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The Importance of Criteria-Based ACL Rehabilitation: A Structured Approach

The Importance of Criteria-Based ACL Rehabilitation: A Structured Approach

Nov 18, 2024

Recovering from an ACL injury can be daunting, but with the right plan, our patients can rebuild strength, regain confidence, and return to the activities they love. A structured, criteria-based approach is essential not just for recovery but for reducing re-injury risk and achieving long-term success.

Here’s the criteria based approach we use to guide our patients:

Acute Phase The focus is on reducing pain (≤3/10 on VAS), managing swelling, and restoring full knee extension. Early progress in these areas is crucial for setting the foundation for later phases. Key methods: neuromuscular stimulation, passive/active extension exercises, and gait re-education drills.

Early Rehabilitation This phase targets movement and endurance. Goals include achieving 120° of knee flexion and improving muscular control with exercises like leg presses and single-leg squats. Building strength here supports long-term stability.

Strength & Control We move into heavier strength training, focusing on 2–4 sets of 8–10 reps at 60–80% of one-rep max. Controlled jumping and landing drills (e.g., sub-maximal bilateral landings) are introduced to prepare for higher-intensity demands.

Advanced Plyometrics Single-leg plyometric training and advanced strength work dominate this phase. We aim for functional goals like an 80% limb symmetry index or 1.5× body weight on leg presses. This phase is about translating strength into power and functional movement.

Return to Sport Here, sports-specific training and multidirectional movements take priority. A safe return to play requires not only physical readiness but psychological confidence, assessed through validated tools and a multidisciplinary team (MDT) approach.

Why This Approach Works:

Recent research highlights the effectiveness of criteria-based protocols:

  • Tailored Programs: Improve outcomes and reduce re-injury rates, ensuring progress at each phase of recovery (Griffin et al., 2020; Hewett et al., 2019).
  • Strength and Neuromuscular Control: Critical for knee stability, reducing risks of compensatory injuries and re-injury (Krebs et al., 2021).
  • Psychological Readiness: Athletes report higher confidence and readiness to return to sport when mental readiness is prioritised (Fitzgerald et al., 2020).

Conclusion:

Recovering from an ACL injury isn’t just about regaining movement it’s about returning stronger and more prepared for the challenges ahead. A criteria-based approach ensures that every phase of rehabilitation has clear goals tailored to each athlete’s unique needs.

References:

  • Fitzgerald, G.K., Paterno, M.V., and Myer, G.D. (2020). Psychological readiness to return to sport after ACL reconstruction: A systematic review. Journal of Orthopaedic & Sports Physical Therapy, 50(10), pp. 558–566.
  • Griffin, L.Y., Albohm, M.J., and Arendt, E.A. (2020). Understanding and preventing noncontact anterior cruciate ligament injuries: A review of the literature. Sports Health, 12(3), pp. 240–246.
  • Hewett, T.E., Myer, G.D., and Ford, K.R. (2019). Preventing knee injuries in athletes: An evidence-based approach to training. Clinical Sports Medicine, 38(1), pp. 1–24.
  • Järvinen, T.A.H., Järvinen, T.L.N., and Kalimo, H. (2021). Rehabilitation of the anterior cruciate ligament: A review. Sports Medicine, 51(3), pp. 447–461.
  • Krebs, A., Naal, F.D., and Maffulli, N. (2021). The role of structured rehabilitation in the management of anterior cruciate ligament injury: A systematic review. British Journal of Sports Medicine, 55(12), pp. 684–690

Biopsychosocial Considerations of Sports Injury and Rehabilitation: A Holistic Approach to Athlete Recovery

Biopsychosocial Considerations of Sports Injury and Rehabilitation: A Holistic Approach to Athlete Recovery

Oct 14, 2024

Opus, founded by David Porter, a new perspective on sports injury rehabilitation is taking shape. Together with Professor of psychology Dave Collins and lead physiotherapist Ian Gilham, the team promotes the biopsychosocial (BPS) model—a comprehensive approach that goes beyond treating the physical injury to address the mental and social factors that impact an athlete’s recovery.

This method aims to support athletes fully, enabling them to return to peak performance with resilience.

