What are we thinking? L shoulder pain, weakness into external and internal rotation, caption with hand held dynamometer by about 35%
Mild pain at end range passive flexion too. Also plays the guitar a lot and that L side is used a lot to stabilize the guitar away from his body.
Impingement signs (if I can still use that term 😅) are all normal.
Swimming limited and just using it in general and also feels a lot of clicking/popping in his scapula area.
Had a bike accident within the year and crashed into somebody where most of the force was on his left shoulder and side.
What are we thinking?
New blog post!
A recent study that tracked 30 athletes from 3 to 12 months post-ACLR, measuring strength, jump performance, and patient-reported outcomes at every time point.
A few things worth knowing. Most of the gains in strength and jumping happen in the first 3 to 6 months, then things slow down considerably.
Even at a year out, the surgical limb still showed deficits compared to the other side.
Single leg CMJ height on the involved side was the strongest predictor of psychological readiness to return to sport across the whole rehab timeline.
Quad strength asymmetry was the best predictor of how patients rated their knee function, and it mattered at every time point, not just at RTS.
One thing to keep in mind, this was a hamstring graft study. Here in the US we’re seeing a lot more BTB and quad tendon grafts, which makes quad recovery harder and slower.
So use these benchmarks as a reference but take with a grain of salt.
Full breakdown on the blog. Link in bio.
#acl #physiotherapy #physiotherapist #atc
ACL rehab is a grind
Lots of peaks and valleys, but it is all worth it when I get that high five at the end! ✋
This is one small piece of the testing that I do to help make return to field decisions.
Can they produce enough quadriceps force, accelerate, and decelerate, and does it translate to function and a controlled environment on the field?
Prior to unlimited return, the athlete must pass all of these tests in order to minimize risk in the first two years.
It’s imperative that you stick with the data and make decisions solely off of that!
For this athlete, she registered a torque of 2.71 Nm/Kg on the surgical side in 2.9 Nm/kg on the non-surgical side.
She is ramping up field activities and will be cleared once she feels comfortable progressing from controlled fieldwork to unpredictable fieldwork.
#physicaltherapy #physiotherapist #dptstudent #athletictrainer #acl
2 days after ACL-PTG and LET in a competitive skier.
Big focus on early extension and flexion, along with swelling control, patella mobility, and just getting everything to calm down.
as you know, I prefer seated at the edge of the table, passive flexion for numerous reasons and think it’s the best position to get early motion.
For two days out, he’s doing great and already getting to 90°.
#physicaltherapy #dptstudent #physiotherapist #atc #acl
Check out my new article on The Science Behind Interval Throwing Programs: A Data-Driven Approach to Safer Pitcher Rehab
Comment "ITP" and I'll send you the link.
Excited to share my new journal article publication in IJSPT! It's my new research paper with all my baseball interval-throwing programs of various durations.
This is the follow-up to my paper from a couple of years ago, which published our long-term 7-month throwing program. We built this on biomechanical torque data and workload modeling to ensure the program was perfect.
This paper adds more variations that cover the vast majority of baseball injuries.
Big thanks to my coauthors Brittany Dowling, @the_biomechanical_man , @wilk_kevin , @lenmacpt , @frank.atc , @drchrisahmad , @dugasmd1 , and Dr. James Andrews.
I wrote a blog post explaining a lot of this, but I want you to be able to download these for free and use them in your practice.
Again, comment "ITP," and I'll send you the link to download my ITPs and the IJSPT articles.
When the doc considers a QT graft after I’ve already mentioned a BPTB graft for our patient!
I just wrote a lengthy blog post on QT grafts and what we need to consider when rehabbing them.
See my website at Lennymacrina.com
I’m still a PTG guy… don’t worry! #physicaltherapy #physiotherapist #dptstudent #athletictrainer #acl
Been playing around with isokinetics on the 1080 Motion @1080motion and honestly it’s changing how I think about quad training post ACL-R.
The traditional knee extension machine has its place and I still use it a lot but it loads at a fixed resistance. What it doesn’t tell you is how fast your patient is producing force.
Rate of force development matters a lot when you’re thinking about what the knee actually has to do when they return to sport.
With isokinetics, the resistance matches the patient’s output throughout the whole movement. You control the speed, not the load. That means you’re getting honest data on RFD, you can load eccentrically at controlled velocities, here at 0.2 m/s.
Still early in working this into my programming but really liking what I’m seeing. Curious if anyone else is using isokinetics in their ACL rehab, #drop a comment below 👇
#physicaltherapy #dptstudent #physiotherapist #aclrecovery
Two days after his ACL-PTG with @asnisacl
Back from his European tour with his band, he had surgery two days ago and in today for his first PT visit.
I wish all of my ACL patients could do this two days out of surgery.
Very good sign that he can activate his quads like this so early and will continue to push as his body allows and allow for natural biological healing.
I added electrical stimulation to the quad sets after taking this video and highly recommend the continuum 2 that is made by @enovismedtech@chattanoogarehabusa
And his ROM is +3-102 degrees. Let’s gooooooo!!
Looking forward to working with him and getting him back to his full function, including skiing!
Music by @couch.theband
#physicaltherapy #acl #aclrecovery #dptstudent #physiotherapy
5 months post ACL-R and the data cleared him to start jogging. 🏃
Quad LSI hit 77%, hamstring symmetry is 98%, and CMJ asymmetry on both concentric and eccentric loading came in under 10%, well within our threshold for introducing repetitive impact.
The one number still climbing is the HS:Quad ratio on the surgical side (59% vs. target ≥66%). Monitoring point, not a red light.
Return to jog isn’t a calendar milestone. It’s a criteria milestone than we recently presented at CSM in Anaheim.
This is what data-driven ACL rehab looks like and not driven by time only.
#ACLrehab #returntorun #sportspt #physicaltherapy #ACLrecovery
Out with the old, in with the new!
Tough today goodbye to Champion 2.0 today. A lot of blood, sweat, tears (and dollars) went into this place and proud of what we did here.
But, wow, Champion 3.0 is here and bigger and better than ever!
9 months after his ACL-QT graft
This HS soccer player is getting close but what do you see?
Chat below and vote!
#physiotherapist #physicaltherapy #dptstudent #athletictrainer #ACL
Close relationships with amazing surgeons, who are like-minded are critical!
That’s all I have to say and I hope you take this very seriously to help grow your future Practice as a PT and ATC.
#physiotherapist #dptstudent #atc #physicaltherapy
