Nutrition: A Missing Link to Treating an Injury

A sports-related injury is the last thing any athlete wants to experience. But, as stated in a recent article posted in Stack Media, “sometimes, injuries can’t be avoided.”

It takes countless amounts of time and dedication to carry out the specific rehab and treatment prescribed by the Athletic Trainer in order to heal properly and get back on the playing field.

The article mentions that the “Good Athlete” will rely soley on treatment and rehabilitation to get back on the field. However, the “Great Athlete” will also use sports nutrition in addition to his or her rehab and treatment regimen to heal his or her body quickly.

Katie Knappenberger, a Registered Dietitian and Certified Athletic Trainer, provides 6 great tips and information on how nutrition plays a major role in the healing process.

Read more by clicking: HERE

Source:
Stack Media: Stack Blog http://blog.stack.com/2012/03/27/use-sports-nutrition-to-heal-your-injury-fast/

ACL Post-Operative Rehabilitation

ACL Hamstring Tendon Graft Post-Operative Rehabilitation

Dr. Carey Winder
Baton Rouge Orthopaedic Clinic

ACL protocol is the same as bone patellar tendon bone except for the following:
1. When performing heel slides, make sure that a towel is used to avoid activating the hamstring muscles
2. Do not perform isolated hamstring exercises for 6 weeks
3. Partial weight bearing with crutches for 4 weeks

Week 1:
- Patient begins physical therapy 3-5 days post-op
- Initial therapy treatment consists of the following:

• EMS/bio feedback to quads


• Quad setting for 10 minutes


• SLRs for 5 min


• HSS sitting in chair (30 sec hold, 5 reps)


• Calf stretching against wall (30 sec hold, 5 reps)


• Patellar mobilization (emphasize superior glides)


• 90-40 open chain manual resistance


• ROM Passive: progress as tolerated (DO NOT MANUALLY FORCE ROM!)

To increase flexion:
May perform heel slides, wall slides, or chair flexions (wall slides preferred for hamstring grafted patients)

To increase extension:
May perform HSS, calf stretches, prone extensions (use biofeedback to relax the
hamstrings or manually teach relaxation of the hamstring during prone stretch)

Weight bearing:

• Weight bearing as tolerated with crutches.


• Continue use of crutches until gains quad control (3-6 weeks), then go to one
  crutch before FWB with no assistive devices

Cycling:

• May begin stationary cycling when can flex to 110 degrees (DO NOT USE STATIONARY BIKE TO INCREASE FLEXION!)

Bracing:

• Knee immobilizer when walking with crutches

Week 2 to 6:
- Will fit with a functional brace in the office. Wear the brace when ambulating to help protect from hyperextension injuries

• Continue above exercises


• Begin leg press from 90 to 20 degrees both legs.


• Progress to single leg press, stopping at 40, 60, and 90 degrees. When
  stopping hold position for 5 seconds.

Bracing:

• We measure for a functional brace such as the DonJoy Defiance at 3-6 weeks post-op:


• We use the brace to protect the patient from possible hyperextension injuries.

Begin proprioceptive training:

• Utilize the K.A.T. for balance, “stork” single leg balance with knee flexed to 20-30 degrees. Addition of biofeedback to enhance the VMO contraction is helpful. Use of sports cord may be instituted as long as patient has good quad control.


• Pool Walking Okay – make sure patient realizes to walk only and not to perform whip kick

Weeks 6-12:

• Lateral step ups


• Progress with proprioceptive training


• May begin running at 8-12 weeks when ROM normalizes and pain and swelling allow.


• Start on trampoline, progress as tolerated to cushioned surface, then hard surface.

Isokinetic test:

• At 180 and 300 degrees per second at 12 weeks.


• Include results in report to M.D.

3 to 6 months:

• Continue with above and may add partial squats, forward lunges with straight bar.


• Progress as tolerated.


• Do not perform if patient has patellar femoral symptoms!

6 to 12 months:

• Begin sport specific drills


• Return to activity based on KT-1000 scores and full ROM, Biodex test, and functional tests.

Patellar Tendonitis

LSU Volleyball Patellar Tendonitis Protocol

Treatment:

1. WARM-UP: make sure you warm up before any activity. You may get on a bike, or use a heat pack or hot tub if available.


2. ICE: Ice the knee after all activity. This will help alleviate pain and reduce inflammation. Do this immediately after activity and again at night before bed.


