I am down here in sunny Las Angeles after finishing another great day of continuing education with Chris Powers professor at USC and biomechanics specialist. I have been flying down to LA once per month for full weekend of training in advanced biomechanics of the lower extremity. Our previous three courses have covered topics which include biomechanics principles in practice, walking gait assessment, and running analysis. Each weekend has been awesome and packed with information on using biomechanics and technology to help patients decrease pain and improve performance.
This weekend’s course was on ACL rehabilitation and return to sport testing following ACL reconstruction. This course hit home since in high school I tore my ACL while playing football. I have always had a close relationship with ACL rehab given my history and passion for sport. The material covered today was jam packed with all the current research surrounding ACL injuries, prevention, and best practices to test for sport readiness.
I understand the idea of return to sports testing might be foreign to my readers so let me explain. After sustaining an injury there is a period of recovery and rehabilitation to restore movement to the level it was pre-injury. This includes things like restoring range of motion, quadriceps and hip strength, decreasing swelling/pain, and restoring a proper walking gait. By fixing these impairments function would be restored to a pre-injury status.
Sport movements however are a great deal more challenging physically than day to day activities. So although an athlete may be pain free and strong they might not have the power, agility, speed, and neuromuscular control for a safe return to sport.
It is therefore essential to perform a biomechanical movement evaluation that is geared toward specific high speed sports motions. These motions include running, jumping, landing, cutting, side-stepping, and squatting. Not only does the athlete have to be able to complete these motions but it is imperative that they perform the motion with correct biomechanics. Significant and substantial research has been published on proper lower extremity movement to decrease injury risk.
ACL Biomechanics and Injury Risk
Some of the movement errors include:
· Knee forward of the toes with squatting
· Knees caving in towards one another (valgus)
· Squatting and landing from a jump with an upright torso
· Side bending through the torso when changing directions and cutting
· Decreased hip and knee bending to absorb shock with jumping.
These are just some of the many movement errors that research has shown to be problematic for the knee and lower extremity.
Do to the high speed nature of these motions and the complexity of movement it is also necessary to record these motions with high speed video. Through slow motion video and angle tracking a physical therapist can assess whether the movement is being done with proper mechanics for sport safety. If you are having return to sport testing done by your therapist and they are just using the naked eye, it is not enough. Although physical therapists received extensive education on biomechanics it is just not physically possible for the human eye to capture motion in multiple planes and at high speed.
A rigorous return to sport test performed anywhere from 6 months to 1 year after ACL surgery can ensure you return to sport with proper biomechanics and substantially decreased injury risk.
If you are looking for a comprehensive return to sport test that uses the best motion analysis equipment then you need to check out Competitive EDGE Physical Therapy in San Jose.
Enjoy the rest of the weekend and I look forward to another jam packed day of ACL testing tomorrow here in LA. I will be posting more material in the coming weeks on lower extremity injuries related to biomechanics and research.