Michael Reeves PT, DPT, ATC, CSCS

How I Rehabbed My Quad Contusion in 1 Week Recently I sustained an impact injury to my right thigh. I thought it might be worthwhile to write down what the injury recovery process looked like for me so it might help others who either treat this injury, or deal with this injury themselves, in the future. I was at a beach Ultimate Frisbee tournament and earlier on in the tournament I either caught a knee, or landed on my right quad (vastus lateralis) at some point earlier in the day because I started to feel a little bit of pain when walking after about our 2nd or 3rd game of the day. This did not bother me and it was not going to affect my ability to play at all.  In the 4th game of the day, I dove to try and catch a disc thrown by my teammate (:16 in video below) and landed directly on the spot that was previously bothering me. This time however, there was a very high level of pain and I immediately called for an injury.  I took about 15 seconds to get my legs back under me an...

Effect of Aerobic Exercise Training With and Without Blood Flow Restriction on Aerobic Capacity in Healthy Young Adults: A Systematic Review With Meta-Analysis. In this systematic review and meta-analysis, the authors' goal was to:  "examine the effects of aerobic exercise training (ET) with and without blood flow restriction (BFR) on aerobic capacity (AC) and to compare the effect of low-to-moderate aerobic ET with and without BFR to high-intensity aerobic ET with and without BFR on AC." Inclusion Criteria: Study was conducted in healthy individuals There was random allocation of study participants to training and control groups BFR was the sole intervention difference between the groups. Total number of studies: 7 5 low-to-moderate intensity 2 high-intensity All 7 studies had a PEDro score of 6 which is pretty good for these types of studies since it is not really reasonable to expect: concealed allocation, blind Subjects, blind therapists, or blind assessors consider...

ACL Rehab for the Athlete: What Should it Look Like? If you have suffered and ACL injury, you likely know that you have a long road ahead of you before you even think about playing sports again.  After an ACL reconstruction, you will need to undergo at least 9 months of rehab before returning to sport.  During these months you will go through many different stages of rehab each with a different primary focus.   According to an  ACL Rehab Guide  published in 2013, there are 5 phases of rehab: Recovery from Surgery Strength and Neuromuscular Control Running, Agility, and Landings Return to Sport Prevention Re-injury You will notice that there is no time frame on the phases. This is to limit progression for the sake of progression at different time points.  Time post surgery progression has the potential to shift focus off of the goals of our rehab as outlined in the various stages and onto time since surgery.  Time since surgery is ...

Where Traditional Physical Therapy Fails the Athlete When an athlete gets hurt, their first thought is rarely “how long until I can walk again?” - it is normally, “how long until I can play again?” If an athlete needs rehab, they are trusting their physical therapist to get them back to playing their sport. Physical therapists are supposed to be the best at this, right? Well unfortunately you need to make sure that you go to the right physical therapist at the right location if you want your needs as an athlete to be met. Just because a physical therapy clinic says “sports medicine” on their doors, does not mean that you are getting quality sports medicine care. Many of the larger physical therapy companies have huge amounts of overhead, and with insurance reimbursement declining for physical therapy, their clinicians are forced to treat more patients in order to keep the company afloat. This means less time with each patient. Also, these companies are big businesses that cr...

Running Injuries Running is one of the most common forms of exercise. It is a convenient and efficient workout that can be an escape from the noise and stress of the outside world; it can be a great way to get your day started off on a good foot, or to decrease stress after a long day of work.  Many runners use running as their primary, and sometimes only source of physical activity.  Running places a lot of stress on our body and just like with any sport there are inherent injury risks.  When compared to other types of aerobic exercise such as biking, swimming, or walking, running has a higher risk of injury.  This is tied to the amount of impact that our body undergoes during running and the need to dissipate those forces between muscles and joints.  In this blog we will discuss some common running injuries, some potential causes, and some potential management strategies. Common running injuries According to Francis et al.  the knee is the most c...

Effectiveness of Active Rehabilitation Program on Sports Hernia: Randomized Control Trial Objective:  "To determine whether an active rehabilitation program that involves repetitive effortful muscle contractions, including core stability, balancing exercises, progressive resistance exercises, and running activities, after a sports hernia, is effective." Population:  40 male soccer players age 18-25 with groin pain with sport for at least 2 months. Methods:  Study Design: Single Blind RCT Group A: Active Rehabilitation Program (also received Group B intervention) Group B: Conventional Treatment Program Randomization via envelope method.  Staff therapist drew an envelope and handed to treating therapist. Both groups instructed to perform stretching exercises for adductor, hamstring, and hip-flexor musculature on days between treatment days. Did not specify if there were different treating therapists. Did not specify any training to provide c...

Open Kinetic Chain Exercise After Articular Cartilage Repair in the Knee: Is it Safe? After articular cartilage repair in the knee, specifically with the tibiofemoral joint, there is a period of protected weight bearing.  Early post-operatively we know that regaining range of motion, regaining quadriceps activation, and decreasing excess inflammation and swelling is important.  Commonly weight bearing is progressed to full by about 8 weeks, sometimes a little longer or shorter depending on the surgeon, the surgery, and lesion factors.   Deficits in quadriceps strength are seen far beyond discharge from rehabilitation and have been seen up to 7 years post op.  Knowing this, it is easy to want to get after quadriceps strengthening early.  There has been a lot of talk in the physical therapy community about "underdosing" our patients when we claim that we are "strengthening" them.  We are aware that we should be cautious with weight bearing exerc...

Post-Operative Sport Participation and Satisfaction with Return to Activity After Matrix-Induced Autologous Chondrocyte Implantation in the Knee Purpose:  To investigate:  The level and improvement in activity in patients at two years after matrix-induced autologous chondrocyte implantation (MACI),  What factors are associated with post-operative (and improvement in) activity level, and  Whether patients are satisfied with their ability to participate in recreational and/or sporting activities." Methods: Study Design:  Prospective Cohort (level of evidence: 3) Population:  150 patients that underwent MACI (Started with 160 but 10 were unable to be found for 2 year follow up so were excluded) 83 tibiofemoral lesions 63 medial femoral condyle 20 lateral femoral condyle 67 patellofemoral lesions 35 patella 32 trochlea 92 patients had undergone prior surgery, most commonly arthroscopy and meniscectomy (88 arthroscopy,...