ACL Treatment Series (1/3)
With non-operative management, good-to-excellent outcomes exist with:
Activity modification. 🙌🏼🙌🏼
Rehabilitation is critical to a successful outcomes
In the acute period, focus on reduction of swelling, pain and restoration of knee ROM.
Strengthen hamstrings and quadriceps to improve overall joint stability.
To counteract anterior tibial translation include:
Closed-chain knee extension
Open-chain knee flexion 🙌🏼
Focus on balance and joint position to minimize symptoms of instability, as a loss of proprioception occurs with ruptures of the ACL.
Progression to sport-specific activity can include:
(Avoiding cutting, pivoting, or jumping activities)
Use during occasional participation in high-risk activities involving twisting, pivoting, and/or cutting, such as a yearly ski trip.
Braces can decrease anterior tibial translation by 30% to 40%, however cannot restore the knee to normal levels of stability with weight-bearing activity.
Activity modification is the key to successful nonoperative treatment of ACL injuries. 🏃🏽
Common sports activities have been categorized on the basis of ACL dependence
Limiting activity to straight-ahead running, without twisting, pivoting, and/or cutting.
Primarily dependent on patient activity. 📈
95% are able to return to work and perform ADL without difficulty.
However, 60% experience some knee pain, primarily with activity.
Few patients are able to return to their pre-injury level of activity; most reduce their activity level by an average of 20%.
In a study of conservatively treated patients who returned to high-level activity, 51% sustained significant re-injury at 1 year and only 36% were able to continue a high level of activity at 5.5 years.
Eventual meniscal surgery occurs with greater frequency with return to high-level activity.
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2. Operative treatment
Bogunovic & Matava 2013. Op
This is basically what my weekends have looked like for the past couple months.. grindin! The hardest part of training is finding a location. This past weekend we jumped around a few of our spots and had to resort to this half sandy court. Don’t let closed gyms/crowded courts prevent you from putting in that work! As always, for the full video, check my FB or Youtube. This one had some solid teaching points from @ototo_ttak on how to read options and train with those in mind. 🤔💡📚
"Mentoring is a brain to pick, and ear to listen, and a push in the right direction." - John Crosby
S/o to Dr Wong - his drive to uplift and positively impact the Physical Therapy community is admirable. SO HAPPY we got to catch up and talk about future goals and dreams!
CHECK OUT the @physio_u APP! 📱📲📲📲📲
Remember to surround yourself with people that inspire you, believe in you, and provide you with the gift of time. .
#mentoringmatters #mentor #rolemodel #physioU #APUPT #stayafterclass #physicaltherapy #DPT #dptstudent #physicaltherapist #physiotherapy
The Glute pallof: this is a great variation to the traditional exercise and really enhances the Glute activation. To perform this exercise, take a band and mount one end to a stationary object and the other end to your ankle so that it pulls your ankle toward the other foot. Next, tighten your core and extend your leg backwards. The key to this exercise is to resist the pull of the band. Use a decently heavy resistance band and try 3 sets of 15 to really feel the glutes burn.
#glutes #exercise #fit #fitness #gym #booty #squats #crossfit #strength #stability #move #movement #mobility #pt #dpt #prehab #rehab #therapy #physio #physicaltherapy #bootygainz #educational #kneepain
A❗️High Ankle Sprain❗️is a ligamentous injury to the distal tibiofibular joint, which is a complex of connective tissues that provide stability to the mortise of the talocrural joint. (ankle joint)
Injured structures include the anterior inferior tibiofibular, posterior inferior tibiofibular, & transverse tibiofibular ligaments as well as the interossious ligament & membrane.
It is caused by aggressive impact where the lower leg rotates internally while the ankle is planted on the ground in dorsiflexion. The talus forces the fibula to separate from the tibia, rotate externally and displace posteriorly, resulting in abnormal stress on the joint complex and structures listed above.
Healing times can vary depending on the severity of the sprain, a study by Mauntel el al, found that 47% of athletes missed >7 days of participation and 16% missed > 21 days.
Mauntel et al. The Epidemiology of High Ankle Sprains in National Collegiate Athletic Association Sports. AJSM 2017
DM #491: We’re all guilty of it. You, me, everyone. Rehab ain’t sexy, so it tends to take a backseat. But if you looked in that rearview mirror you’d see that your future gains are sitting right there next to that unsexy rehab. Funny how that works.
Far from a soapbox speech tonight, because, like I said, I’m guilty of it too. But the fact of that matter is, when you’ve got something that just won’t go away, be it pain, asymmetry, dysfunction of any kind…ignoring it likely isn’t going to make it get better.
Training harder typically just serves to increase that asymmetry as the strong side gets stronger faster than the weaker side can catch up, or, eventually that stronger side craps out from just doing too much, and there go ALL the gainz.
