6 Keys to ACL Rehabilitation

The latest Inner Circle webinar recording on 6 Keys to ACL Rehabilitation is now available.

 

6 Keys to ACL Rehabilitation

6 keys to acl rehabilitationThis month’s Inner Circle webinar is on 6 Keys to ACL Rehabilitation.  In this presentation, I’ll go over the 6 key foundational principles that you need to understand to maximize your results with ACL rehab.  There are many surgical and patient variables that may speed up or slow down the standard rehab progression, however, you can build an optimal program by following these 6 principles.

This webinar will cover:

  • The #1 complication after ACL rehab, prolonged weakness, and how to minimize this
  • The two most important things to focus on during the first week of rehabilitation
  • How to develop advanced strength programs and alter periodization schemes in the rehab setting
  • My simple, yet effective, criteria to return to activities

 

To access this webinar:

 

OnlineKneeSeminar.com Bloopers!

Since I’m writing this on Friday the 13th, I thought it would be funny to share some bloopers from OnlineKneeSeminar.com, our program teaching you exactly how Lenny Macrina and I evaluate and treat the knee.  

It’s not as easy as everyone thinks to film these programs so Lenny and I wanted to share some quick bloopers from the filming!

Happy Friday the 13th!

Learn Exactly How I Evaluate and Treat the Knee

Want to learn even more about how I evaluate and treat the knee?  You still can!  My online program on the Recent Advances in the Evidence-Based Evaluation and Treatment of the Knee is now available.  I’ll show you everything you need to master the knee.  Click the button below for more information and to sign up now!
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The Best and Easiest Way to Restore Knee Extension

One of the most common complications following a knee injury or surgery is not restoring full knee extension.  Losing knee extension causes a lot of issues, ranging from anterior knee pain, to altered movement patterns, to even difficulty when walking.

It’s super important to assure you restore full knee extension.

In this video below, Lenny Macrina, my co-owner of Champion and co-author of OnlineKneeSeminar.com, shares what he considers the best way to restore full knee extension.  Luckily, it’s not only the best in our minds but also the easiest to perform!  More importantly, he discusses why he doesn’t like one of the most common exercises that people tend to use.

 

 

Learn Exactly How I Evaluate and Treat the Knee

Want to learn even more about how I evaluate and treat the knee?  My online program on the Recent Advances in the Evidence-Based Evaluation and Treatment of the Knee is now available.  I’ll show you everything you need to master the knee.  Click the button below for more information and to sign up now!

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The One Thing You Must Do When Evaluating for an ACL Injury

Anterior cruciate ligament (ACL) injuries are common. When evaluating the ACL, special tests like a Lachman Test or Anterior Drawer have been shown to have great reliability and validity.

However, there is one main reason why you may get a false positive for an ACL injury of the knee that is often overlooked – you actually injured your posterior cruciate ligament (PCL)!

I know, it seems backwards, but watch this quick video for my explanation!

 

Learn Exactly How I Evaluate and Treat the Knee

Want to learn even more about how I evaluate and treat the knee? My online program on the Recent Advances in the Evidence-Based Evaluation and Treatment of the Knee is now available. I’ll show you everything you need to master the knee.  Click the button below for more information and to sign up now!

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3 Tips for Assessing the Patellofemoral Joint

The latest Inner Circle recording on 3 Tips for Assessing the Patellofemoral Joint is now available.

3 Tips for Assessing the Patellofemoral Joint

3 Tips for Assessing the Patellofemoral Joint

This month’s Inner Circle presentation is on 3 Tips for Assessing the Patellofemoral Joint.  In this live inservice recording, I discuss a few tips that that I follow when evaluating someone with anterior knee pain, or patellofemoral pain syndrome.  Often times the patellofemoral joint gets little attention during the examination.  But, in order to treat patellofemoral pain successfully, you need to have an accurate diagnosis that is very specific.  Not all anterior knee pain is the same!

This presentation will cover:

  • How your anatomy of your trochlea can alter your ability to statically stabilize
  • How to assess the static stabilizers of the patella
  • A detailed overview of how I palpate different soft tissue structures around the knee
  • How and why you need to look both proximally and distally as well as at the knee
  • The one simple test I do with everyone to assess how proximal and distal factors xalter the forces at the knee

To access this webinar:

The Effect of Ipsilateral and Contralateral Loading on Muscle Activity During the Lunge

One thing I talk about a lot when it comes to training and rehabilitation is the need to train the body in all three planes.  This often requires moving in one plane of motion and stabilizing in the other two.   We are often very good at moving in the sagittal plane, and poor at stabilizing in the transverse and frontal planes.  This is a big topic of discussion in my program Functional Stability Training of the Lower Body.

