NM Sports Rehab

This U21 Divisie 2 Player came to see us post-ACLR + meniscus suture on his left knee (april 2021). Interestingly, hthe related trauma happened shortly after RTP from his previous ACLR + meniscus suture-rehab on his right knee (operation: june 2019), followed by a menisectomy on his right knee (june 2020).

Things we additionally adressed before and during handing him back to his club:

🏋️‍♀️fitness level🏃‍♂️❤️

💥chronic LBP and insufficient lumbo-pelvic motor control + mobility 🦴

🧠reactive and intuitive COD combined with lunge movements (his mechanism of injury)👀

The Video shows some of the clinical groundwork and progressions.

After 4 (!) repetitive hamstring strains within one year .vo_ put in all the effort to be back on the pitch playing. Within 8 weeks of super progressive rehab we focussed on aspects of strength, mobility, running machanics, core control, load management and - most importantly in this case - taking all the time necessary to justify robustness to go for 90 minutes of ballgame.

.6 after ACL-R and medial menisectomy showing:

✅ full active hyperextension 4 weeks post-op

✅ nearly free active flexion 7 weeks post-op

✅ minimal effusion, good single-leg squat control, 90%< LSI (Y-Balance) 8 weeks in

💪 On to a progressive 5 week strengthprogram 💪

ACL-R Athlete .6
shows:

✅ full active hyperextension 4 weeks post-op

✅ nearly free active flexion 7 weeks post-op

✅ minimal effusion, good single-leg squat control, 90%< LSI (Y-Balance) 8 weeks in

💪 On to a progressive 5 week strengthprogram 💪

ACL-R Athlete .6 shows:

✅ full active extension 4 weeks post-op
✅ Almost free flexion 7 weeks post-op
✅ mimimal effusion + good control during single leg squat +90%+ LSI (Y-Balance) 8 weeks in

💪 Ready for a progressive 5 week strength plan before preparing him for a return to jogging 💪

📑 I'd like to discuss a case of a footballer after ankle subluxation fracture (Weber B) and deltoid ligament complete rupture, who underwent plate fixation the day he was injured in training.

The video starts at 48 days post-op, one day after resection of the tibal-fibular screw.

Milestones:

✅ 38 days post-op: partial loading inside Vacuped boot

✅ 75 days post-op: normal gait pattern

✅ 111 days post-op LSI >80% (calf raise endurance & sl-legpress 5RM)

✅ 126 days post-op: return to running

✅ 203 days post-op: return to full team trainig

✅ 222 days (~7 months) post-op: return to play

⛔ Things that complicated the process were contraindications to early loading and mobilization and remaining postsurgical ankle stiffness, which stil influences the players running mechanics.

❓I struggle with the observation, that almost every operated ankle fracture seems to be ultimately unable to restore full range of motion. I am thankful for every case study, trial study review or practical experience to challenge my observations.

TECHNIQUE REFINEMENT WITH ADDED STIMULUS
from Surfing Physiotherapy
This is a short but rather brilliant clip of an exercise designed to refine the right lower body positioning on a surfboard while using the upper body to rotate like one would during turns.

The balance/wobble discs underneath the athlete's feet provide proprioception and core stability work, while the added stimulus of a swiss ball being bounced around by the athlete forces them to split their focus, simulating a wave-riding situation during a manoeuvre - such as eyeing the section of the wave you want to perform your next turn in.

It is important that the athlete maintains the desired lower-body positiioning during the exercise in order to help the brain 'imprint' the technique so that it can be assumed subconsciously during wave riding.

Video credit to Surf Camp from Senegal.
Featured Surfer: Sasou Ndoye, Senegal