Build Physio & Performance

Build Physio & Performance Sports physical therapy clinic in Bozeman, MT. Experts in ACL rehabilitation & sports injuries, isokinetic strength testing and sports performance.

We discussed lingering concentric phase impulse asymmetry in the double limb countermovement jump in our previous post. ...
11/17/2025

We discussed lingering concentric phase impulse asymmetry in the double limb countermovement jump in our previous post. What about single leg countermovement jumps? What metrics do we find useful?

We plotted typical output metrics, jump height and mRSI against 2 metrics that we like from the braking (eccentric deceleration) phase. Remember from our last post, that braking is the “downward” phase of a jump.

A strategy, typical in an ACL reconstructed patient, is to reduce both the distance downward (countermovement depth) and speed (peak eccentric velocity) likely because the person has inadequate braking impulse needed to stop their momentum at the bottom of a squat at a depth similar to their non affected side. This is noted as the “stiff knee” strategy.

We can see that over time, the affected limb counter movement depth and eccentric peak velocity improves to values similar to the non affected side. Jump height and mRSI (more on mRSI later) as “outputs” are relatively similar, but achieved by different strategies and remain consistent deficits throughout all of rehab.

We aren’t the only ones to note that concentric impulse phase asymmetry during a countermovement jump persists well afte...
11/13/2025

We aren’t the only ones to note that concentric impulse phase asymmetry during a countermovement jump persists well after athletes complete their ACL rehabilitation and return to sport.

For those less familiar, concentric is the “push off” phase of a jump, and impulse is the product of force and time.
Rehab focus tends to focus heavily on the physical components of deceleration because the majority of ACL injuries occur while someone decelerates.

The “downward movement” or braking phase of a countermovement jump is how we may track progress in someone’s braking capabilities over time by looking at net braking impulse and asymmetry. We’ve compared both braking (eccentric deceleration) impulse and concentric impulse asymmetry over time in ~45 patients each month.

Even with very good rehab, athletes often feel persistent performance deficits in their ability to produce high concentric forces rapidly, such as during high speed sprinting, often named “flat tire effect”, even after being cleared back to sport. These patient experiences correspond to the concentric impulse asymmetry we see in serial countermovement testing.

How much of a performance deficit would you allow in your return to sport decision making? Are we doing enough?

We recently were updating our clinic’s ACL testing data and decided to sort by graft type and pulled 6 month testing dat...
11/11/2025

We recently were updating our clinic’s ACL testing data and decided to sort by graft type and pulled 6 month testing data as that is a commonly reported time point in research.

This clinical data backs up a commonly reported issue for PTs when rehabbing quad tendon grafts where it is much more challenging to regain quad strength compared to other graft types. While they ultimately catch up, and many can do well early on, it is often a slower progression early on in rehab.

May be an important talking point when considering graft type choice with patients pre operatively, especially when working under a tight timeframe for return to sport or limited time to dedicate to rehab.

6 months post BPTB ACL and at 90% LSI isometrically and 85% isokinetically! Time for more quads, plyo progression and ba...
10/10/2025

6 months post BPTB ACL and at 90% LSI isometrically and 85% isokinetically! Time for more quads, plyo progression and back to basketball/track!

Patient twinning is winning!
10/07/2025

Patient twinning is winning!

10/02/2025

This was a rehab session for a hockey player 12 days post patellar dislocation. While he remains locked into extension for 2 weeks post injury, there is still a lot we are able to do in order to maintain not only quad/hamstring strength in the injured leg but also the rest of the athletic qualities required to play hockey.

🏒 SLR w/NMES + BFR
🏒 Plank Leg Lifts
🏒 Lateral Band Walks
🏒 MB Rotational Throws
🏒 SL RDLs
🏒 SL Balance w/stick handling
🏒 Long Lever Adductor Isometrics
🏒 Contralateral Quad Eccentrics on Humac
🏒 Bike Sprints

Let’s go  !
10/01/2025

Let’s go !

First test for rugby player  at 8 weeks post ACL with quad tendon graft + LET.  Hamstrings well above normal values and ...
09/24/2025

First test for rugby player at 8 weeks post ACL with quad tendon graft + LET. Hamstrings well above normal values and able to kick out a good amount of quad torque today. First 8 weeks of nudging the quads and ROM along and we are set up for a fantastic rest of rehab.

.lyons_ putting up more great numbers this month!  We are getting so close to skiing ⛷️
09/17/2025

.lyons_ putting up more great numbers this month! We are getting so close to skiing ⛷️

Not  first rodeo- but pretty cool to see that at only 3 months post OATS procedure his quad torque roasted his previous ...
09/10/2025

Not first rodeo- but pretty cool to see that at only 3 months post OATS procedure his quad torque roasted his previous metric PR following an MCL reconstruction 2 yrs ago. That’s some fire quad torque to body weight Jack! 🔥

Qualitative appraisal of force-time curves has significant utility.This patient has history of cartilage repair procedur...
09/08/2025

Qualitative appraisal of force-time curves has significant utility.

This patient has history of cartilage repair procedure and has pain limiting force output above 80-90 degrees of knee flexion. On non surgical leg peak torque output was at 63deg which is an expected angle. However for surgical leg peak torque output is at 87 degrees.

If we only examined the torque output it would only give us part of the story of this patients knee. Tolerance to force output in these shallower ranges is something we want to monitor over time with testing but is not something we are actively training due to pain. Rather we are training in pain free ranges and allowing that greater output to carry over his more sport specific tasks. Rising tide raises all ships.

.lyons_ had a huge bump in torque output this month post her QT ACLR.  She’s been very consistent in the gym and also ma...
08/14/2025

.lyons_ had a huge bump in torque output this month post her QT ACLR. She’s been very consistent in the gym and also making time to get on her bike all summer. Next up? 🎿

Address

609 Pronghorn Trl
Bozeman, MT
59718

Opening Hours

Monday 7am - 6pm
Tuesday 7am - 6pm
Wednesday 7am - 6pm
Thursday 7am - 6pm
Friday 7am - 6pm

Telephone

+14065800803

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Build Physio & Performance

Est. 1/4/2019

Build Physio & Performance is an evidence based practice sports physical therapy clinic in Bozeman, Montana. Our goal is to give our patients access to the best technology and education to address their unique situation.

Build Physio & Performance is centered on elevating our profession by offering continuing education courses at our clinic as well as mentorship across the globe. We consider ourselves to be a model clinic for the future of physical therapists as a profession and not an intervention.