Post image for PE #032 How to rehabilitate ACL Injuries with Enda King

PE #032 How to rehabilitate ACL Injuries with Enda King

by David Pope

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

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, discusses ACL injuries with David Pope. Covering the most important factors in pre-operative management and post-operative exercise programming so you can help your patients get back to sport safely and with improved sporting performance.

We cover ACL Rehabilitation in depth, including:

  • Enda King and SSC, and working with ACL athletes
  • Edna’s PhD in 3D biomechanical analysis after ACL reconstruction, aim to assist in RTP decision making and what a fully rehabilitated athlete looks like
  • 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

3:35 What does a fully rehabilitated athlete look like?

5:40 Incorporating performance goals into the rehab process

6:50 Can athletes achieve better performance post ACL rehab than they were pre-injury

8:20 Types of ACL grafts

11:10 Preoperative 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

14:20 Preoperative education

14:40 Restoring knee extension, balancing pain and improved range of movement, empowering your patient with

15:40 Guidelines for pain, swelling when restoring range of movement

16:15 Restoring quadriceps activation, normalising gait patterns

17:10 Clinical Edge’s sponsorship of the Physio Edge podcast

18:45 Clinical Edge’s free webinar program

19:30 Preoperative length of time

20:35 Post-op – initial management

23:20 To use or not use co-contraction exercises of quads and hamstrings

24:50 Should you use squatting style exercises Week 1 post op

25:25 Activating quadriceps – internal quadriceps cues or external exercise focus

26:30 How much pain should a patient experience during or after an exercise

27:30 Week 2 post-op

28:30 When can heavy gym training commence

29:30 Changing movement patterns throughout the kinetic chain

31:00 Advice for patients in the early stages of rehab

32:10 Frequency of exercise

32:55 Week 2 onwards – exercises incorporating balance and proprioception

34:10 Open vs closed chain exercises

35:40 Advice for patients in weeks 2–6

37:15 Nutrition and dietary advice for patients

37:45 Gym based rehabilitation

38:50 Choosing and modifying exercises for middle stages of the rehabilitation process

41:00 Various types of squatting movement, and progressing the types of squats

41:45 Goblet squats

42:30 Retraining ideal squat patterns

43:25 Progressing squats, deadlifts and lunges

44:00 Front squats

46:00 Front squats and trap bar deadlifts vs back squats during rehabilitation

47:25 When can an athlete start cycling

48:00 Disadvantages of using cycling as the main part of a rehabilitation program

48:30 Hamstring rehabilitation after semitendinosis/gracilis graft

49:45 Strength and power development

51:00 Strength testing – mid thigh pull, leg press

53:15 Should we use open chain strength tests

54:20 When to perform strength tests

55:00 Strength vs power and rate of force development

55:50 Running – incorporating into the program. When can your patient start running?

57:30 Preparation for running

58:35 Running drills

1:00:30 Ideal movement patterns in running

Links:

Enda King

Enda on Twitter @enda_king

Sports Surgery Clinic, Dublin

SSC Research Foundation

David Pope on Twitter

Clinical Edge Webinar program – register your interest

Clinical Edge

Review the podcast in iTunes

Tags: ACL, knee, injury, anterior cruciate ligament, surgery, rehabilitation, soccer, football, strengthening, movement, non-contact, physiotherapy, physio edge, podcast, enda king, SSC, sports surgery clinic, david pope, clinical edge, webinar

 

 

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