I get it. The ‘accessory’ work that I asked you not to call accessory work (DM #486 😜) isn’t as fun as clangin and bangin the iron. So then you know what? Use that as motivation. Do that unsexy stuff (btw, @marcusfilly bout to make ALL that stuff look good though, @revive_rx coming correct), fix your 💩, then get back to doing whatever it is you love.
Give it the attention it deserves then get back to giving attention to whatever it is that tickles your pickle. The choice is yours.
Daily Maestroisms dropping every night at 7pm-ish PST. Get yours.
Like it? Repost it. Don't understand it? Hit me up and get #Maestrofied.
Be sure to follow The Movement Maestro on FB, Instagram, Twitter, and YouTube for all things #movement and #mobility related. Come move with the Maestro.
Doesn't get much better than this! Honored to talk shop tonight and be back on @lionheartradio with @run.lift.evolve
Podcasting today with a view. Just had a great conversation with @primalstrengthdoc about breathing, movement & how to start repairing the human condition 🦍🏃🏽♀️🏋🏽♀️ Dropping on LionHeart Radio in a few weeks! #noneofthefilters .
#podcast #lionheartradio #dpt #primalstrengthpt #socal #athlete #passion #strength #dowhatyoulove #crossfit #endurance #ironman #triathlon #training #nutrition #breathing #functionaltraining #movement #movementismedicine #getbetter #findthewhy #workout #assessdontguess #sunset #view
Why do we like the Bottoms Up KB Overhead Carry so much? . . . .
This exercise has all the components of a great rotator cuff (RTC) training exercise. Balancing the weight forces the RTC to work dynamically to stabilize the shoulder joint. Packing and loading the shoulder joint with weight overhead increases RTC recruitment. Firm gripping has been shown to increase RTC recruitment.
I love this exercise as a prerequisite to overhead pressing exercises for someone with a painful shoulder. Try this one out and then burn out with a few overhead KB presses.
#kettlebell #overheadathlete #baseballtraining #shoulderstability #scapularstrength #tacomafitness #fitspiration #athleterehab #dpt #physicaltherapy #overheadcarry #overheadtraining #overheadathlete #tacomaphysicaltherapy #tacomasmallbusiness #physiostrength
Fifth and FINAL year of undergrad 🤓📚📝 time to get this sh*t doneeeee😜😈 •
• #senioryear #msu #bobcats #futureplans #montana #montanastateuniversity #buckledown #schoolisinsession #study #nolife #livingon #naps #andcoffee #exercisescience #futuregradschool #hittingthebooks #DPT #whatsnext #path #goals #plans #positive #schoollife #busybee #yogapants #determined #perspective #wheresmycapandgown
This is part of a series with @theprehabguys. Carpal tunnel syndrome (CTS) results in the highest number of days lost among all work related injuries. It is the most common of all nerve entrapment syndromes. CTS has symptoms of numbness and tingling in the first 3 and a half fingers (thumb through half of ring finger). The symptoms start gradually and become more constant over time. It occurs from compression of the median nerve at the hand/wrist as it passes through the carpal tunnel. Decreased space at the carpal tunnel is the main issue. Symptoms include:
✅A lack of 2 point discrimination/proprioception
✅Atrophy of the thenar/thumb muscles.
There are many approaches to treat carpal tunnel syndrome, but research supports conservative treatment is a good first step.
Unsure if you have carpal tunnel syndrome? Have no fear, the Wainner clinical prediction rule is here! There are a series of criteria to make sure you correctly rule in CTS.
1️⃣Hand shaking improves symptoms.
2️⃣Wrist ratio of Anterior/posterior width to medial/lateral width is >.67. Calipers can be used at the distal wrist crease to measure. Women are more likely to have CTS because their wrists are on average smaller than men's wrists.
3️⃣Symptom Severity Scale score of >1.9 which is an 11 item questionnaire that can be administered by your physical therapist.
4️⃣Reduced sensation in the thumb. The median nerve supplies the sensory nerves of the thumb pad.
5️⃣Age greater than 45
If 4 of these tests are positive there is an 83% chance you have CTS, and if five of these test are positive there is a 95% .
#physicaltherapy #dpt #spine #yogi #fitness#gainz#gym #life #exercise#strength#conditioning #research#crossfit#athlete #fitness #yoga #therapy #pain #physio #motivation# #science #back
@Regrann from @strengthcoachtherapy - T Spine Mobility:
There are a few different ways to perform quadruped (all fours) spine rotations:
1️⃣ Sit normally on all fours and rotate while letting the entire spine move. This allows the most overall spine and accessory hip movement. It is closer to how our spine functions naturally, as in a golf swing.
