Petroski Physio is a local Philadelphia, PA based sports and orthopedic practice that creates personalized treatment plans that improves recovery and showcases noticeable results. Our one-on-one approach allows us to listen to your concerns and provide a hands-on experience that is tailored to your goals. Call our office at (215) 576-4796 to discover the difference. #RehabDifferent
Early in the ACL reconstruction rehab process there are two main goals. The first is to maximize quadriceps activity and the second is to restore full knee extension. For us, in addition to our exercises, there are also two absolute necessities immediately following surgery. We must be using nueromuscular electrical stimulation on the quad for the entire session, and we must use blood flow restriction.
While using these modalities, we perform a variety of exercises as seen in this video. We also will be completing your standard lower level activities such as straight leg raises, quad sets, heel slides and knee extensions. Manual therapy should consist of range of motion interventions, along with patella and scar mobilizations.
At the six week mark in ACL rehab we begin to transition from lower level activities to functional exercises. At this point your range of motion should be equal to the non-operated leg, the swelling should be minimal, and the quad strength should be continually improving. If you meet all these requirements it is appropriate to move to functional strengthening exercises such as squats, lunges, lateral lunges, step ups ect.
We should continue to use Blood Flow Restriction and Nueromuscular electrical stimulation throughout the session. Manual therapy should continue for scar and patella mobilization, and range of motion.
Blood Flow Restriction is a tool used in rehab to occlude blood flow into and out of the muscle. This occlusion causes pooling in the capillaries of muscles that will issue a hormonal response within the muscle to increase strength and hypertrophy. Using this allows us to increase strength in the quad without increasing external resistance. It is important for ACL rehab because the quad muscle becomes inhibited following surgery. The BFR allows us to build back the strength we need to perform activities and to progress in rehab. It is a vital part of the ACL rehab process.
Nueromuscular electrical stimulation is a device used to assist muscle activation. The unit should be applied and kept on the quad muscle for the entire session. Placing your Estim unit on the NMES setting at a high frequency and intensity (high enough to cause visible muscle contraction) can facilitate the necessary muscle strengthening. Early NMES helps to reduce muscle atrophy and has been proven to work on a cellular level to mitigate maladaptions.
UCL reconstruction surgery is also known as “Tommy John Surgery”. UCL injuries are most common in Baseball players and the surgery is a treatment option that, with the right rehabilitation, can get you back on the field and ready to compete. The surgical procedure replaces the injured ligament with a tendon from another area of your body.
Immediately post operative you will be wearing a sling and a brace. At your first Physical Therapy visit your DPT will perform a full body evaluation and specific injury assessment to create your plan. Exercises will include passive range of motion exercise and soft tissue treatment. What makes Petroski Physio different is that we also include exercises that will position you to have more success down the road. These exercises include breathing techniques, scapular positioning exercises and core patterning.
At six weeks post-op, we are ready to start moving towards advanced exercises. Progressing these exercises takes specific interventions that appropriately stress the medial elbow and also prepare you to return to throwing. Understanding how each thrower is different is the key to long term rehab success. At this point it is imperative to address the inter-relationships between the full chain of upper extremity. This includes the spine, the rib cage, the scapula, shoulder and elbow.
At the four to five month mark is when we are looking to begin a throwing program, depending on the time of year. At this point your physical therapist should be working with your pitching coach to collaborate on developing a plan that can lead you to have the most success. Every return to throwing program is different and has many variables including level of play, time of year, progress through rehab program, and confidence in returning, among other aspects.
Your Achilles is the strongest and thickest tendon in your body. With that said, it is one of the most commonly injured tendons. Direct trauma, unplanned dorsiflexion (foot forced upward), and forced plantar flexion (downward movement), are all common cause of Achilles injuries. If you have strained, torn, or ruptured your Achilles, it noticeably effects common movements such as walking, running, and jumping.