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A question I get all the time.
Are you going to share the protocols you use with your patients?
The answer is:
Sometimes— Each plan is customized for each one of our patients through our Anti-Fragile Athlete Framework.
But, since many asked for a look at our programs, here is the shell we used for Sue’s knee rehabilitation
Sue was a patient at The Athlete Spot™. Reproduced with her permission.
Some information has been altered to maintain the privacy of our patients.
It’s important to note that not everyone heals at the same rate, and every tissue has its specific healing rate. Read Sue’s story here
The following is the shell and general principles for Sue’s knee rehabilitation following the Anti-Fragile Athlete Framework according to her level of fitness, muscle health, and compliance week to week.
Desensitization techniques are not included as the pain was minimal and it continued to improve the more she moved!
Day 1 - 7 post-op:
General range of motion. Focus on extension and flexion of the knee.
Cycling is encouraged for 10-15 minutes, 2-3 times a day as long as swelling is not present.
Day 8 - 14 post-op:
General range of motion. Focus on seated tibial rotation.
Begin loading (to comfort) the squat and hinge patterns at hom. Focus on flexion and extension of the knee.
Day 14 - 21 post-op:
Low Load squat and hinge patterns to mild discomfort as long as the pain does not increase past “mild discomfort.”
Moderate soreness is okay in the knee as long as it doesn’t last more than a day.
Tempo-based step-ups, and step-downs - minimize hip shift during these movements
Day 22 - 45 post-op:
Progressive Strength Training with Barbell, KB, and DBs. - Focusing on controlled movement and full range of motion of the knee during flexion and extension.
Weighted step-ups, and step-downs. - control decent and increase step height.
Cycling/Rowing to comfort.
Foam Roll Hamstrings, adductors and calves 5-10 minutes post-training
Day 30 - Introduce Plyometric training - landing focused.
Focus on Single leg exercises (single leg squat, hinge and weighted step-ups)
Day 45 - 90 post-op:
Continue Progressive Strength Training - Progressive overload barbell movements, including conditioning, and return to regular training.
Plyometric Introduction - jump and land-focused warmups.
Continue with Single leg exercises
Olympic lift re-introduction.
Foam Roll Hamstrings, adductors and calves 5-10 minutes post-training
During Sue’s 90-day evaluation, these were her rehab results:
Body weight squat: full range of motion with zero lateral body shift; no pain
Single leg squat (half rep): Full Range of motion with no side shift; no pain
Single leg squat (full rep): Full range of motion with minimal body shift; no pain
Barbell Squat: 185lbs full range of motion; no pain, body midline throughout the squat
Barbell Deadlift: 185lbs full range of motion; no pain,
Single leg KB deadlift: no hip shift, full range of motion; no pain - some hamstring tightness
At 90 days Sue was given the green light to return to training at 60-75% capacity and increase 5-10% each week as long as pain, tightness, or discomfort remained minimal following a training session.
Most of Sue’s rehabilitation was tracked online with in-person visits when Sue felt she needed some hands-on assistance to reduce tightness and discomfort.
Within a year of her initial visit, Sue returned to the competition floor, and has continued getting stronger, faster, and more confident in her knee.
We are aware there are physical changes inside her knee that may cause some pain and some discomfort in the future, but she is well-equipped with tools, strategies, and techniques to handle any pain or discomfort that may present itself.
That is all for this issue!
Thank you for taking the time to read this week’s The Athlete Spot™ Weekly.
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