 

Key Points:

  • Interdisciplinary Teamwork: The BPS model draws on a team of specialists, including doctors, physiotherapists, psychologists, nutritionists, and coaches. This interdisciplinary approach ensures that all aspects of an athlete’s recovery are covered, promoting a more rounded and complete rehabilitation.

  • The Biopsychosocial Model: Traditionally, rehabilitation focuses on the physical aspects of injury. However, the BPS model acknowledges that injuries affect athletes in other ways too, such as their mental health (e.g., anxiety or loss of identity) and social status (e.g., their role within the team). The model addresses these factors together for a holistic recovery.

  • Patient-Centred Care: One of the core principles of the BPS model is putting the athlete at the centre of their care. This patient-centred approach ensures that athletes are actively involved in their recovery process, which can increase motivation and help tailor the rehabilitation to their specific needs.

  • Real-Life Examples: The article shares practical case studies where the BPS model has been effectively applied. In one case, a competitive equestrian rider with a severe pelvic injury received coordinated care involving medical, psychological, and social support, which helped her overcome fears about returning to competition.

  • Rehabilitation Stages: Recovery under the BPS model follows a clear, structured path, with each phase of rehabilitation managed by the interdisciplinary team. Early stages focus on reassurance and stabilisation, while later stages incorporate goal-setting to keep the athlete motivated and engaged.

  • Social Support: The social aspect of recovery is vital for maintaining mental wellbeing. The BPS model encourages athletes to remain connected with their teams during rehabilitation, helping them feel included and supported throughout the process.

  • Goal Setting and Progress Measurement: Setting clear, achievable goals is central to the BPS model. Breaking the rehabilitation process into manageable steps allows athletes to see progress and stay motivated. Tools like the “Challenge Ladder” help measure this progress, giving athletes a clear path forward.

  • Addressing Psychological Barriers: Injuries often bring psychological challenges, such as fear of reinjury. The BPS model incorporates psychological support to address these fears early on, helping athletes regain their confidence and return to competition without hesitation.

  • Clear Roles for Specialists: With many professionals involved, clear communication is essential. The BPS model establishes well-defined roles for each specialist, doctors, physiotherapists, and coaches, ensuring consistency in care and avoiding confusion for the athlete.

  • A Look to the Future: The authors advocate for broader adoption of the BPS model across sports rehabilitation settings, noting that its holistic approach leads to more effective and complete recovery. This model is particularly beneficial in helping athletes not only return to play but come back stronger, both physically and mentally.

In this article, David Porter, Dave Collins, and Ian Gilham highlight the benefits of the biopsychosocial approach to sports injury rehabilitation.

Focusing on the athlete’s physical, mental, and social well-being, the BPS model provides a more complete path to recovery. Through interdisciplinary collaboration and patient-centred care, this approach ensures that athletes return to their sport stronger and more resilient.

This innovative approach is setting a new standard in sports medicine, helping athletes achieve the best outcomes in their recovery journey. To learn more about how the BPS model can enhance sports injury rehabilitation, read the full article here

 

 

Injuries in paddle

Injuries in paddle

Oct 10, 2024

Paddle tennis has increased in popularity over the last few years and due to the fast-nature of the sport, it is unsurprising that musculoskeletal injuries are very common. Paddle takes place on a small field and surrounded by glass which increases the speed of the game. Paddle requires ‘motor anticipation, explosive force, reactive speed (acceleration and deceleration), resistance, flexibility and agility’(Virgolino, 2022). These components of fitness are key for health, wellness and longevity however there is an increased risk of injury if one does not apply appropriate preventative techniques (Virgolino, 2022).

 

Sportsman playing padel game

The most common MSK injuries in senior players include knee sprains, lateral epicondylitis, shoulder pain (20.6%) and lower back pain (27.5%) (Castillo-Lozano, 2017). However, lower back pain is the most prevalent among junior players (Virgolino, 2022). These findings enable practitioners to create preventive strategies and programmes which focus on scapular stability, trunk stability and lower limb strength (Castillo-Lozano, 2017).  Despite the risk of injury, paddle provides many benefits, especially to elderly players. There is a variety of research demonstrating the physical advantages (muscular strength, endurance and reaction time) of paddle, however literature has shown paddle to also provide psychological benefits such as reducing anxiety and stress (Eirale, 2023).

