ACL Reconstruction Surgery Physical Therapy Treatment | Phase 2 | Case Study Part 3 | FPF Show Episode 52

By dpope2020

September 30, 2022

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ACL Reconstruction Surgery Physical Therapy Treatment | Phase 2 | Case Study Part 3 | FPF Show Episode 52

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In today's episode we go over ACL Reconstruction Surgery Physical Therapy Treatment | Phase 1 | Case Study Part 2 | FPF Show Episode 51:

  • 0:00 Introduction
  • 2:27 Week 6 range of motion after ACL surgery
  • 4:08 Single leg strength at week 6 after ACL surgery
  • 7:00 Week 6 isolation strength, accessory exercises and balance / neuromuscular control
  • 9:37 What do do on "Off" days after ACL surgery
  • 10:35 Strength work at week 10
  • 11:50 Preparation for running and plyos 
  • 12:48 How many day's per week should we be doing strength training at week 10 after ACL surgery?
  • 12:52 When should you be strength testing your athletes?
  • 14:22 When can we start loading up open chain knee extension?
  • 16:13 When do we start phasing out blood flow restriction training after ACL surgery?
  • 16:25 How do we continue to increase the challenge of balance and neuromuscular control exercises?
  • 17:11 Neurocognitive training after ACL surgery
  • 17:40 Advancing conditioning exercises and getting ready for return to run after ACL surgery
  • 20:20 Approach return to running, impact, plyometrics and eventual sports specific drills after ACL surgery
  • 22:03 What does the entire strength program look like from beginning to end?
  • 23:54 Long term planning for return to sport and activity after ACL surgery

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Thank you!

Dan Pope DPT, OCS, CSCS

References:

  1. Delaware - ACL-R Physical Therapy Protocol https://cpb-us-w2.wpmucdn.com/sites.udel.edu/dist/c/3448/files/2016/01/UDPT-ACL-Rehab-Guideline-REVISED.pdf

  2. Failla MJ, Logerstedt DS, Grindem H, Axe MJ, Risberg MA, Engebretsen L, Huston LJ, Spindler KP, Snyder-Mackler L. Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction? A Comparative Effectiveness Study Between the MOON and Delaware-Oslo ACL Cohorts. Am J Sports Med. 2016 Oct;44(10):2608-2614. doi: 10.1177/0363546516652594. Epub 2016 Jul 14. Erratum in: Am J Sports Med. 2017 Apr;45(5):NP9. PMID: 27416993; PMCID: PMC5537599.

  3. Kim DK, Park G, Wang JH, Kuo LT, Park WH. Preoperative quadriceps muscle strength deficit severity predicts knee function one year after anterior cruciate ligament reconstruction. Sci Rep. 2022 Apr 6;12(1):5830. doi: 10.1038/s41598-022-09816-3. PMID: 35388112; PMCID: PMC8986796.

  4. Minshull C, Gallacher P, Roberts S, Barnett A, Kuiper JH, Bailey A. Contralateral strength training attenuates muscle performance loss following anterior cruciate ligament (ACL) reconstruction: a randomised-controlled trial. Eur J Appl Physiol. 2021 Dec;121(12):3551-3559. doi: 10.1007/s00421-021-04812-3. Epub 2021 Sep 20. PMID: 34542671.

  5. Thomas AC, Wojtys EM, Brandon C, Palmieri-Smith RM. Muscle atrophy contributes to quadriceps weakness after anterior cruciate ligament reconstruction. J Sci Med Sport. 2016 Jan;19(1):7-11. doi: 10.1016/j.jsams.2014.12.009. Epub 2015 Jan 13. PMID: 25683732; PMCID: PMC4500756.

  6. Lepley LK, Davi SM, Burland JP, Lepley AS. Muscle Atrophy After ACL Injury: Implications for Clinical Practice. Sports Health. 2020 Nov/Dec;12(6):579-586. doi: 10.1177/1941738120944256. Epub 2020 Aug 31. PMID: 32866081; PMCID: PMC7785904.

  7. Charles D, White R, Reyes C, Palmer D. A SYSTEMATIC REVIEW OF THE EFFECTS OF BLOOD FLOW RESTRICTION TRAINING ON QUADRICEPS MUSCLE ATROPHY AND CIRCUMFERENCE POST ACL RECONSTRUCTION. Int J Sports Phys Ther. 2020 Dec;15(6):882-891. doi: 10.26603/ijspt20200882. PMID: 33344004; PMCID: PMC7727417.

  8. Watson A, Brickson S, Brooks MA, Dunn W. Preseason Aerobic Fitness Predicts In-Season Injury and Illness in Female Youth Athletes. Orthop J Sports Med. 2017 Sep 5;5(9):2325967117726976. doi: 10.1177/2325967117726976. PMID: 28904982; PMCID: PMC5588804.