Reaxing’s Post

Day 4 of #40DaysOfBEAR 2.0 02/17/24 I want to shout out and thank Mike St. George, PT, DPT. Clinic Director at IvyRehab Physical Therapy in Pennsylvania And Coach Joe Hos, NSCS-CPT, CFSC. Owner of Sports Rehab PA and Sports Rehab FLA for inviting me and having me on the Coach Hos Podcast yesterday! Stay tuned for the full episode when they post it and FOLLOW these guys; SUBSCRIBE to their Podcast if you have any interest at all in ALL THINGS ACL/injury prevention/ACL rehab/sports rehab/sports performance, etc. etc. I had a blast on the show talking all things BEAR/ACL and even throwing some Regenerative Medicine pearls in on where #MLSlaser ⚡️#PRP and #BMAC may fit in. Thanks again Joe and Mike! Answer to yesterday’s Poll: 9-12 months to “return to sport” is the AVERAGE after Bridge Enhanced ACL Restoration/Repair/BEAR surgery (as well as ACL Reconstruction/ACLR surgery) HOWEVER, my experience is usually the athlete does not hear 9 to 12 months but hears “9 MONTHS”, and the reality is most do not get back until the 11 or 12 month point and even that is not a guarantee. Certainly some people can get back sooner, but those are usually athletes who have had an amazing strength base already, had really good neuromuscular control prior to their injury, they’re well balanced, their mechanics are good, all prior to the injury. Many athletes, who tear their ACL did not have good mechanics, strength, had strength imbalances, did not have good form, etc., so they have to learn all of that after they have their surgery, which is much more difficult, and takes longer, but they don’t understand that. It is our job to get them to understand that, but it is very difficult. (We cover a lot of this on the Coach Hos Podcast!) Today’s Poll: What is the BEAR implant made from? Human purified tissue Pig purified tissue Shark cartilage Cow/bovine purified tissue #BEARImplant #ACL #ACLtear #ACLinjury #KneePain #KneeInjury #KneeSprain #KneePainRelief #KneeArthritisPrevention #ACLRepair NOT #ACLReconstruction #ACLRepairNOTACLReconstruction #BEARimplant #KneeRepair NOT #KneeReplacement #KneeRepairNOTKneeReplacement #PhysicalTherapy #Rehab #Rehabilitation #Fitness #VFit #ACLrehab #VictorySportsMedicine #VictoryInMotion #DrMarcPietropaoli Joe Hos, NSCA-CPT, CFSC Mike St. George PT, DPT www.victoryinmotion.com https://lnkd.in/eBeXrPUU For more information on Bridge Enhanced ACL Restoration/Repair (BEAR🐻) surgery, please call: 315-685-7544 315-707-8891 or e-mail: BEAR@victorysportsmedicine.com

Just because your patient has shoulder pain does not mean they have a shoulder problem… And need shoulder rehab. WTF Andy! I had a patient just yesterday in the clinic complaining of left shoulder pain for the last 3 months, yet it was not his shoulder that was the problem… But his left elbow! In short, he had flared his left elbow on holiday carrying his youngest child a lot, developing a distal bicep problem. This had seemingly fixed itself up, however, a month after the elbow pain, the shoulder on the same side started to hurt. The body is clever like that. It will find a way around a problem. It will compensate. In this case the shoulder, and specifically his left anterior deltoid and pec minor were doing more work, to help out the bicep problem. Initially, this is a good strategy, as it allows the body to keep functioning, but… If not addressed it causes issues longer term, just like this patient’s shoulder pain. The last physio he saw rehabbed his shoulder and gave him all the usual shoulder rehab exercises… But he did not get better, because… His shoulder was not the problem. If your shoulder pain patient is not improving, make sure to check that another issue elsewhere is not driving the problem. Hope this helps, Andy Barker The New Grad Physio Mentor PS. Being able to make sense of this patient’s injury stated with the subjective assessment… And the ability to be able to identify previous injuries that might have been contributing to his shoulder pain… Before testing out these assumptions in the objective assessment. Would you know how to work out if a patient’s elbow issue (or some other injury) was causing their shoulder pain, or not? Need some help? Head here and I’ll show you how to do this… https://lnkd.in/gGyB8aHF #newgradphysio #newgradphysiomentor #newgrad #newgrads #physiotherapy #physio #physicaltherapy #students #therapy #MSK #physiotherapist #studentphysiotherapist #physiostudent #sportstherapy #studentphysio #sportsrehab #learning #cpd #sportsphysio #mentor

