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Build Physio & Performance

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Bozeman, MT
Build Physio & Performance

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

01/12/2026

Torque Unsteadiness ⚡️

When performing an MVIC isometric quad contraction (first video), occasionally we note difficulties in maintaining steady torque production. In some cases this can be exceedingly shaky which is illustrated in the force time curve (2nd pic).

We can quantify unsteadiness using TorqLab (thetorqlab.com) by using raw data from our Humac (3rd pic). The great folks at Dave Sherman’s lab at Northeastern are fighting a good fight and we appreciated the time Dave took to clarify the metrics used.

Two metrics might be useful:
CoV- the magnitude of force fluctuation (low numbers are better)
Yank- max yank will tell us the instantaneous rate of toque (think of the steepest point of the jagged lines versus a smooth line).

It doesn’t make sense to compare the two limbs when each is producing a different amount of torque, so we rectified this by repeating the test so that each side produced the same amount of torque. We chose 50% MVIC on the affected side and repeated the test for both sides using that target which was 75 ftlbs (4th pic). There is still a large difference between sides partially with max yank.

One of the interventions utilized to improve torque steadiness is NMES. We had to of course test that out too (2nd video). Did it work? You bet (last pic).

If you want to read more- Dan Cobian, PT, DPT, PhD. U Wisconsin
has a great post from his study looking at force unsteadiness. Force unsteadiness can persist throughout rehab and is a prerequisite to restoring quad strength symmetry post ACL.

Thank you to Dave Sherman, PT, DPT, ATC, PhD for taking our call. And thank you to our athlete for being a good sport!

01/08/2026

Recent PT graduate .johnson just returned to Manhattan Christian women’s basketball team after having successful MPFL + TTO surgery 7 mo ago. Markelle crushed all parts of rehab some of which included:

- Countermovement jump
- Single leg CMJ
- RTD isometric quad (norm 13+)
- R: 15.2 Nm/Kg/s
- L: 14.75 Nm/Kg/s
- Isometric strength
- Quad LSI 96%, 143%BW R, 148%BW L
Isokinetic strength
- Quad LSI 93%, 93%BW R, 99%BW L
- Hamstring LSI 94%, 67%BW R, 63%BW L

12/11/2025

looking fire 4 months post ACL with quad tendon autograft hitting big quad numbers very close to 100% torque to body weight with isometric testing on his surgery side and 133% on non surgical side. Isokinetic testing equally impressive. He gets a break from us as he heads home for Christmas but we’ll be ready to ramp up when he gets back! No doubt he will be spending lots of time in the gym 🦵🏉

11/26/2025

Big thank you to .44 for the infograms as part of his senior project! We can’t wait for Matthew to join our profession some day 💙💙💙

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.

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?

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.

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!

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

10/01/2025

Let’s go !

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.

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

Website

http://buildphysio.com/

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