To enhance this triplanar stability, we often attempt to facilitate greater contraction of the gluteus medius muscle during sagittal plane exercises.  The lunge in particular is a great exercise for triplanar stability as the narrow stance challenges strength in the sagittal plane and stability in the transverse and frontal planes.

 

The Effect of Ipsilateral and Contralateral Loading on Muscle Activity During the Lunge

The Effect of Ipsilateral and Contralateral Loading on Muscle Activity During the LungeA recent study was published in the Journal of Strength and Conditioning Research that investigated the effect of holding a dumbbell in either the contralateral or ipsilateral hand during a split squat and forward lunge.  (Note: they called it a “walking lunge” but I am 99% certain it was a forward lunge, so I’m just going to say forward lunger in this article…  probably just semantics.)

The study found that:

  • Holding the dumbbell on the ipsilateral side had no effect on glute med activity.
  • Holding the dumbbell on the contralateral side resulted in a significant increase in glute med activity, but only during the forward lunge, not the split squat.

I was a bit surprised that glute med activity was not impacted during the split squat, but perhaps the static nature of the position inherently requires less transverse and frontal plane stability.

There was one other finding from this study that I thought was interesting.  Kinematic differences during the forward lunge were found between a group of trained individuals in comparison to a group without training experience.

This makes sense as the forward lunge is a complex movement pattern that requires an understanding of how to control the pattern.  It requires both mobility and stability, but also the ability to control the eccentric deceleration phase.

contralateral lungeHowever, there were no kinematic differences between training age during the split squat, meaning that both novice and experienced trainees performed the split squat in a similar fashion.  This make split squats a great exercise to incorporate in the early phases of training for those with limited training experience, eventually progressing to forward lunge as they get better at moving and stabilizing the pattern.

This helps solidify the use of split squats in our lunge regression system.

 

Implications

I like simple studies like this.  Having the rationale to make small tweaks to your program is what sets you apart.  It’s the small things that may not be obvious at first but will produce better results over time.

Based on these results, I would recommend using the split squat with bilateral dumbbells to maximize strength gains since a unilateral load did not alter glute med activity.  The split squat is more of a basic exercise, so why not just use it to work on strength gains in the novice trainee.  As the person progresses, you can add the forward lunge variation with a contralateral load to enhance triplanar stability.

 

 

 

Can PCL Injuries Be Successfully Treated Without Surgery?

Champion Physical Therapy and Performance

My latest article is now up on the new Champion Physical Therapy and Performance blog!  I discuss a recent research study that looked at the outcomes of subjects with PCL deficient knees that were followed for up to 21 years.

Pretty interesting stuff that shows the efficacy of our programs!  However, as you’ll read, we can do as much harm as good when designing exercises for people with PCL injuries.

Read the article here and be sure to sign up to receive all the updates from the Champion blog, there is plenty more coming from the Champion team!

 

I have also announced my latest Inner Circle webinar will overview my manual therapy system.  I’ve been really trying to create systems for all aspects of what I do as we build out Champion Physical Therapy and Performance.

Last month, I talked about how I design functional rehabilitation programs.  This month is devoted to manual therapy.  In this webinar I’ll discuss my system to performing manual therapy, including the specific order and techniques that I perform.  This system can be used for any issue depending on the needs of the patient.

I like to take a systematic approach for several reasons:

  1. Assures consistency between sessions
  2. Assures consistency between therapists
  3. Creates reliable and predictable results
Join me Wednesday August 27th at 8:00 PM EST for the live webinar or be sure to catch the recorded when it is posted.

Expert Advice on Youth ACL Injuries

youth acl injuriesFor this week’s post, I wanted to share what I thought was a great video from the American Orthopedic Society for Sports Medicine (AOSSM) on youth ACL injuries.

In this video, noted orthopedic surgeons Chris Harner, Lyle Micheli, James Andrews, and Peter Indelicato share their advice on several topics regarding youth ACL injuries, return to play, female ACL injuries, and preventative programs.

Videos like this are important to education the parents and coaches on the realities of issues like youth ACL injuries.

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5 Things You Need to Understand to Master Functional Rehab and Performance

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