ACL rehabs are very well researched, but what about the cognitive component? The ACL is not just about knee stability; it’s a crucial component of our sensory system. ACL injury disrupts sensory feedback, impacting neuromuscular control and cognitive skills. This means athletes post-ACLR may struggle with cognitive tasks, motor skills, and adapting to environmental changes. Research shows that ACLR patients exhibit deficits in reaction time, impulse control, and overall cognitive performance. This affects their ability to respond quickly and accurately, leading to potential biomechanical risks and reduced sports performance. Practitioners are now emphasizing cognitive-motor training in rehab to bridge these gaps. By integrating neuroplasticity principles and cognitive challenges into exercises, patients can improve motor skills, reaction times, and overall performance. The journey post-ACLR isn’t just about physical rehab but also about honing cognitive abilities for optimal athletic performance and injury prevention. Understanding this holistic approach can pave the way for better outcomes in sports rehabilitation. Read the Sportsmith Premium article from Roberto Ricupito 👇🏼 https://lnkd.in/eQCst26R

When it comes to special testing at the ankle the odds are good that you will find the right diagnosis... As the tests are quite good! They are fairly accurate and therefore help you to differentially diagnose. But only if you pick the right tests... And do them in the right order!!! You should have a deliberate plan when it comes to special testing the ankle. There are a few reasons for this... None more so than the fact that some special tests are more provocative than others. Typically, you want to do the least provocative tests first... So you don't stir up unnecessary symptoms, resulting in loads of false positives... And uncertainty as to what is actually going on. When planning special testing, I use something called my special testing 'ladder.' Essentially it is a tool to structure your special testing sequence so you not only do the right special tests... But also structure your assessment so you do the right tests in the right order. Even the best special tests are not that good if they are not done properly. Want to learn more? Well you are in luck as I'll be showing you my special testing 'ladder'... With examples for both lateral ankle and syndesmosis injury testing on tomorrow night's free ankle webinar... 🦵 Ankle Differential Diagnosis 🗓️ Thursday 14th November 2024 🕰️ 19:00-20:00 (GMT) 📍 FREE & Online (Zoom) On the webinar I will also be showing you... - The Key Subjective Assessment Clues That Will Help You Differentially Diagnose The Ankle Whatever The Injury - Early Ankle Management Strategies To Ensure You Get Patient Rehab Off To A Great Start & Avoid Any Unnecessary Surgery Plus at the end of the webinar I will stay online for as long as needed to answer any of your questions. Catch you tomorrow! Andy Barker The New Grad Physio Mentor PS. I'll be posting you a private link (zoom) tomorrow both via email and also on my social channels. You can find me her on Instagram or here on Facebook. PPS. Just to note... This is a live webinar and a replay will not be made available for free after the event... So if you want to see it for free then do everything you can to join me tomorrow! #newgradphysio #newgradphysiomentor #newgrad #newgrads #physiotherapy #physio #physicaltherapy #students #therapy #MSK #physiotherapist #studentphysiotherapist #physiostudent #sportstherapy #studentphysio #sportsrehab #learning #cpd #sportsphysio #mentor

Let's talk about the PCL (Posterior Cruciate Ligament). The PCL is one of the four major ligaments in the knee, crucial for stabilizing the joint. PCL tears typically occur due to a direct blow to the front of the knee, hyperextension, or during high-impact sports activities. Unlike the Anterior Cruciate Ligament (ACL), PCL tears are less frequent but can significantly impact an athlete’s performance. PCL tears often result from sudden, forceful impacts to the front of the knee. This can occur during sports like football, soccer, or in motor vehicle accidents. Find out more in our blog post ⬇️ https://lnkd.in/ehGnHB6y 📞 828-365-8133 #asheville #ashevillenc #Run828 #828isgreat #AVL #runAVL #NC #WNC #ashevillelocal #visitasheville #ashevilletrails #exploreasheville #AVLlocal #ashevillenorthcarolina #ashevillefit #ashevillelife #AVLfitness #ashevillehealth #ashevillewellness #backpain #kneepain #hippain #828health #physicaltherapist #physicaltherapy #physicaltherapyclinic #physiotherapy #physiotherapist #ashevillestrong #avltoday

