, breathing, sweating, and urination. It is recommended that you drink 6 to 8 glasses of water a day to maintain proper fluid balance. Keep yourself hydrated by making water intake part of your daily routine. A good strategy to maintain hydration is taking a water bottle with you throughout the day and refilling it as needed.

Hydration Tip

Another tip to reduce dehydration is limiting sun exposure and replenishing fluids after exercise to maintain water loss from perspiration. It is recommended to rehydrate from increased activity by drinking fluids before, during, and after exercise. Sports drinks, such as Gatorade and PowerAde, have essential vitamins and electrolytes to rehydrate from fluid loss during exercise. It is also important to be aware of environmental conditions, since excessive temperature and heat may cause an increased rate of dehydration.

Various ways to determine whether you are hydrated include using urine color charts and monitoring your weight to ensure proper fluid replacement. Well-hydrated individuals should have lighter yellow color urine and retain enough water to maintain a consistent weight from day to day. Maintaining a healthy lower sodium diet, avoiding drinks with high caffeine content, as well as reducing alcohol intake, can help your body maintain a good fluid balance. Generally, if you are feeling thirsty and need something to drink, your body may already be dehydrated. Staying hydrated is an easy way to keep your body healthy and functioning properly.

Why You Should Be Drinking Water

Why is water so important for the body?

Water is a necessity for your body to function properly. The adult human body is made up of about 60% water. It plays some major key roles in your body to maintain health. Water helps your body maintain homeostasis (normal temperature), it can help with lubrication in joints, and can also help get rid of waste your body produces.

How much water should you drink?

This is a tricky question, each person is different and the need of water depends on many factors such as environment, activity level and illness. The suggestion of eight 8 ounces of water a day is nice because it is easy to remember, but it is not quite enough water for the average adult ending at about 1.9 liters of water. Studies have shown that the average male needs about 3 liters of water and the average woman needs about 2.2 liters. This is not enough for a person who is out in high temperatures and humidity, or a person very active who is sweating a lot.

How can water help you lose weight?

There have been a few studies done showing that drinking 16 ounces of water about 30 minutes before a meal can help aide in weight loss. By doing this it will fill your stomach up giving you a more full feeling before your meal, stopping a person from eating so much. Also by drinking water before a meal will cut calories as opposed to drinking a calorie sugar filled drink. These studies show that people who drink water lose up to 3 pounds more than those who don’t in a three month stud

Choosing Crossfit

By: Heidi Austin, PT, DPT

With the increasing popularity of CrossFit, I have seen an influx of patients in my office with CrossFit related injuries. CrossFit is a style of working out that combines functional based movements, gymnastics, high intensity training, and Olympic weight lifting. As an avid CrossFitter myself, I think the functional movement based sport has a lot to offer many ranging from weekend warriors, the elderly, to also professional athletes. The design is to offer universal scalability regardless of experience.

Crossfit Errors

However, when you combine poor quality coaching, bad form, and lack of motion or mobility to complete a movement, you are ultimately asking for an injury. There are definitely a lot of movements in CrossFit that can be classified as dangerous. (Although that can be said for most sports) A better injury prevention approach is to ask your gym or coach these questions:


    1. How experienced is your coach? Did they simply go to a weekend seminar and then call themselves a coach? Do they have a kinesiology or anatomy background? Many Olympic lifting techniques are highly complicated and take years to master the skill…. forget coaching it. A high quality coach needs more than a weekend course to be instructing CrossFit and any type of Olympic weight lifting technique and also should have solid kinesiology background.
  1. Ask yourself, “Do I have the mobility to perform the task at hand”? If your shoulder range of motion is so horrible and your pecs are so tight that you are unable to fully extend your arms overhead—you have no business attempting a snatch, overhead squat, push-press, thruster, or even a simple pull-up. YOU need to focus on mobility and range of motion ONLY before attempting anything overhead. This applies to any joint in the body. More importantly, if you have a good coach they will easily recognize your deficits and prohibit you from doing that specific movement until ready.
  2. Does your gym include a mobility aspect to the workouts or workout of the day (WOD)? Mobility is vital these days to see optimum results both in and out of the gym. A well-educated coach will program the workout with a relevant piece of mobility to coincide with that workout. A simple example would be: a coach advising you to do a soft tissue release to your pec major using a lacrosse ball prior to completing a workout that includes a lot of pull-ups. This will ensure you have full range of motion and good mechanics prior to completion of the exercise.

Intro Classes

  1. Does your CrossFit gym have an introductory class? A properly programmed gym will take you through a month long course of fundamentals to teach you the basic technique for all CrossFit movements. If you start at a gym that just throws your right into a WOD with the regular class, RUN far  away!
  2. Lastly, with all CrossFit movements it is not normal to have pain. If you have pain, do not push through it. (Although your coach may ask you to!) And if your coach is knowledgeable, they will know how to properly scale the movements. An example would be substituting ring rows instead of pull-ups. If you still have pain even with a scaled movement, I would recommend seeing a professional right away. If you continually push through, you are likely creating micro-trauma that can eventually lead to some type of tear.

In the end, CrossFit can be an innovative way to stay fit and strong. Also, it can help you perform well in and out of the gym. However, please choose your gym and coach wisely.

Tennis Management and Performance Services

Tennis Management and Performance Services at the Sports Center will be given and directed by our experienced Sports Medicine Team that is able to work directly with your physician, coach, or Pro to coordinate your progress. Performance Services focus on reducing risk of injury, return to play after an injury, and decreasing performance deficits limiting ability to play tennis at an optimal level. Performance Services for tennis are different for each person to meet specific needs of each patient. Packages:

The Advantage Package: $75

  • USTA High-Performance Profile Injury Risk Assessment and Review of Findings

 Rally Package: $198

  • USTA High-Performance Profile Injury Risk Assessment and Review of Findings 
  • Tennis Serve Video Analysis and Review of Findings

The Challenger Package: $225

  • Tennis High Performance Testing and Review of Findings 
  • Tennis Serve Video Analysis and Review of Findings

The Grand Slam Package: $398

  • USTA High-Performance Profile Injury Risk Assessment and Review of Findings 
  • Tennis High Performance Testing and Review of Findings 
  • Tennis Serve Video Analysis and Review of Findings 
  • Elite Athlete Profile with Dr. Yorio*

A La Carte Services:

  • Re-Screen of USTA High Performance Profile Injury Risk Assessment or High Performance Test: $50
  • Training Program Session based on Personalized Test Results: $50
  • To schedule an appointment for physical or occupational therapy, call 904-858-7045 or call any of the 12 area JOI Rehab Centers.

JOI Fracture and Injury Care

JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904)JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care.


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