Madison Physical Therapy and Consulting

11/30/2025

https://www.facebook.com/share/1CZ3dxCQtJ/?mibextid=wwXIfr

■ 🧭 𝐍𝐚𝐯𝐢𝐠𝐚𝐭𝐢𝐧𝐠 𝐑𝐞𝐜𝐨𝐯𝐞𝐫𝐲: 𝐓𝐡𝐞 𝐏𝐡𝐚𝐬𝐞𝐝 𝐀𝐩𝐩𝐫𝐨𝐚𝐜𝐡 𝐭𝐨 𝐏𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐀𝐂𝐋 𝐑𝐞𝐜𝐨𝐧𝐬𝐭𝐫𝐮𝐜𝐭𝐢𝐨𝐧 𝐑𝐞𝐡𝐚𝐛𝐢𝐥𝐢𝐭𝐚𝐭𝐢𝐨𝐧

■ Postoperative rehabilitation following Anterior Cruciate Ligament (ACL) reconstruction surgery is crucial for restoring function and strength, promoting a successful return to sport, and minimizing the risk of reinjury.
■ This intensive recovery process typically spans 9 to 12 months.
■ Rehabilitation adheres to a structured, phased, criterion-based approach.
■ This system ensures that objective milestones are met before progression, which helps restore confidence and function as patients work toward returning to sport.
■ Here is a thorough breakdown of the recovery stages after ACL reconstruction:

■ 🩹 𝐄𝐚𝐫𝐥𝐲 𝐏𝐡𝐚𝐬𝐞 (𝐖𝐞𝐞𝐤𝐬 𝟎–𝟔)

■ The primary goals during the initial weeks are foundational:
■ Reducing pain and swelling
■ Restoring knee range of motion (ROM)
■ Restoring quadriceps strength

■ A key objective is achieving a quadriceps Limb Symmetry Index (LSI) of 60% or greater.
■ The LSI is often calculated using the uninvolved limb as a comparator.
■ Clinicians frequently use modalities such as neuromuscular electrical stimulation (NMES) to assist with strengthening during this phase.
■ NMES has been a studied component of functional recovery after ACL reconstruction.
■ Additionally, open kinetic chain exercises can be initiated, provided the surgeon has given clearance and the progression is appropriate to load the quadriceps safely without placing excessive strain on the newly reconstructed ACL.
■ (The use of open- versus closed-kinetic-chain exercises remains a significant topic in ACL rehabilitation research.)

■ 🔄 𝐈𝐧𝐭𝐞𝐫𝐦𝐞𝐝𝐢𝐚𝐭𝐞 𝐏𝐡𝐚𝐬𝐞 (𝐖𝐞𝐞𝐤𝐬 𝟕–𝟗)

■ Progression to this phase is criterion-based, requiring several early-phase goals to be met:
■ Knee ROM of 0° to 115°
■ Effusion (swelling) of 1+ or less
■ A normalized gait pattern

■ The focus shifts to initiating balance activities, neuromuscular re-education, and aerobic training.
■ The most crucial objective is reaching full, symmetrical ROM and achieving a quadriceps strength LSI of 70% or greater.
■ This goal is typically achievable through diligent adherence to a structured, progressive overload strength training program.

■ 🏃 𝐋𝐚𝐭𝐞 𝐏𝐡𝐚𝐬𝐞 (𝐖𝐞𝐞𝐤𝐬 𝟏𝟎–𝟏𝟔)

■ This phase introduces higher-level activities:
■ Running is introduced when quadriceps strength reaches an LSI of 80% or greater.
■ Training emphasizes proper landing mechanics.
■ Strength training is progressively advanced and transitioned into a more intensive, gym-based program.
■ The target strength LSI for this phase is 75% to 80% or greater.

■ 🔁 𝐓𝐫𝐚𝐧𝐬𝐢𝐭𝐢𝐨𝐧𝐚𝐥 𝐏𝐡𝐚𝐬𝐞 (𝐌𝐨𝐧𝐭𝐡𝐬 𝟒–𝟔)

■ The transitional phase integrates dynamic, multidirectional movements essential for sport:
■ Patients begin jumping, sprinting, decelerating, and agility drills.
■ The established goals for this phase are an LSI for both quadriceps strength and hop testing of 85% or greater.
■ Hop testing symmetry often utilizes the uninvolved limb as a comparator.

■ 🏅 𝐑𝐞𝐭𝐮𝐫𝐧-𝐭𝐨-𝐒𝐩𝐨𝐫𝐭 𝐏𝐡𝐚𝐬𝐞 (𝐌𝐨𝐧𝐭𝐡𝐬 𝟔–𝟏𝟐)

■ This final stage is dedicated to high-intensity preparation:
■ The focus is on sport-specific drills and conditioning in preparation for return to competition.

■ Clearance for full return to sport and competition is granted only when specific, rigorous criteria are met:
■ No pain or effusion
■ LSI for quadriceps strength and hop testing of 90% or greater
■ Patient fear/confidence levels are evaluated

■ 𝑩𝒚 𝒔𝒕𝒓𝒊𝒄𝒕𝒍𝒚 adhering to these objective, criterion-based milestones, patients are best positioned to safely return to sport at preinjury levels while significantly minimizing their risk of reinjury.
■ This rigorous, multi-phased rehabilitation process acts like a highly detailed building code—each stage must meet specific safety and structural requirements before the next phase of construction can begin, ensuring the final structure (the knee's function) is strong, stable, and ready to withstand high-level stress.

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Link to Article 👇

04/11/2025

You can get your own pulse device using discount code: MadisonPT

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A little humor for the day!...

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Sustained weighted knee extension hangs. Did you know full knee extension is one of the most important aspects of gait? Slow prolonged weighted stretching helps tissues creep to restore extension for the initial contact phase of gait. Full extension and symmetrical gait are key check points for reconstructive knee surgeries

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Spring is in the air. Nothing like the beautiful flowers around the square this time a year. Here’s the view from our office today. Tulip season is almost upon us! Come and get your steps in 🏃🏽‍♀️🏃🏼

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Had the honor of serving as the physical therapist for the US freestyle ski team at the toyota grand prix/world cup

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So excited for the premiere movie Rising Phoenix about the Paralympic movement. Some of our favorite athletes we have worked with these last couple years are paralympians of a variety of sports. Their achievements, advancement and dedication to sport are simply amazing. Here's the preview, it is being release August 26 on Netflix.

Rising Phoenix tells the extraordinary story of the Paralympic Games. From the rubble of World War II to the third biggest sporting event on the planet, the ...