Elbow tendinopathy mostly impacts novice players. This is most likely due to players hitting backhand strokes in wrist flexion, the sudden increase of eccentric loading of forearm extensors and the vibrations impacting the elbow when the ball reaches the racket. Lateral epicondylitis is extremely common due to the repetitive movements and duration of the game (2-4hours). However there have been recent improvements in racket technology which reduce the risk of epicondylitis.  It is also unsurprising that patella tendinopathy often occurs due to repetitive jumping and sudden change in direction. Interestingly, males are 2-4 times more likely to develop patella tendinopathy, whereas females are more likely to experience chondromalacia patellae (Eirale, 2023).

Disc-related lower back pain and facet joint syndrome are predominantly the main cause of lower back pain (LBP) in paddle. Sward et. al found 50% of their participants suffered with LBP and 1/5 experienced severe symptoms. This is likely due to paddle incorporating all ranges of motion in the lumbar spine combined with explosive movements; therefore, it is important to consider trunk stability and lumbar mobility to prevent injury (Eirale, 2023).

Lastly, repetitive movements such as ‘smash’ and ‘bandejas’ cause muscle imbalances in the shoulder, increasing the risk of rotator cuff injuries and scapular instability. Also due to repeated overhead movements, there is a possibility of impingement in the glenoid humeral joint leading to a SLAP lesion. Consequently, rotator cuff strengthening and scapular stability are key to prevent shoulder injuries (Eirale, 2023).

Reference list

Castillo-Lozano, R. (2017). Epidemiology and prevention strategies for the musculoskeletal injuries in the paddle-tennis senior players. Science & Sports, 32(3), pp.e101–e106. doi:https://doi.org/10.1016/j.scispo.2016.09.009.

Eirale, C. (2023). Aspetar Sports Medicine Journal – INJURIES IN PADEL. [online] Aspetar.com. Available at: https://journal.aspetar.com/en/archive/volume-12-targeted-topic-sports-medicine-in-padel/injuries-in-padel [Accessed 22 Aug. 2024].

Virgolino, M. (2022). Running in Paddle. Springer eBooks, pp.179–183. doi:https://doi.org/10.1007/978-3-662-65064-6_19.

 

 

 

 

 

 

 

 

Stay Active, Stay Healthy: The Importance of Physiotherapy for Active Individuals

Stay Active, Stay Healthy: The Importance of Physiotherapy for Active Individuals

Oct 3, 2024

Photo by Annie Spratt on Unsplash

Maintaining an active lifestyle is crucial for overall health and well-being in today’s fast-paced world. Whether you’re a seasoned athlete or simply someone who enjoys staying active through sports and exercise, taking care of your body is paramount. However, as you age, changing your approach to fitness is essential to stay active. Proactive preventive approaches such as physiotherapy can prevent injuries, enhance performance, and enable you to continue enjoying the activities you love for years to come.

Who is a physiotherapist? How can a physiotherapist help me?

Physiotherapists, also known as physical therapists, are highly trained healthcare professionals who specialize in assessing, diagnosing, and treating a wide range of musculoskeletal and movement-related conditions. Their primary focus is on optimizing movement, promoting physical well-being, preventing injuries, and rehabilitating individuals who have experienced physical impairments. Here’s an overview of what physiotherapists do and how they can help you stay active:
  • Assessment: Physiotherapists begin by comprehensively assessing the patient’s condition. This involves evaluating their physical function, range of motion, strength, posture, and pain or discomfort. The goal is to identify the underlying issues that may be causing the patient’s problems.
  • Diagnosis: Based on the assessment, physiotherapists diagnose the underlying causes of the patient’s symptoms. They determine the root of the issue, whether it’s a specific injury, a musculoskeletal problem, a neurological condition, or a combination of factors.
  • Treatment Planning: Physiotherapists create personalized treatment plans tailored to the patient’s needs, goals, and condition. These plans often include a combination of various therapeutic techniques and exercises designed to address the identified issues.
  • Exercise Prescription: Physiotherapists prescribe specific exercises and therapeutic activities that target the patient’s condition. These exercises strengthen weak muscles, improve flexibility, enhance balance, and address movement abnormalities.
  • Patient Education: Educating the patient about their condition, proper body mechanics, injury prevention, and self-management techniques is a significant part of a physiotherapist’s role. Patients are empowered to participate in their recovery and long-term health actively.
  • Rehabilitation: Physiotherapists play a crucial role in the rehabilitation process after surgeries, accidents, or injuries. They help patients regain strength, flexibility, and function, guiding them through a structured recovery program.
  • Monitoring Progress: Throughout the treatment process, physiotherapists continually assess the patient’s progress and adjust the treatment plan as needed to ensure optimal results.

