ACL Reconstruction Surgery Physical Therapy Treatment | Pre-Operative Guidelines | Case Study | FPF Show Episode 50
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In today's episode we go over ACL Reconstruction Surgery Physical Therapy Treatment | Pre-Operative Guidelines | Case Study | FPF Show Episode 50:
- 0:00 Introduction
- 2:12 Subjective information: Patient age, female, demographics, psychosocial influences
- 5:37 Mechanism of injury and reason for ACL reconstruction surgery
- 6:15 Diagnostic imaging and concomitant pathology prior to ACL reconstruction surgery
- 7:43 Multi-disciplinary decision making prior to ACL reconstruction surgery (Graft choice, surgeon, timing)
- 11:40 Patient training age and goals prior to ACL reconstruction surgery
- 12:47 Pre-operative ACL reconstruction surgery physical therapy - Strength, neuromuscular control, return to sport and long term outcomes
- 14:05 Pre-operative goals prior to ACL reconstruction surgery
- 16:18 Pre-operative physical therapy - swelling, range of motion and quad control
- 17:15 Pre-operative physical therapy - Atrophy, neuromuscular control, balance and aerobic fitness
- 18:55 How to restore range of motion prior to ACL reconstruction surgery
- 22:58 The importance of PRE-operative quad strength and LONG term (1 year after ACL reconstruction surgery) outcomes and return to sport
- 26:25 How much weaker and smaller is the quad after ACL reconstruction surgery?
- 27:34 Contralateral limb training after ACL reconstruction surgery and training the rest of the kinetic chain
- 29:57 The importance of aerobic conditioning after ACL reconstruction surgery and MAINTAINING as much as possible early on
Listen and Subscribe to the Podcast
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Show Notes / Relevant Articles:
- FPF Mini Course - 7 Reasons Why Injuries Happen in the Gym and What to do About it
- Guide to ACL Reconstruction Exercise Prescription for Physical Therapists | Part 1 | FPF Show Episode 48
- Guide to ACL Reconstruction Exercise Prescription for Physical Therapists | Part 2 | FPF Show Episode 49
- The Evidence Based Guide to Patellofemoral Pain Syndrome for Physical Therapists
- Physical Therapy Evaluation and Treatment (Meniscus Tear Case Study)
- The Ultimate Guide to Getting Out of Knee Pain and Back to Squatting and Olympic Lifts
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Dan Pope DPT, OCS, CSCS
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
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.
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.
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.
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.
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.
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.
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.