3. MEDICATION: You may take over-the-counter anti-inflammatory medication, as directed, such as Advil, Aleve, or Ibuprofen.


4. TAPING/BRACING: you may want to use a strap or tape job over the patellar tendon. The cheapest way is to take pre-wrap and wrap it around the leg and roll it up into a small tube and allow it to rest on the patellar tendon where the most pain is present. Do this under your kneepad and use the kneepad to keep it in place. You may also purchase a strap used for “jumper’s knees”, however, this may not be as comfortable under the kneepads.


5. STRETCHING: you should be stretching the entire leg daily. Emphasis should be placed on the quadriceps muscles as the patella is connected to them. You may want to consider using a foam roller if available.
   REST: if you are currently in season or doing heavy lifting in a weight room, you should back off the squats or plyometric work (jumping).

Rehabilitation:
The main goal to strengthen and stretch the quadriceps muscles.
These exercises should be done 3-4 times a week. Proper technique is very important, or you could actually make your injury worse.

1. Straight Leg Raise 4x25 reps. Lying on your back, raise your leg up with the knee straight. Variation: add a cuff weight to the ankle.


2. Leg Extensions 4x15 reps. If you have access to a weight room, you may use the leg extension machine, use one leg at a time. If not, sit on a table with your legs hanging off and using one leg at a time straighten your leg at the knee joint. You can increase resistance by adding a cuff weight to your ankle or wrapping elastic bands around your ankle and the table leg.


3. Wall Sits 3x1min. Variations: ball behind your back or ball between your legs, squeezing your legs together.


4. Body Weight Minisquats 5x20 reps. Do not allow your kneecap to go in front of your toes. Variation: one leg at a time.

LSU Women’s Basketball Jump Training Program

Created by Micki Collins, ATC

The following exercises can be done 3x’s per week-but no more. Read the instructions to make sure you are landing properly!!

Picture references can be found below.

Phase I

Week 1:

1. 180 Jumps: 2 foot jumps, rotate 180 degrees in midair, hold landing 2 seconds, then repeat in reverse direction. 1 x 6


2. Bounding in place: jump from one leg to the other, straight up and down, progressively increasing rhythm and height. 2 x 15


3. Jump, Jump, Jump, Vertical: three broad jumps with vertical jump immediately after landing the third broad jump. 1 x 5


4. Broad Jumps: as far as possible, hold landing 5 seconds. 1 x 5


5. Wall Jumps, Ankle Bounces: with knees slightly bent and arms raised overhead, bounce up and down off toes. 3 x 15 seconds

Week 2:

1. 180 Jumps: 2 foot jumps, rotate 180 degrees in midair, hold landing 2 seconds, then repeat in reverse direction. 1 x 6


2. Bounding in place: jump from one leg to the other, straight up and down, progressively increasing rhythm and height. 2 x 15


3. Jump, Jump, Jump, Vertical: three broad jumps with vertical jump immediately after landing the third broad jump. 1 x 5


4. Broad Jumps: as far as possible, hold landing 5 seconds. 1 x 5


5. Wall Jumps, Ankle Bounces: with knees slightly bent and arms raised overhead, bounce up and down off toes, 3 x 20seconds

Week 3:

1. 180 Jumps: 2 foot jumps, rotate 180 degrees in midair, hold landing 2 seconds, then repeat in reverse direction. 1 x 8


2. Bounding in place: jump from one leg to the other, straight up and down, progressively increasing rhythm and height. 2 x 20


3. Jump, Jump, Jump, Vertical: three broad jumps with vertical jump immediately after landing the third broad jump. 1 x 6


4. Broad Jumps: as far as possible, hold landing 5 seconds. 1 x 6


5. Wall Jumps, Ankle Bounces: with knees slightly bent and arms raised overhead, bounce up and down off toes, 3 x 30seconds.

