Justin Lang

@LenMacPT In Aus, our ACLR patients work with exercise physiologists who specialise in exercise prescription/loading in the mid to end stages of rehab. In Aus EP is the specialisation between acute stage physio (PT) and S&C.

@LenMacPT Lenny in AUS, we work closely with a very good surgeon who has done a lot of QT grafts. We don’t see this issue. They all get there and that is with isokinetic testing & force plate testing. Do you think it is an exercise prescription issue? 7 months post example below

Former College soccer player 2+ years out of ACL-QT graft and trying to play pro soccer BUT she can’t get the strength back in her quads.

@spikesonly Is this a 5s isometric assessment?

If you are really smart about isokinetic testing, you realize that isokinetic training is overrated. We live on planet Earth, not Cybertron. Please look at testing isolated joints as a part of the assessment process, but not a true target. Let's move on from the 1940s.

Some NRWL girls getting ready in their offseason

@hjluks Very good Sir

@LenMacPT Hey @LenMacPT In most instances I find that this is an ‘under dosing’ exercise prescription issue. - increase load in leg extensions between 90-40 - keep shin forward in RFESS 7.5 weeks changes. Similar case to yours. Are you supervising the gym sessions?

CASE STUDY ACL-QT 9 months out. About to be a college freshman athlete, highly motivated, weight room junkie BUT: 55% LSI on isometric strength testing at 90 deg and pain at QT, so sent him for an Isokinetic test Still showed ~55% LSI but less pain. We’ve done BFR, ice, vibration, hip extended knee extensions, NMES with extensions, squats, RFESS, and much more. What do you do now?

@RicupitoRoberto @ForelliFlorian This is so clinically relevant. Thanks for sharing

If you are interested in jump post ACL! Check this out! mdpi-res.com/d_attachment/j… @ForelliFlorian

@LenMacPT SLJ, 30cm SLDJ and Countermovement jump. The main issue we find with 30cm SLDJ is the variability in the drop. Some step down, some jump off, some roll off (which we cue). Consider tracking eccentric deceleration impulse asymmetry of CMJ 👌

Single leg drop jumps. I’ve been doing 12 inches for double and single leg. What do you guys do for your ACL testing?

@LenMacPT Hey Lenny, These are tough. It can be improved ⬇️ Ultimately not suited to high speed change of direction field sports in IMO. The client above had massive improvement in all areas of lower limb function but unfortunately re-ruptureD upon returning to sport. Seen a few like this.

What do we think about this uninvolved squat position? Is one ‘Better’ than the other? First one has his foot straight forward and in a traditional position Second video is his ‘comfortable’ position and more stable. How do you coach this?

I’ve been coaching in women’s league for 10+ yrs now. Every year they are getting better younger. This is year 7 & 8 at Endeavour sports. Lots have fathers, uncles and brothers that have played or are playing NRL. This crop being mentored by Corban McGregor and Tiana Penitani

@drjohnhaiti @JackAChew @Claire_Minshull @TPMPodcast @physiojack @AdamMeakins @JLTHphysio @R_Sphysio @rob_chiro @clairepatella @bellkneesurgeon @lizbayleyphysio @JApproach Another one…

@JackAChew @Claire_Minshull @TPMPodcast @physiojack @AdamMeakins @JLTHphysio @R_Sphysio @rob_chiro @clairepatella @bellkneesurgeon @lizbayleyphysio @JApproach What are common results in patients with neck pain?

Right who is joining me in this? 💪 I can’t think of a time I’ve been this excited to attend a course! I’ve been on the waiting list for this bad boy for a while because I’ll admit that I use dynamometry rather sub-optimally… 😬 @Claire_Minshull is going to be my hero once again! 🙌 🦸 Enroll here for a bargain! getbacktosport.com/how-to-use-dyn…

@drjohnhaiti @JackAChew @Claire_Minshull @TPMPodcast @physiojack @AdamMeakins @JLTHphysio @R_Sphysio @rob_chiro @clairepatella @bellkneesurgeon @lizbayleyphysio @JApproach @Claire_Minshull ‘s course will be amazing. It’s the future. We have been working with some surgeons in Australia diagnosing deficits in shoulder vs elbow flexion/extension capacity in patients with neck & shoulder pain.

@omarsedefence Great work mate. Conditioning that high hamstring insertion.

Functional Rugby mobility is a massive advantage to players. How much do you do? Check out omardefence.com for more drills and tutorials . #rugby#rugbytackle

@drnickUSA @Hewett1Tim This is great! We love a backwards hop in ACL rehab. It somewhat silences the posterior. Very difficult to hinge at the hip and jump backwards which is precisely what happens in forward hops in the presence of quads deficit/ knee pain

Recovery after knee ACL injury & surgery is a complex process. Not only must the "new" implanted ACL fully heal, mature and gain adequate strength (can take up to 2 years to reach maximal strength!), but the remainder of the body (not just knee, but also hips, gluteal, core and much more) must re-gain full functional strength and endurance. And the neural system must get "re-wired" and optimized (like an internal GPS system that is responsible for agility & proprioception). Also there is a psychological recovery that is often under appreciated. So it's never easy to fully and accurately determine when someone has recovered fully, or even adequately to "return to play." Here's one new measurement that may help determining physical recovery level after ACL surgery: ABILITY TO HOP BACKWARDS (as opposed to the usual forward hopping evaluation)... sciencedaily.com/releases/2024/… @Hewett1Tim @aossm1972 @AOSSM_STOP #ACL @ACLrecoveryCLUB @ACLclub @GALs_and_ACLs

Glen ‘Mad dog’ Marzhew #knightscowboys

@angiejphysio Can’t wait to read this. We see so many 14-19 year old talented male athletes with extension related back pain.

Delighted to be asked to write an article about my favourite topic of Youth Athlete Low Back Pain Should youth athletes with extension related low back pain play with pain? Read more to find out

@LenMacPT Lenny could you direct me to thread I may have missed re your concerns with QT?

Dear ACL docs We don't think the QT is the future of ACL reconstruction. It's a viable option but it is NOT the future. If it is, then we need to reconsider our RTP protocols and better understand how to rehab it because we PT's (many of us!) dislike it as a graft option. Sincerely Sports PT of 20+ years PTG guy!

@DrJN_SportsMed Femur stress fracture

Consent ✅ Late 40s female Referred as L ‘tight hip flexor’ Increased running volume to 120K /week for Ultramarathon See videos Diagnosis?

@RICH_AgilityLab This is all very on point mate. Another thing we see when athletes are training say a 45deg cut is no penultimate decel, a heavy plant on the COD step (giving them ~30deg) and then sweeping their way around with a curve to make up the final 15deg.

@RICH_AgilityLab @StuartMcMillan1 This is excellent 👍