032. How to rehabilitate ACL injuries with Enda King

Dec 9, 2014

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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:

01:20 Enda 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
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
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

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