4 Tips for Returning to Play After an ACL Reconstruction

By Anne Bierman, PT, DPT, SCS for Athletico Physical Therapy

The ACL is a major ligament that helps to stabilize the knee joint. Athletes and recreational enthusiasts of all ages can experience an ACL tear, especially those who participate in high demand sports like soccer, football, volleyball and basketball.4 Tips for Returning to Play After an ACL Reconstruction After surgery, athletes tend to be very anxious to get back to the sport they love. To help them get back to their sport safely with minimal risk of re-injury, Athletico developed an ACL 3P Program. The three “P’s” stand for prevention, progression and performance. The performance aspect of the program emphasizes limb symmetry, proper landing/cutting mechanics and match fitness to minimize the athlete’s risk for re-tear. Learn more about the program by reading Athletico’s “Can ACL Tears Be Prevented?” blog.

Evidence suggests that an athlete may be 30 percent likely to re-tear an ACL, 20 percent on contralateral leg and 10 percent on same leg2. Athletico’s program aims to lower that risk by making sure an athlete has good landing and cutting mechanics when fatigued. Here are the top four things to consider before returning to play after an ACL-Reconstruction.

1)  Timing isn’t everything

A decade ago, most patients were discharged from physical therapy around the three month mark, then released by their physician to return to play at the six month mark. Instead of a time-based criteria, evidence suggests more objective criteria. Athletico’s ACL 3P program includes a cluster of tests – Y balance testing, hop testing, and video analysis of cutting and landing tasks to determine an athlete’s readiness to return to play. Educating patients from the first day of post-op about criteria-based return to play instead of returning right at the six month post-op mark will help them have realistic expectations.

2) Hop testing alone is NOT sufficient

A recent article came out suggesting that hop testing by itself is insufficient to allow an athlete to return to play. If hop testing is the only criteria for return to play, the athlete has been done a disservice. Other objective, sport-specific criteria should also be used.

Similarly, power is one of the last items to come back. Athletico includes single leg, triple hop testing in the “prevention” screen so that we have a baseline on athletes. If that athlete ever has an injury, Athletico clinicians can make sure that athlete not only returns to their baseline, but exceeds it.  Athletes often demonstrate symmetry by the 6six month post-op mark. However, their power often doesn’t return until the 7-8 month post-op mark.  By having a baseline, Athletico clinicians can ensure athletes are not only symmetrical but re-gain power as well.

3) Fatigue

Athletico’s final RTP phase includes a five minute fatigue protocol. Because athletes are most likely to get injured when they are tired, Athletico ACL 3P clinicians want to ensure that landing and cutting mechanics are flawless when fatigued. This is a key differentiator of Athletico’s program.

4) Athletes should not expect to play in a tournament their first weekend back in contact

Patients are often allowed to return to non-contact practice participation before the six month mark, or before they pass all return to play criteria under fatigue. This allows the athlete to start getting some sport-specific muscle memory and fitness. Many parents and athletes think that “getting released” means they can go back to playing a 90-minute soccer match (or even worse – an entire tournament) the first week back.

To ensure safe progression, when “released,” athletes should participate in several weeks of full contact practices before trying just a few minutes in each half of a match.  Physical therapists work hard to mimic sport-specific movements in physical therapy, but reactive decision-making is difficult and best replicated during practice and games. This can fatigue athletes quickly. Educating patients about appropriate progression is key to minimizing their risk for re-injury!

Returning To Play!

If you are interested in Athletico’s ACL 3P Return to Play testing, please email ACL@athletico.com.

These 3 Surprising Workouts Are the Best For Your Health, Says Harvard

There’s nothing like a multitasking sweat session to help us burn calories, banish stress, and clear our minds. But as Business Insider reports, not all fitness routines are created equal. A new health report released by Harvard Medical School titled “Starting to Exercise” outlined the most effective workouts that not only aid in weight loss, but also help strengthen your brain, bones, and heart.

“Research shows that just a half-hour of moderately intense exercise a day can improve your health and extend your life,” the report says. I-Min Lee, a Harvard professor and author of the study, notes that activities like long-distance running can have negative effects on your digestive system and joints. In addition to explaining the best ways to avoid injuries and use the proper breathing techniques, the research also reveals some of the most beneficial workouts for your health—and a few of them may surprise you. Read on below for three routines that help you live longer and only require 30 minutes of your time.

Walking. This activity may seem like a no-brainer, but as Business Insider reports, some studies have found that walking for at least 30 minutes at a leisurely pace can help boost your memory and reduce depression. For those who don’t exercise regularly, Harvard suggests starting off with 10- to 15-minute strolls and building up to 30- to 60-minute walks.

Tai chi. A Chinese martial and meditative art that involves a series of gentle and flowing movements, this ancient practice emphasizes deep focus and paying attention to breathing. Lee writes that tai chi is “particularly good for older people because balance is an important component of fitness, and balance is something we lose” as we age.