ACL rehabilitation after surgery is not an easy road and requires a great deal of commitment and discipline from an individual. It is important therefore to have the right support team in the form of experienced and qualified experts along with a customised approach within standardised protocol so that the rehabilitation process can be optimised and return to sport or full activity with complete confidence can be achieved. . Seya is a perfect example of an athlete with great determination as well as her awareness and curiosity about her rehabilitation process. We have enjoyed the experience of working with her as her support team and we are committed to help Seya return to sport in the best physical and mental condition she has ever had. . In the world of sports, timing is key. Your rehabilitation journey can make a world of difference, shaping not just your comeback timeline but also your resilience against future injuries. At Sporting Ethos, we recognize the vital importance of proper care and support from the get-go. With our team of seasoned physical therapists and sports medicine specialists, each step of your recovery is meticulously crafted for optimal results. For those grappling with knee pain or recovering from surgery, the choice of where to rehabilitate is paramount. Settle for nothing but excellence. Join us at Sporting Ethos and experience the pinnacle of rehabilitation care. Let us guide you back to an active life filled with confidence and strength. Your comeback story starts right here. . #ACLRecovery #Resilience #SportingEthos #ReclaimYourActiveLife #SportsRehabilitation #InjuryRecovery #PhysicalTherapy #StrengthTraining #FitnessJourney #SportScience #AthleteCare #SportsMedicine #RehabilitationGoals #ComebackStronger #SportingExcellence #OptimalRecovery #FitnessMotivation #AthleteSupport #RoadtoRecovery #HealthandWellness

Let's cut to the chase...
 You do not like treating shoulders, right?

 I know this because it is the joint I get asked the most questions about.

 From finding the right diagnosis...

 Explaining this diagnosis and a prognosis to your patient...

 And knowing what treatments and rehab to use for shoulder pain patients is hard! I blame University!

 Seriously, like me, I bet you were taught to diagnose largely by using special testing.

 Helpful when the tests are good...

 Like the Lachman's test at the knee...

 Or anterior draw test at the ankle...

 But not so good at the shoulder.

 Shoulder special tests are poor.

 They have low sensitivity and low specificity...

 In simple terms meaning they are poor at actually diagnosing what the tests are meant to test...

 Or put another way...

 They are a waste of your time and effort to even use in the first place. If you are reliant upon on special tests to find the right diagnosis with your shoulder pain patients...

 Then you are always going to struggle! 

 The shoulder is a more complicated joint in many ways than other joints like the knee or ankle, due to it's more complex structure and anatomy...

 With so much going on in such a tight space.

 But this does not mean you can’t still get great patient results…

 Even without a clear shoulder diagnosis. All this week I will be giving you some of my biggest tips to help you make sense of shoulder pain symptoms... And giving you some simple strategies to help you get even the most complex shoulder pain patients out of pain... And back to full fitness... Even as a young and inexperienced shoulder physio! Keep your eyes peeled! In the meantime... Get my FREE shoulder pain PDF... ‘5 Breakthrough Steps To Confidently Treat The Shoulder Right Every Time, Avoid Mistakes & Stop You Feeling Less Adequate Than Other New Grads’ Just head to www.newgradphysio.com to download this FREE resource right away. Any problems getting access, just let me know and I will send you a copy over! Hope it helps! Andy The New Grad Physio Mentor #newgradphysio #newgradphysiomentor #newgrad #newgrads #physiotherapy #physio #physicaltherapy #students #therapy #MSK #physiotherapist #studentphysiotherapist #physiostudent #sportstherapy #studentphysio #sportsrehab #learning #cpd #sportsphysio #mentor