Phase II

Week 4:

1. Bounding for Distance: start bounding in place and slowly increase distance with each step, keeping knees high. 3 x 15


2. 360 Jumps: 1 x 10


3. Wall Jumps: 4 x 30 seconds


4. Scissor Jumps: start in stride position with one foot well in front of the other, jump up, alternating foot positions in midair. 1 x 12


5. Single Legged-Jumps Distance: one legged hops for distance, hold landing, knees bent for 5 seconds, 1 x 5

Phase III
Week 5:

1. Bounding for Distance: start bounding in place and slowly increase distance with each step, keeping knees high. 3 x 15


2. 360 Jumps: 1 x 10


3. Wall Jumps: 4 x 30 seconds


4. Scissor Jumps: start in stride position with one foot well in front of the other, jump up, alternating foot positions in midair. 1 x 15


5. Single Legged-Jumps Distance: one legged hops for distance, hold landing, knees bent for 5 seconds. 1 x 6

Week 6:

1. Bounding: 3x’s through


2. Wall Jumps: 4 x 15 seconds


3. Squat Jumps: standing jump raising both arms overhead, land in squatting position touching both hands to the floor. 1 x 6


4. 360 Jumps: 1 x 10


5. Scissors Jumps: start in stride position with one foot well in front of the other, jump up, alternating foot positions in midair. 1 x 12


6. Hop, Hop, Stick: single-legged hop, stick second landing for 5 seconds, increase distance of hop as technique improves. 1 x 8

Week 7:

1. Bounding: 3x’s through


2. Wall Jumps: 4 x 15 seconds


3. Squat Jumps: standing jump raising both arms overhead, land in squatting position touching both hands to the floor. 1 x 6


4. 360 Jumps: 1 x 10


5. Scissors Jumps: start in stride position with one foot well in front of the other, jump up, alternating foot positions in midair. 1 x 12


6. Hop, Hop, Stick: single-legged hop, stick second landing for 5 seconds, increase distance of hop as technique improves. 1 x 8

Week 8:

1. Bounding: 3x’s through


2. Wall Jumps: 4 x 15 seconds


3. Squat Jumps: standing jump raising both arms overhead, land in squatting position touching both hands to the floor. 1 x 6


4. 360 Jumps: 1 x 10


5. Scissors Jumps: start in stride position with one foot well in front of the other, jump up, alternating foot positions in midair. 1 x 12


6. Hop, Hop, Stick: single-legged hop, stick second landing for 5 seconds, increase distance of hop as technique improves. 1 x 10

180 Jumps

Bounding in Place

Jump, Jump, Jump, Vertical

Broad Jumps

Wall Jumps, Ankle Bounces

Bounding for Distance

360 JumpsScissor JumpsSingle Leg Jumps for Distance

Squat Jumps

Hop, Hop, Stick

ACL Jump Training

LSU Women’s Basketball ACL Jump Training Program
Created by Micki Collins, ATC

Level 1
Jump Rope 200 reps

Begin with 2 foot hops

Progress to alternating feet, skiers, side to side, and single leg hops as tolerated

Quick Box Jumps (8 inch box)

Up-Up-Down-Down 2x15 reps

Switches 2x15 reps

Quick Jumps 2 feet- 2x15 reps

Two Foot Box Jumps (12-18 inch Crown Gym Mat Boxes) 3x10 reps

• Take off with both feet


• Use your arms


• Concentrate on sticking the landing


• Land with soft knees

Level 2

Depth Jumps 4x8 reps

• Stand on 12 inch box. Step off and as soon as you hit the ground, explosively jump onto a higher box (18-24 inches)


• Spend as little time on the ground as possible


• Concentrate on your landing

Practice Vertical Jump 4x5 reps

• Feet hip width apart


• Hands at shoulder level


• Explosively dip and jump straight up. Reach and extend with your dominant arm
  

Jump Rope-same as level 1, but progress to more advanced exercises

Quick Box Jumps-same as level 1

Level 3

Hurdle Hops x5

• Stand on 12 inch box. Step off and jump over a series of adjustable hurdles


• After jumping over the last hurdle do a long jump as far as possible


• Stick the landing

Tuck Jumps 3x15 reps

• Jump explosively with both feet, bringing your knees to chest and getting gas high as possible


• Be quick off the ground and use your arms

Standing Long Jump x3

• Drill is done form one end of the platforms in the weight room to the other


• Try and get to the end in as few jumps as possible


• Recover after each jump, reset, and explode out as far as possible


• Use your arms, stick the landing
  

Single Leg Explosive Jumps 3x10 reps each leg (advanced)

• Start with one leg on a 12-15 inch box (you want the quad close to parallel to the ground


• Explosively jump up, getting as high as possible


• Switch legs in midair so that you come down with the opposite leg on the box


• Drive up explosively with the opposite leg


• Repeat until prescribed reps are completed