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11 August 2015 · Physio Edge podcast · 1 h 9 min

Physio Edge 032 How To Rehabilitate ACL Injuries With Enda King

ACL injuries can be career ending, or they can be an opportunity to sort out movement efficiency, motor control and and technical skills, coming back from the rehabilitation process with more power, speed and efficiency than they had before they injured their ACL.

In this podcast, Enda King from the Sports Surgery Clinic in Dublin currently completing his PhD in 3D biomechanical analysis after ACL reconstruction, with the aim to assist in RTP decision making and identifying fully rehabilitated athletes, and David Pope discuss ACL injuries, and the most important factors in pre-operative management and post-operative exercise programming to get your patients back to sport with improved sporting performance.

Going deep on the details involved in ACL Rehabilitation, including:

  • What does a fully rehabilitated athlete look like?
  • Incorporating performance goals into the rehab process
  • Can athletes achieve better performance post ACL rehab than they were pre-injury
  • Types of ACL grafts
  • Preoperative ACL Physiotherapy, helping your patient to prepare for the surgery
  • Preoperative education
  • Restoring knee extension, balancing pain and improved range of movement, empowering your patient
  • Guidelines for pain, swelling when restoring range of movement
  • Restoring quadriceps activation, normalising gait patterns
  • Clinical Edge
  • Clinical Edge’s free webinar program
  • Preoperative length of time
  • Post-op - initial management
  • To use or not use co-contraction exercises of quads and hamstrings
  • Should you use squatting style exercises Week 1 post op
  • Activating quadriceps - internal quadriceps cues or external exercise focus
  • How much pain should a patient experience during or after an exercise
  • Week 2 post-op
  • When can heavy gym training commence
  • Changing movement patterns throughout the kinetic chain
  • Advice for patients in the early stages of rehab
  • Frequency of exercise
  • Week 2 onwards - exercises incorporating balance and proprioception
  • Open vs closed chain exercises
  • Advice for patients in weeks 2–6
  • Nutrition and dietary advice for patients
  • Gym based rehabilitation
  • Choosing and modifying exercises for middle stages of the rehabilitation process
  • Various types of squatting movement, and progressing the types of squats
  • Goblet squats
  • Retraining ideal squat patterns
  • Progressing squats, deadlifts and lunges
  • Front squats
  • Front squats and trap bar deadlifts vs back squats during rehabilitation
  • When can an athlete start cycling
  • Disadvantages of using cycling as the main part of a rehabilitation program
  • Hamstring rehabilitation after semitendinosis/gracilis graft
  • Strength and power development
  • Strength testing - mid thigh pull, leg press
  • Should we use open chain strength tests
  • When to perform strength tests
  • Strength vs power and rate of force development
  • Running - incorporating into the program. When can your patient start running?
  • Preparation for running
  • Running drills
  • Ideal movement patterns in running
  • Enda King and SSC, and working with ACL athletes
  • Podcast timeline

Links:

  1. 01:20Enda King and SSC, and working with ACL athletes PhD in 3D biomechanical analysis after ACL reconstruction, aim to assist in RTP decision making and what a fully rehabilitated athlete looks like
  2. 3:35What does a fully rehabilitated athlete look like?
  3. 5:40Incorporating performance goals into the rehab process
  4. 6:50Can athletes achieve better performance post ACL rehab than they were pre-injury
  5. 8:20Types of ACL grafts
  6. 11:10Preoperative ACL Physiotherapy, helping your patient to prepare for the surgery - an opportunity to prepare your patients knee, ROM, strength and educate them on the rehabilitation process
  7. 14:20Preoperative education
  8. 14:40Restoring knee extension, balancing pain and improved range of movement, empowering your patient with
  9. 15:40Guidelines for pain, swelling when restoring range of movement
  10. 16:15Restoring quadriceps activation, normalising gait patterns
  11. 17:10Clinical Edge
  12. 18:45Clinical Edge’s free webinar program
  13. 19:30Preoperative length of time
  14. 20:35Post-op - initial management
  15. 23:20To use or not use co-contraction exercises of quads and hamstrings
  16. 24:50Should you use squatting style exercises Week 1 post op
  17. 25:25Activating quadriceps - internal quadriceps cues or external exercise focus
  18. 26:30How much pain should a patient experience during or after an exercise
  19. 27:30Week 2 post-op
  20. 28:30When can heavy gym training commence
  21. 29:30Changing movement patterns throughout the kinetic chain
  22. 31:00Advice for patients in the early stages of rehab
  23. 32:10Frequency of exercise
  24. 32:55Week 2 onwards - exercises incorporating balance and proprioception
  25. 34:10Open vs closed chain exercises
  26. 35:40Advice for patients in weeks 2–6
  27. 37:15Nutrition and dietary advice for patients
  28. 37:45Gym based rehabilitation
  29. 38:50Choosing and modifying exercises for middle stages of the rehabilitation process
  30. 41:00Various types of squatting movement, and progressing the types of squats
  31. 41:45Goblet squats
  32. 42:30Retraining ideal squat patterns
  33. 43:25Progressing squats, deadlifts and lunges
  34. 44:00Front squats
  35. 46:00Front squats and trap bar deadlifts vs back squats during rehabilitation
  36. 47:25When can an athlete start cycling
  37. 48:00Disadvantages of using cycling as the main part of a rehabilitation program
  38. 48:30Hamstring rehabilitation after semitendinosis/gracilis graft
  39. 49:45Strength and power development
  40. 51:00Strength testing - mid thigh pull, leg press
  41. 53:15Should we use open chain strength tests
  42. 54:20When to perform strength tests
  43. 55:00Strength vs power and rate of force development
  44. 55:50Running - incorporating into the program. When can your patient start running?
  45. 57:30Preparation for running
  46. 58:35Running drills
  47. 1:00:30Ideal movement patterns in running
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