Swimming. Harvard’s Healthbeat newsletter calls swimming “the perfect workout,” all thanks to its ability to work almost every muscle in your body. From protecting your brain from signs of aging to raising your heart rate, this aerobic workout also reduces potential injuries “because it’s less weight bearing,” Lee writes in a recent issue of the newsletter.

By DANIELLE DIRECTO-MESTON

COLLEGE STUDENT BEATS BONE CANCER

CHARLOTTE: RECIPIENT OF BONE ALLOGRAFT

In 2005, Charlotte was a healthy, active 24-year-old just finishing her Master’s degree at Colorado State University. When she started to experience pain in her arm, Charlotte initially thought it was nothing serious.

She started some chiropractic treatments but the pain did not get better. Next, Charlotte noticed that there was something under her skin that would stick out when she moved her arm. Shortly thereafter an MRI confirmed a tumor and Charlotte was diagnosed with osteosarcoma – bone cancer.

Charlotte went to see Dr. Ross Wilkins at the Denver Center for Extremities at Risk where she learned about the daunting road ahead: they would do everything they could to beat her cancer, but she may be facing amputation.

After a regimen of chemotherapy that shrunk the tumor, Dr. Wilkins and his team were able to remove Charlotte’s bone and replace it with a bone allograft from AlloSource. Charlotte’s arm was saved from amputation and today she is back to some of the physical activity she enjoyed before cancer.

Although Charlotte has limited mobility in her arm, she is working every day to improve it. She embraced her drug regimen and has also explored nutritional and holistic therapies to assist in her recovery. Charlotte now works at Philmont Scout Ranch in New Mexico, one of three high adventure bases owned by the Boy Scouts of America. This summer she will be the staff and events coordinator at the training facility.

While she can’t rock climb anymore, she does pursue the high ropes course, backpacking, hiking and takes hip hop and Zumba classes.

Charlotte cites her faith as a major component of her strength through the cancer battle: explaining that she felt like she was in God’s hands throughout her entire diagnosis and healing process. Now, she’s thrilled to have reclaimed her life and is relishing finding new ways to do old things: a small price for being able to keep her arm.

If These Walls could Talk-Chicago Bears; The Return of Zach LaVine; Understanding Probiotics

Episode 17.31 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One (01:27):  Former Chicago Bear Otis Wilson talks with Steve and Dr. Cole about how the game has changed from 1985 and about his new book, If These Walls Could Talk: Chicago Bears: Stories from the Chicago Bears Sideline, Locker Room, and Press Box. Led by stars like Walter Payton, Jim McMahon, Mike Singletary, William “Refrigerator” Perry, head coach Mike Ditka, and defensive coordinator Buddy Ryan, the Chicago Bears in the 1980s were an NFL powerhouse.

As anyone who’s seen “The Super Bowl Shuffle” surely knows, they were also an unforgettable group of characters. Otis Wilson, the Bears starting outside linebacker, was right in the center of the action, and in this book, Wilson provides a closer look at the great moments and personalities that made this era legendary. Readers will meet the players, coaches, and management and share in their moments of triumph and defeat. Be a fly on the wall as Wilson recounts stories from those days in Chicago, including the 1985 Super Bowl-winning season. If These Walls Could Talk: Chicago Bears will make fans a part of the team’s storied history.


Segment Two (12:58): Dr. Cole and Steve discuss the return of Zach LaVine and the rehab process after ACL reconstruction. Fred Hoiberg confirmed that the Bulls will be bringing Zach LaVine (knee) along slowly once he’s cleared for contact.Zach LaVine #8 of the Chicago Bulls poses for a portrait during the 2017-18 NBA Media Day on September 25, 2017 at the United Center in Chicago, Illinois.

“We’ll still take things slow,’’ Hoiberg said. “We won’t throw him out for an hour scrimmage the first day he gets cleared for contact. It will be a gradual process. But he’s doing great, doing everything he’s supposed to do.’’
LaVine is on track to be cleared for contact within the next few weeks, but the Bulls will be taking an extremely cautious approach with his return, so it could be a while until he’s fully up to speed working without restrictions.

Segment Three (19:41): Karen Malkin from Karen Malkin Health Counseling decribes probiotics, why and when they should be used.

Probiotics are live bacteria and yeasts that are good for your health, especially your digestive system. We usually think of bacteria as something that causes diseases. But your body is full of bacteria, both good and bad. Probiotics are often called “good” or “helpful” bacteria because they help keep your gut healthy.

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Good bacteria are naturally found in your body. You can find probiotics in some foods and supplements.

It’s only been since about the mid-1990s that people have wanted to know more about probiotics and their health benefits. Doctors often suggest them to help with digestive problems. And because of their newfound fame, you can find them in everything from yogurt to chocolate.