Top 5 reasons why physiotherapy is essential for active individuals

Active lifestyles put increased stress on our bodies, making them more susceptible to overuse injuries, muscle imbalances, and joint problems. Physiotherapists at Opus Biological specialize in identifying and addressing these issues before they escalate, thus reducing the risk of injuries. They design personalized exercise plans to strengthen weak areas, improve flexibility, and optimize biomechanics, improving performance and efficiency in sports and activities. Moreover, as individuals age, physiotherapy ensures that they can adapt their exercise routines to maintain mobility, balance, and function, allowing them to enjoy an active lifestyle for life. Here are the top 5 reasons to choose physiotherapy to maintain an active lifestyle:

  • Injury Prevention: Active individuals often engage in high-impact activities that put a strain on muscles, joints, and ligaments. Physiotherapy helps identify areas of weakness, imbalance, or poor biomechanics. Through targeted exercises and corrective techniques, physiotherapists can prevent injuries by strengthening these vulnerable areas, reducing the risk of overuse injuries, strains, and sprains.
  • Improved Performance: Physiotherapy isn’t just about preventing injuries; it’s also about optimizing performance. Physiotherapists can analyse an individual’s movement patterns, identify inefficiencies, and provide tailored exercises to improve form, strength, and flexibility. This optimization leads to better athletic performance and increased endurance.
  • Faster Recovery: If an active individual does experience an injury, physiotherapy is essential for a swift and effective recovery. Physiotherapists employ manual therapy, targeted exercises, and modalities like ultrasound or electrical stimulation to speed up the healing process, restoring function and reducing the risk of complications.
  • Personalized Guidance: Physiotherapy at Opus Biological offers individualized care that aligns with your needs, goals, and physical condition. This personalized approach ensures that active individuals receive tailored advice, exercises, and strategies that address their unique challenges, helping them achieve their fitness objectives while minimizing the risk of setbacks.
  • Staying Active for Life: Physiotherapy helps adapt exercise routines to address age-related changes, such as reduced joint flexibility or muscle strength. This ensures active individuals can continue enjoying their preferred activities as they age, promoting overall health and well-being.

Managing Injuries Better with Physiotherapy

Photo by Sincerely Media on Unsplash

Preventing injuries is always better than treating them, and that’s where physiotherapy shines. A physiotherapist is a healthcare professional trained to assess and address musculoskeletal issues, identify potential problems, and design personalized prevention plans. By identifying weak areas, poor movement patterns, or imbalances, a physiotherapist can create exercises and strategies to address these issues, reducing the risk of injury.

For active individuals, this proactive approach is a game-changer. It allows you to identify and correct small issues before they become significant problems. It’s like giving your body a regular check-up, ensuring every joint, muscle, and ligament functions optimally. By investing time in physiotherapy, you’re investing in your body’s longevity.

Individualized Care Matters

Photo by Sincerely Media on Unsplash

One of the significant advantages of physiotherapy at Opus Biological is its personalized approach. Every person is unique, and their needs, goals, and physical conditions are distinct. Our physiotherapists work closely with you to understand your specific conditions and design a customized plan that addresses your concerns.
Whether recovering from a sports injury, looking to improve your athletic performance, or seeking guidance on maintaining an active lifestyle as you age, our physiotherapists can provide the tailored care you require. The individualized attention you receive ensures that you’re on the right path, with exercises and strategies that align with your goals, ultimately helping you achieve desired results.

