Final con edu summary for me for the day (more tomorrow, hopefully):

@BartDingenen on RTP after #ACL injury in football (again, soccer for the Americans) players

#sportfisio2020
@BartDingenen End goal must be known at the start of rehab - what are the individual requirements of the sport?
@BartDingenen Underloaded rehab --> unprepared athletes --> overload --> unsatisfactory outcomes
@BartDingenen QUADS QUAD QUADS.
Also hits on importance of RFD.

Plyos: consider how you're instructing. If you tell them to land softly, often increases ground contact time. But in sport, usually short ground contact times +high forces. High loads, short contact times need to be considered.
@BartDingenen Mov't quality!

Look at whole body, whole task (decel, transfer, accel), w/ perturbations, multidirectional, unanticipated, high speeds, etc!
@BartDingenen Deceleration activities extremely impt in football/soccer - more common than accel activities. Must train.
@BartDingenen Fantastic resources from Buckthorpe re: on-field soccer rehab
1) Part 1 jospt.org/doi/10.2519/jo…
2) Part 2
jospt.org/doi/10.2519/jo…
@BartDingenen Practicing passing, shooting and dribbling a football/soccer ball does NOT mean you're training for the sport.

98% of the sport occurs WITHOUT the ball!!

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More from @czuppons

3 Dec
#ACL injuries in professional football (aka Soccer for the Americans in the crowd - anyone else challenged when they hear this lol) with @MarkusWalden

My note thread to follow....

#Sportsfisio2020
@MarkusWalden "ACL injuries in men's professional football: a 15-year prospective study on time trends and return-to-play rates reveals only 65% of players still play at the top level 3 years after ACL rupture" bjsm.bmj.com/content/50/12/…

FREE to download
@MarkusWalden In their database:
- Few career-ending injuries (1.8%)
- Approx 7% retear rate w/in 1 yr post #ACLR

Are these re-injuries failures? Or a deliberate high-risk decision? Interesting question.
Read 6 tweets
3 Dec
Next up: Nicola Maffiuletti on Explosive Strength in Sports Rehab

Notes to follow in this thread.....

#sportfisio2020
Explosive strength = the capacity to generate FORCE as QUICKLY (<200ms) as possible. Often quantified as rate of force development (RFD).

Impt bc it's FUNCTIONALLY more relevant than max strength - not just for athletes, but even unexpected perturbations in ADL.
Explosive strength influenced by speed of motor neuron recruitment &discharge rate.
Discharge rate reduced w/ disuse, aging, pathology but has HUGE adaptability to training.
Read 4 tweets
3 Dec
But onward ho! First up with my note thread attached: @DrKateWebster on #ACL RTS and reinjury rates in elite female athletes.

Impt to point out: a lot of data is often on male athletes, not as much known about female athletes!

#sportsfisio2020
@DrKateWebster At ALL LEVELS OF PARTICIPATION, females are at greater risk for #ACL injury.

Overall, elite athletes: 83% return to pre-injury level

Elite females: Also 83%!
(incl handball, soccer, alpine skiing/snowboarding, basketball)
@DrKateWebster Time for RTS:
- No sex difference (Walden et al, KSSTA 2017)
- NCAA Division 1 soccer: cleared at 6 mths (Howard 2015)
- WNBA (Namdari 2011): 11.8 mths
Read 9 tweets
3 Dec
Finally getting to Part 3 of @ACLStudyDay - integrating motor learning into #ACL rehab, with @Dusty_Grooms !

First: required pre-reading:
1) jospt.org/doi/10.2519/jo…
2) ncbi.nlm.nih.gov/pmc/articles/P…

Thread of my notes from the lectures to follow .....
@ACLStudyDay @Dusty_Grooms The brain functions as a hierarchy of networks that promote movement. Everything eventually links to the motor cortex.

Environmental context influences how well a patient looks in different environments.
@ACLStudyDay @Dusty_Grooms Neuroplasticity results in:
- incr cortical area assoc w/ the skill (the more you do a skill, the more your brain dedicates to it)
- new neuron support cells to facilitate skill
- improves neural efficiency (as ability incr, neural activity req decr for more complex tasks)
Read 24 tweets
27 Oct
On to topic #2 from @ACLStudyDay home study session:

Return to run post-ACLR with @rwilly2003 ! Notes to follow in this thread...
@ACLStudyDay @rwilly2003 Resolving basic fundamentals is impt prior to running - edema, ROM, strength, etc - or these impairments may persist/be magnified once pt returns to running
@ACLStudyDay @rwilly2003 Recreational running may become exercise of choice for some athletes who choose NOT to return to pre-injury sport
Read 33 tweets
23 Oct
Tips to return athletes confidently to sport with @clare_ardern via @ACLStudyDay Home Study Sessions!

Notes in the thread below....
@clare_ardern @ACLStudyDay MIND MATTERS.

Psych readiness critical across all injuries, not just ACL, for return to sport.

Fear of re-injury is #1 reason for not returning to pre-injury sport.
@clare_ardern @ACLStudyDay Physical and mental readiness often don't coincide!

When expectations don't match reality, can feed into greater negative emotions. Need to help athlete set realistic goals.
Read 9 tweets

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