Navigating Life After Your Athlete's Knee Injury Discovering that your athlete has a meniscus tear can be overwhelming, but knowing the next steps is crucial for their recovery. Here's a simple guide tailored for parents. Understanding the Tear: Side Matters Lateral Tear: Common Causes: Often happens during quick turns or impacts in sports. What to Watch for: Your athlete may feel instability or locking during movements. Sports Impact: Think sports like soccer or basketball. Medial Tear: Common Causes: Typically linked to wear and tear over time. What to Watch for: Your athlete might feel discomfort during regular activities or prolonged standing. Daily Impact: Consider activities that involve a lot of walking or standing. Next Steps: To Surgery or Not? Surgery: What to Expect: A doctor might suggest removing the torn part or stitching it up, especially if your athlete is keen on a faster recovery. For Active Kids: Athletes often choose surgery to get back into their sports groove sooner. No Surgery: What to Expect: Physical therapy becomes the hero. Strengthening and modifying activities take center stage. For Consideration: This could be the path if your athlete prefers a non-surgical route. For Active Kids: Post-Injury Post-Surgery: First Steps: Gradual return to movement under a therapist's guidance. Training Twist: Tailored exercises to mimic sports moves. No Surgery: Focus on PT: Physiotherapy will be intense, with a keen eye on strengthening and flexibility. Back to Play: A step-by-step return to sports activities. Golden Rules for All Parents: Talk to the Doc: Discuss everything with the healthcare team, considering your athlete's age, health, and goals. Stick to Rehab: Whether surgery happened or not, physical therapy is a must. Watch for Changes: Keep an eye on pain, swelling, and progress. Future-Proof: Encourage long-term strategies—strength training, flexibility, and proper warm-ups to prevent future injuries. In a Nutshell: Recovery is a journey, and whether your athlete is opting for surgery or not, personalized care is key. Working closely with healthcare pros ensures a comeback that's strong and safeguards against future issues. It's a process that requires patience, commitment, and a comprehensive game plan. 🌟💪 #physio #physiotherapy #physicaltherapy #meniscus

Injuries to the MCL (medial collateral ligament) are one of the most common traumatic knee injuries you will see… But despite their prevalence, there are no definitive protocols as to the best way to manage these types of injuries! So unless you have managed a lot of these types of injuries it can be really difficult to know how to manage this type of problem. If you are faced with this sort of injury you will need to decide… - Whether to brace the knee or not - If you brace, decide what sort of brace to use - If you brace, decide what angle to brace the knee at - If you brace, decide how long to brace the knee for, and when to change the brace settings - What clinical markers you will use to determine the removal of the brace There’s 5 clinical decisions, that just relate to the use of a knee brace! And that is not including what treatments, rehab or other specific MCL strategies you need to know to ensure you manage your patient, or athlete, with an MCL injury, in the best possible way. I have managed dozens of these injuries during my time working in professional sport and private practice, from grade 1’s to grade 3’s and have had experience of surgical MCL cases too. Having seen so many of these injuries and having had this injury myself (I gave injured both my MCL’s in the past), the way I manage an MCL injury has greatly changed over the years… And is very different to what the textbooks, many other therapists and even consultant knee surgeons would advise. All this week I’ll be focusing on MCL injury management. To ensure I help you in the best possible way… Let me know what you need to know! Post a comment below or send me a DM and let me know... 'What your biggest challenge is when it comes to MCL injury management.' I'll collate the best questions and put some content together and post this week to help you out. Speak soon, Andy The New Grad Physio Mentor PS. I’d like to tell you both my MCL injures happened playing sport. One did, the other… I injured when I fell off a table I was dancing on on a lads holiday in Malia! The less we talk about that one the better! #newgradphysio #newgradphysiomentor #newgrad #newgrads #physiotherapy #physio #physicaltherapy #students #therapy #MSK #physiotherapist #studentphysiotherapist #physiostudent #sportstherapy #studentphysio #sportsrehab #learning #cpd #sportsphysio #mentor

🇬🇧🇺🇸 There was a need to shout out my friend and colleague Mathieu Pulver (show him some love 🫶) You may have seen studies assessing physiotherapists' practice when treating patients who underwent ACL reconstruction. Mathieu did that for his Master's Thesis, looking at this problem in Switzerland, and it's finally published under the link there (open access!) https://lnkd.in/eKVvX6Hf Some good news: 91% of participants include open kinetic chain exercises during the rehab - I can hear Florian FORELLI screaming with happiness in the background. Selection bias, tho? Maybe... But still! Really positive But there's still a lot to improve; not many Swiss physios use PROMs or consider psychological criteria when treating patients with ACLR. A few take-homes I have: 1. Hop tests are considered more important than strength. We may discuss that point since strength certainly influences hop tests (generate impulse to jump). Still, the opposite may differ, especially for horizontal jumping (e.g. landing without a functioning quad). 2. The fact that "quadriceps strength is mainly assessed with leg press, squat test, and knee extension test" feels a bit weird when we have cheap tools that allow us to quickly get a measure of quadriceps torque (if interested: www.tindeq.com) That study is a great step in the right direction. It may help CPD to focus on the gap we have in our practice and help us improve (I see you Nicolas Le Coroller - may be interesting for the next course you give 😉). Everybody loves these ACL rehabs. But we still need to improve some things, even though it's a good start. So get your pencils to hand those PROMs out, and hop on your hand-held dynamometer. And let's try to be a bit more objective 🙏