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Brian Schiff’s Blog

Injury Prevention, Sports Rehab & Performance Training Expert

Archive for 'knee'

Improving proximal hip stability and reducing frontal plane collapse is critical for protecting the knee. Poor frontal plane control often contributes to anterior knee pain, IT band syndrome, shin splints, plantar fasciitis and other injuries. This exercise is an advance progression of the standing pallof press, and it is very effective for enhancing single leg strength as well as hip/core stability.

Click here to read my full column on this exercise in PFP Magazine.

Unfortunately, too many athletes who recover from ACL tears go on to suffer another injury within a short period of time. Click here to read a prior post on secondary injuries. There are differing opinions on when or if there is an exactly “right time” to clear an athlete for return to play.

We already know that athletes have persistent weakness and asymmetry at 1 year post-op and even beyond. I recently had one of my collegiate soccer players re-tear while helping out with a youth soccer camp. She had not yet done hop testing with me or been cleared for full soccer, but as she was 1 year out she did not think it would be an issue playing with 12 year-old girls. It only took 20 minutes before she suffered a non-contact re-injury and lateral meniscus tear.

Consider the following paper that reveals low rates of patients meeting return to sport (RTS) criteria at 9 months post-op:

https://www.ncbi.nlm.nih.gov/pubmed/29574548

Another paper recent published in the Journal of Sports Rehabilitation revealed marked deficits in balance and hop testing at 6 and 9 months post-op:

https://www.ncbi.nlm.nih.gov/pubmed/29466066

A recent paper in the American Journal of Sports Medicine (https://www.ncbi.nlm.nih.gov/pubmed/29659299) lists positive predictors of a return to knee-strenuous sport 1 year after ACL reconstruction were male sex, younger age, a high preinjury level of physical activity, and the absence of concomitant injuries to the medial collateral ligament and meniscus.

In 2016, research in the American Journal of Sports Medicine revealed delaying return to sport at least 9 months markedly reduced re-injury risk in those who passed RTS testing. Click below for more on that study:

https://www.ncbi.nlm.nih.gov/pubmed/27162233

So, where are we now? I employ multiple functional tests including the Y-Balance Test, FMS, single leg squatting, hand held dynamometry, hop testing, qualitative movement assessment and jump landing assessments. But, is that enough?


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Today through the end of Memorial Day I am offering 50% off my entire product line of e-books and DVDs on my website. So if you or your friends and colleagues are looking for information on rotator cuff pain, frozen shoulder treatment, ACL prevention, or programs to eliminate knee pain in runners or those with osteoarthritis, now is the time to grab one of my guides.

Visit http://www.brianschiff.com/Products.asp to see my catalog of products and simply enter the code BFIT50 in the coupon box at checkout. The sale will end Monday at midnight.

Have you ever experienced a significant injury? If so, do you remember wondering if you would ever be whole again? Pain, fear and the inability to do your sport or physical activity can cripple the human spirit.

Over my 21 years as a physical therapist and fitness professional, I have witnessed how powerful the mind is and how critical it is to have the right mindset to overcome physical obstacles. Some people are mentally stronger than others – period. With that said, adversity and pain has a way of testing the spirit and will of an individual.

In any given week, I see at least 5-10 patients rehabbing an ACL injury. The injury, surgery and rehab is physically and mentally grueling. The injury itself takes the athlete away from his/her passion or sport immediately, while presenting them with a long path back to full health. Many suffer an identity crisis as they become isolated and away from their peers. Physical therapy that fully restores function is a must in this group of patients. For more on what complete ACL rehab looks like, click here to read one of my previous posts.

Fear of reinjury and persistent knee symptoms are common reasons for a lack of return to play after ACL reconstruction. Click here to read an abstract regarding kinesiophobia in this group of patients.

With any injury, it is only natural to worry about the outcome. Clients often wonder quietly whether they will be able to return to their previous level of play. In this post, I want to talk about the elephant in the room for patients coming back from an injury, and that is a legitimate fear of reinjury.

fear1


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Poor landing mechanics are often cited as a predictor of ACL injury risk. In my 20 years as a physical therapist, I have rehabbed many athletes with this injury. I believe that injury prevention, whether to prevent a primary or secondary injury, hinges on the ability to train the body to decelerate and land appropriately. Some athletes simply move better than others. Nonetheless, teaching a soft bent knee landing while minimizing dynamic valgus is essential.

The following video from my online PFP column reveals a foundational exercise that can be used in prevention and rehab alike.

Click here if you want to read about another landing exercise that I utilize in my training and rehab programs.