2️⃣ Sit back as far as you can and reduce movement from the low back and hips. This targets the upper back more specifically and creates a firm end point of rotation. You will get less total rotation with a more targeted stretch.
3️⃣ Thread the needle: this is a spinal flexion + rotation movement, it is a different overall motion than the first two, but still very valuable.
4️⃣ Reach + Rotate: this is a hybrid of the first 3 movements that I kind of freestyled one day and it stuck. I like to use it towards the end of mobility work in order to really open up.
These are all acceptable mobility exercises. The key is to find what works for you. As always, it depends on your goals, your body, and the context.
#kneerehab #kneepain #aclrehab #aclsurgery #acl #jumpersknee #patellartendonitis #patella #patellatendon #dptstudent #dpt #doctorofphysicaltherapy #physiotherapy #physicaltherapy #pt #physio #therapist #massagetherapist #massagetherapy #chiro #chiropractor #chiropractic #exerciseaddict #physicalfitness #biomechanics #squatgains #sprainedankle #anklerehab #kinesiology #exercisescience
I push this exercise on all my patients with LBP, inhibited lumbar multifidi, or weak glutes (which often occur in conjunction with one another) to maximally stimulate "core" activation. #physicaltherapy #physicaltherapist #multifidus #multifidi #exercise #fitness #core #coreactivation #inspiration #lowbackpain #backpack #glutes #gluteworkout #painmanagment #TideWayPT #galveston #houston #dpt #plank #birddog
It’s officially fall (although it was 80 degrees this weekend) and that means it’s finally pumpkin spice, football, & chili season!! I am a huge fan of easy crockpot meals that I can prep before work, cook all day, and come home to at the end of a late work day. Today I am sharing one of my favorite recipes - healthy buffalo chicken chili! This recipe can also be paleo if you leave out the beans! Try it out & let me know what you think!
Healthy Buffalo Chicken Chili
🔹1 pound ground chicken breast
🔹1 sweet potato, peeled & diced
🔹 2 carrots, peeled & diced or 10-12 baby carrots cut in 1/3’s
🔹2 stalks of celery, diced
🔹1 yellow onion, diced
🔹2 garlic cloves, minced
🔹1 teaspoon chili powder
🔹1 teaspoon smoked paprika
🔹1 teaspoon cumin
🔹1 teaspoon salt
🔹1 cup tomato sauce
🔹1 cup diced tomatoes (canned, not drained)
🔹 ½ cup buffalo sauce (I used Frank’s Red Hot Buffalo Sauce)
🔹 ½ cup organic chicken broth
🔹1 large can of red kidney beans (for paleo= no beans!)
1. Place all ingredients in crockpot, mix together.
2. Cover & cook on low 8 hours OR high 4 hours
3. Optional garnish- cilantro, chia & quinoa chips, cheese, avocado, ranch
#healthyrecipes #healthychili #buffchick #fitrecipes #crockpotrecipes #slowcookermeals #fallrecipes #paleo #paleorecipes #pncoach #physicaltherapist #fitness #nutrition #wellness #eatclean #eatwell #healthylifestyle #dpt #fitdoc #sportsPT #drcoachkat
"Weak posterior tibs you have, calf raises you must do." -#Yoda
If you have a navicular drop/arch collapse/over pronated hind foot as in A), but it gets better with B) your issue may simply be decreased #tibialisposterior strength or control. The muscle plantar flexes the ankle and inverts the subtalar joint and plays a large role in proper walking mecahics - so this is your green light to do more calf raises!
Toe-in calf raises, a @mobilityfit method, can be performed with those who have no prior aggravating knee symptoms. Maintain pressure on the first toe, and calf raise away.
Calf raise with a ball squeeze from @can_physio, forces you to maintain inversion throughout the full range of plantar flexion. Maintain a squeeze throughout!
Plantar Flexion Alternators are fairly difficult and require a lot of stability, as you can see Left-Yoda needs some work. Focus on maintaining knee extension and press into the balls of your feet for this one - alternating accordingly.
If going for endurance perform 3-4 sets of 15-20 reps and turn your calves into 🐮s 👍🏼. (Exercises performed at x2.5 speed*)
Who told you, you couldn't?
Who said it wasn't possible?
Who hasn't supported you?
Who doesn't believe in you?
Don't do it for them. Do it for YOU.
Then give them a smile and say "I told you I could"💪🏼
#yourock #nevergiveup #mondaymotivation #momof2 #mombod #cleaneating #lowcarb #nikegirl #lululemon #momlife #mondayvibes #anxietyawareness #anxietywarrior #thyroidhealth #strongnotskinny #weightloss #basementworkout #plyometrics #kindergartenmom #physicaltherapist #dpt #nutritioniskey #absafterbaby