Subject: Can you do these? Return to Play Guidelines after an ACL Tear!

Hi Friend!



Happy Wednesday to you!



I recently attended a Training Seminar, and like so many conferences you attend there were many gold nuggets I took home.  One that I've been chewing on and wanted to share with you are Criteria based return to play guidelines from Melbourne.  Criteria based is a newer model in which you must be able to do certain tasks before you return to play vs. a timed based model that says 3-4 months after surgery you can start doing (fill in the blank).  


What I love about the criteria based is that you have concrete objectives to hit, that allow you to go at your own pace, so you don't necessarily feel rushed.  You either can or can't do these things (pass or not pass).  It makes it a lot easier for the Athletic Trainer when returning athletes to play.  Either the athlete can or can't do these things.  If they can, they go back.  If they can't they don't go back yet.  Pretty simple.  



Here are some of the Criteria Based Return to Play Guidelines for Strength & Neuromuscular Control.
Athlete / Client must be able to:
  • stand from a seated position on 1-leg and return w/ arms crossed x10e
  • 1-leg squat to 60 degrees w/ arms crossed (tempo = 1-0-1-0) x5e
  • 1-leg calf raise on step (tempo = 1-0-1-0) x20e
  • foot elevated 1-leg bridge x20e
  • side plank (straight leg) x30s/side
  • 1-leg balance w/ arms crossed x45sec (eyes open) and x9sec (eyes closed)


What we do in Change Your Body Boot Camps / Athletes by Alves!
  • side planks are a foundational part of our program that we address as a group for 6-months every year in Q1 and Q2.  For private clients and program design clients I address them as needed based on their movement screens, subjective feedback and observation.   
  • 1-leg squats to a bench we do every Q3 if someone has earned the right to do them.  Same goes for private clients.  I'm not going to program them if you're not ready to do them.
  • 1-leg squats on a bench we also do every Q3 and Q4 with our hockey squats, again if someone's earned the right to do them.  
  • 1-leg calf raise off a step for 20 reps is very interesting because I only do them as part of our triple extension dynamic warm up exercises.  I mostly viewed these as a body building and rehab exercise.  I'll have to figure out how to build these in more often.  
  • Feet Elevated 1-Leg Bridges are an annual staple & programming staple for all clients.  We do these all year long in different forms (2-leg, 1-leg, bent knee, straight leg, feet elevated, trunk elevated, with dumbbells overhead or on hips, with mini bands around knees or rollers between legs.
  • 1-Leg Balance we address every workout all year long with our warm ups and single leg exercises.  We don't do eyes closed 1-leg balance exercises in our program only because I hadn't considered it before, but if we only have to hold for 9 seconds to be criteria eligible, I'm sure I can find a way to fit them in.  



Criteria Based Return to Play Guidelines for Running, Agility and Landings.
Some of the things athletes and clients need to be able to do are:
  • slalom running, shuttle runs and ladder drills
  • jumping (2-leg), hopping (1-leg) and bounding (1-leg to the other leg)
  • forward & stick, forward continuous, side to side, side to side for distance
  • elevation (box jumps / box hops), altitude (drop jumps / drop hops)
  • balance with head motions

More specifically 
  • single leg hop and stick for distance
  • triple hop and stick for distance
  • triple hop crossover (zig zag forward over a line) and stick for distance
  • side to side hop for 30sec 
  • dynamic balance (reach swing leg forward, backwards to outside and backwards to inside for distance)
  • dynamic balance with head motions (side to side x15 in 15sec; up & down x15 in 15sec)
  • single leg squat to bench (90 degrees) x22reps


What we do in Change Your Body Boot Camps / Athletes by Alves!
  • We don't do slalom running, but we do have cones always set up, so that's something to consider for our Q1 to Q3 training.
  • Shuttle Runs we do all year long in the form of band relays.  
  • Ladder drills we only do in Q4, though they're so good and well loved, that it's worth reconsidering the rest of the year.
  • We do single leg hops, bounds and jumps all year long, forwards & side to side.  We usually alternate doing 2-leg jumps and 1-leg lateral hops in 1 quarter and 1-leg linear hops and lateral bounds in another quarter progressing them from sticks, to double bounces to continuous.  A linear (or even lateral) zig zag hop is a very interesting and fun option, especially because we have plenty of lines on the gym floors.
  • We don't do any side to side continuous hops for time currently though we've done it as part of our Q4 Winter Sports Training programs in the past.
  • Dynamic Balance with reaches is a good assessment exercise for injury risk, that I'm not sure I see addressing other than with similar movement planes in our warm ups.  
  • The same goes for Dynamic Balance with head movements.  That's more of an assessment drill vs. a functional training exercise.  
  • Single Leg Squat to 90 Degrees is something we do every Q3 and Q4 with our 1-Leg Squats to a Bench and to a Medicine Ball.  The 1-Leg Squats on a bench and the 1-Leg Hockey Squats are similar as we aim for 90 degrees, but there's nothing we touch our butts too only our foot / knee to the ground respectively.  We rarely if ever do 22 reps as its much more efficient to add weight and do fewer reps.  


Now most everyone one of our clients could pass at least 1 of these drills today, but not necessarily when they first joined.  Some members could past most and fewer could pass all of these exercises today, but even if they can't, we address the large majority of these exercises in a proactive manner to reduce the risk of injury before it happens, both in our daily programming and definitely over the course of the year.



Injuries can still happen and often times people are working through something and that's the key.  Whether you're hurt (you can play) or injured (you can't play) you still can train with exercise modification and so long as you modify and keep exercising you can still get better, manage your mood and remain an active part of your community, preserving your identity and avoiding isolation and depression. 


Criteria for Return to Play is a Brilliant Concept of Checking Boxes to Make Sure your Body is ready to perform in sport with the lowest risk of re-injury.  No one wants to get injured.



Thinking about all of these things so you don't have to,



Coach Mike
p.s.  when you're ready, here are 3 ways I can help you.



1.  Group Personal Training:  know someone who wants a coach who thinks about doing no harm FIRST, awesome people to train with, a results-oriented & injury risk reducing program to follow and a high energy place to get better, then this is for you.  Reply with "CYBBC" in the subject line when you're ready to be a guest and/or try us out.  The next guest weeks are 10/28 - 11/8 and 11/25 - 12/6.



2.  Private Training.  Got some old injuries you want to address and need some support with your self-care goals?  Do you prefer the convenience and privacy of 1-on-1 training and thrive with the individualized attention and the custom programming?  Our recurring appointments the accountability you need to guarantee your success.  I have afternoon availability on M / W / F for 1 person.  When you're ready, reply with "Private Training" in the subject line and let me know.



3.  Program Design.  If you want access to a coach, yet our mutual schedules don't line up or you simply want to train most of the time on your own, but you have something specific you want to work on like a body part, a posture / injury problem, a performance goal, or a specific event (reunion, beach vacation, adventure trip or athletic competition) reply with "Program Design" in the subject line and let me know how I can help you.


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