Final Thoughts

Staying active is a beautiful way to maintain your health and enjoy life to the fullest. However, taking a proactive approach is essential to ensure that you can continue being active without unnecessary setbacks. Physiotherapy offers a comprehensive solution, focusing on prevention, performance enhancement, and longevity in your active lifestyle.
By investing in regular physiotherapy sessions at Opus Biological, you’re investing in your body’s well-being. You’re taking steps to prevent injuries, optimize your performance, and adapt your approach to physical activity as you age. With the guidance of a skilled physiotherapist, you can ensure that you’re staying active and healthy for years to come, enabling you to enjoy the activities you love and lead a fulfilling, active life. So, make physiotherapy an integral part of your active lifestyle – your body will thank you for it.
Nutrition and Performance: How our Sports Medicine Doctors optimize Diets for Athletes

Nutrition and Performance: How our Sports Medicine Doctors optimize Diets for Athletes

Aug 4, 2024

Photo by Nicolas Hoizey on Unsplash

The world of sports is not just about raw talent and rigorous training; it also hinges on the foundation of optimal nutrition. The dietary choices of athletes play a critical role in determining their performance, recovery, and overall well-being. While athletes often follow disciplined training routines, it is the guidance of Sports Medicine doctors who fine-tune diets, which helps athletes unlock their full potential.

The Role of Nutrition in Athletic Performance

Nutrition forms the cornerstone of athletic performance. An athlete’s diet fuels their body, affecting their energy levels, strength, and endurance. Carbohydrates are essential for providing quick energy, making them vital for athletes engaged in high-intensity sports. On the other hand, proteins aid in muscle repair and growth, while fats act as long-lasting energy provisions during endurance activities.

Moreover, vitamins and minerals are indispensable for various physiological processes, such as metabolism, oxygen transport, and nerve function. Athletes can maximize their performance potential by optimizing their nutrient intake to achieve peak results in their respective sports.

Inadequate nutrition and athletic injuries

High-intensity sports training for athletes demands high functional joint mobility, and a solid musculoskeletal system, making it essential to ensure physical fitness levels and optimal nutrition. Athletes often overexert their bodies and ignore optimal nutrient intake, which can result in athletic injuries that include:

  • Sprains and Strains are injuries to ligaments (sprains) or muscles/tendons (strains) due to overstretching or tearing.
  • Muscle Cramps are painful contractions of muscles caused by dehydration, overuse, or electrolyte imbalances.
  • Tendinitis is an inflammation of a tendon, often caused by repetitive movements or overuse.
  • Stress Fractures are small cracks in bones due to repetitive impact or over training.
  • Concussions are head injuries resulting from a blow to the head, common in contact sports.
  • Shin Splintsis the pain along the shinbone caused by overuse or improper footwear.
  • Knee Injuries include anterior cruciate ligament (ACL) tears, meniscus tears, and patellofemoral pain syndrome.
  • Ankle Sprains are ligament injuries in the ankle, often from twisting or rolling the foot.
  • Groin Strains are strains or tears in the muscles of the inner thigh.
  • Shoulder Injuries  include rotator cuff tears and shoulder impingement and are common in sports involving overhead movements.

Sports Medicine Doctors: The Architects of Athletic Nutrition

Sports Medicine Doctors at specialised clinics such as Opus Biological play a crucial role in athletic success. Their expertise in athletic nutrition, exercise physiology, and injury prevention helps them take a personalized approach, ensuring they meet each athlete’s unique nutritional requirements.

Assessment and Tailoring Dietary Plans

Crafting an athlete’s optimal diet begins with a comprehensive assessment. Sports medicine doctors consider the athlete’s sport, training intensity, body composition, medical history, and specific goals. They may conduct blood tests and other investigations to evaluate nutrient levels and identify any deficiencies that could hinder performance. With this information, the sports medicine doctor develops a tailored dietary plan that addresses the athlete’s needs. These plans encompass appropriate caloric intake, macronutrient ratios, and micronutrient-rich food sources. The goal is to provide the body with the proper nutrients at the right time, optimizing performance and promoting recovery.

Impact of Specific Nutrients on Athletic Performance

Nutrients play vital roles in supporting various physiological processes directly influencing an athlete’s abilities and performance. Here are some key nutrients and their effects on athletic performance:
  • Carbohydrates: As the primary energy source for athletes, carbohydrates are critical for maintaining high-intensity performance and replenishing glycogen stores after intense workouts. Sports medicine doctors work with athletes to determine the optimal carbohydrate intake to sustain energy levels during training and competitions.
  • Proteins: Protein is essential for muscle repair and growth, making it crucial for athletes to support their physical demands. Sports medicine doctors help athletes determine the right amount of protein to include in their diet, considering factors such as training intensity and any injuries requiring additional tissue repair.
  • Fats: While often underrated, fats play a vital role in endurance sports. They serve as an energy reserve, especially during long-distance activities. Sports medicine doctors ensure athletes consume healthy fats to maintain sustained energy and support overall health.
  • Hydration: Proper hydration is paramount for athletes to perform at their best. Sports medicine doctors guide athletes on fluid intake, considering factors like climate, intensity, and duration of activity to prevent dehydration and maintain optimal performance.

Recovery and Injury Prevention

Adequate nutrition is crucial for top-notch athletic performance, post-exercise recovery, and injury prevention. Sports medicine doctors focus on the following aspects:
  • Muscle Recovery: Nutrients such as protein, carbohydrates, and antioxidants aid in muscle repair and reduce inflammation. Sports medicine doctors emphasize post-training meals that facilitate the body’s recovery process.
  • Injury Management: Nutritional support is essential during injury rehabilitation. Sports medicine doctors ensure athletes receive proper nutrition to promote tissue healing and boost their immunity.
  • Bone Health: Calcium and vitamin D are vital for maintaining strong bones, reducing the risk of stress fractures and other bone-related injuries. Sports medicine doctors ensure that athletes’ diets include adequate nutrition.

Conclusion

Nutrition is the bedrock on which athletic performance is built. Sports medicine doctors are pivotal in optimizing athletes’ diets, considering their needs, performance goals, and health conditions. By tailoring dietary plans and emphasizing the importance of specific nutrients, sports medicine doctors can unlock an athlete’s full potential, enhance their performance, aid in recovery, and reduce the risk of injuries. At Opus Biological, we understand your sports nutrition needs. Our sports medicine doctors optimize your nutrient intake, enhance recovery, and boost endurance. Additionally, we provide personalized dietary plans and supplements catering to individualized training regimens, ensuring you receive the right nutrients at the right time. With our support, athletes can maximize their potential, improve overall athletic performance, and maintain their competitive edge in the world of sports.
Working from home checklist

Working from home checklist

May 5, 2024

Photo by Ian Harber on Unsplash
Office jobs can often result in several injuries, including back pain and repetitive strains, to name a few. Now, in light of the pandemic, these injuries have been transferred from the workplace to home, with many of us now adopting the working from home life. The most prevalent injury in the workplace is back pain, with sedentary office jobs causing this to develop from long periods of physical inactivity, incorrect posture, and poorly designed workspaces.
Making the shift to working from home offers us an opportunity to address these injury risk factors and make work as comfortable as possible. But what do we suggest?
  1. Create an ergonomic workspace. The word ergonomic has been thrown around a lot in recent months and refers to a space designed for efficiency. This includes positioning everything you will need for your working day, whether that be pens, phones, or a water bottle, within an arm’s reach. How does this help prevent injuries? Well, if you can reach anything you need by reaching out your arm, there will be no need for you to lean and stretch, potentially causing strains. An ergonomic workspace also means adjusting your monitor height, ensuring the screen brightness is optimal and adjusting your desk and chair height to ensure maximum comfort.
  2. Choose the correct office chair. This is one of the most important points of the working from home checklist. The correct office chair can be the difference between back pain and no back pain. A good office chair will promote proper posture by having an adjustable height, an adjustable backrest, and adjustable armrests, alongside lumbar support and the ability to swivel.
  3. Practice good posture. Following on from a good office chair is practising good posture throughout the day. When sitting for extended periods of time, we often subconsciously slouch or lean, which can cause severe back pain if not corrected. Using correct posture reduces the gravitational pressure that is placed on your spine, improving comfort and reducing the risk of back pain.
  4. Take frequent short breaks. Short and frequent breaks minimise the length of physical inactivity during the day. Even if this solely involves standing for five minutes every hour and stretching your back and legs, this can have a profound impact on the incidence of workplace injuries.

If you are still experiencing back pain even after taking these suggestions into account, there may be something deeper going on, and it is worth you coming in to get this checked out by the team at Opus. An assessment from one of our sports medicine specialists may identify exercises and changes you can incorporate into your daily life that will ease any pain your are experiencing.