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191 | Focus on What Matters: The MIT Approach in ACL Rehab · The ACL Athlete Podcast

• 0:18
  SPEAKER_00: Welcome everyone to the ACL Athlete Podcast.
• 0:22
  SPEAKER_00: This is the podcast where we talk about everything related to the ACL, whether that's the injury itself, the rehab process, return to sport, and more.
• 0:31
  SPEAKER_00: I'm your host, Dr.
• 0:32
  SPEAKER_00: Ravi Patel, performance physical therapist and coach.
• 0:36
  SPEAKER_00: Between myself and fellow guests and experts, you'll learn through the lens of the patient, the healthcare professional, and the coach.
• 0:43
  SPEAKER_00: The goal of this podcast is to equip you, the athlete, with the education to make the best informed decision about your care and your ACL journey.
• 0:54
  SPEAKER_00: Thanks for joining.
• 0:55
  SPEAKER_00: Now let's dive into today's episode.
• 1:02
  SPEAKER_00: What is up everyone?
• 1:04
  SPEAKER_00: Welcome back to the ACL Athlete Podcast.
• 1:07
  SPEAKER_00: We are diving into this MIT concept for ACL rehab.
• 1:12
  SPEAKER_00: And so, what MIT stands for, the most important thing.
• 1:18
  SPEAKER_00: MIT, most important thing.
• 1:20
  SPEAKER_00: It's a concept and framework I've learned in productivity and in business, especially with trying to manage my own time.
• 1:27
  SPEAKER_00: It's easy to get through a day and feel like you have accomplished literally nothing.
• 1:32
  SPEAKER_00: There have been so many days like that.
• 1:34
  SPEAKER_00: And so having these different ways to navigate managing time and priorities is super important, just as human beings, but especially trying to create my own time and manage my own time.
• 1:47
  SPEAKER_00: This is really helpful.
• 1:48
  SPEAKER_00: That's where this MIT concept comes in.
• 1:51
  SPEAKER_00: You pick one thing or goal to complete every day.
• 1:56
  SPEAKER_00: My most important thing for the day, or my MIT.
• 1:59
  SPEAKER_00: Something I try to tackle first thing in the morning.
• 2:02
  SPEAKER_00: And so, for example, this podcast was my MIT for this morning.
• 2:06
  SPEAKER_00: It was my most important thing.
• 2:08
  SPEAKER_00: And so I am tackling this podcast, recording it.
• 2:11
  SPEAKER_00: So that is my MIT.
• 2:13
  SPEAKER_00: And this reminds me of a quote I really like.
• 2:16
  SPEAKER_00: I'm a big UGA fan, born in Georgia, went to university of undergrad.
• 2:21
  SPEAKER_00: I coached there with strength conditioning.
• 2:23
  SPEAKER_00: So very near and dear to my heart.
• 2:26
  SPEAKER_00: And so I heard Kirby Smart, the head coach for UGA, reference this quote.
• 2:31
  SPEAKER_00: And this was when we were chasing a national championship.
• 2:35
  SPEAKER_00: And he said, keep the main thing the main thing.
• 2:38
  SPEAKER_00: Loved it.
• 2:39
  SPEAKER_00: Then I looked it up and it actually comes from Stephen Covey's Seven Habits of Highly Effective People.
• 2:45
  SPEAKER_00: And he says the main thing is to keep the main thing the main thing.
• 2:49
  SPEAKER_00: So that is something that seems so simple, but it's emphasizing the importance of prioritizing and focus on achieving goals, right?
• 2:58
  SPEAKER_00: This concept encourages people to identify and be able to dedicate their attention to specifically primary objectives without being too sidetracked or having distractions or these secondary tasks.
• 3:12
  SPEAKER_00: ACL rehab is faced with all kinds of noise and ways to get distracted or sidetracked.
• 3:19
  SPEAKER_00: I feel like procrastination kind of sets itself in.
• 3:22
  SPEAKER_00: We don't really want to work on certain things, just like we do with just work or school or whatever that might be.
• 3:28
  SPEAKER_00: Same thing with ACL rehab, especially if there's like some pain to work with, or it's just not our favorite thing to do.
• 3:34
  SPEAKER_00: We're not choosing to be here.
• 3:37
  SPEAKER_00: We just happen to have this injury and it's in the way of us getting back to something we love to do and want to do.
• 3:43
  SPEAKER_00: So there's all this noise and ways to get distracted.
• 3:47
  SPEAKER_00: So I have enjoyed using this concept with my athletes, whether that's a phase we're in, the week, or even a session theme, for example.
• 3:56
  SPEAKER_00: The MIT could be used, for example, the phase that we're in.
• 4:02
  SPEAKER_00: So our MIT is quad strength, basically, all of ACL rehab, as you guys know, quad strength, quad strength, quad strength.
• 4:10
  SPEAKER_00: But let's say, for example, we are in this phase where it is such a huge focus for quad strength.
• 4:16
  SPEAKER_00: I've got this athlete right now where they have been playing this game of catching up on quad strength.
• 4:21
  SPEAKER_00: They were elsewhere.
• 4:23
  SPEAKER_00: And you know, they had had these battles with Cyclops Legion and all these other things coming up.
• 4:28
  SPEAKER_00: And so quad strength has been their limiting factor or their bottleneck.
• 4:33
  SPEAKER_00: So our phase has been so focused on this because of where they are in this process.
• 4:38
  SPEAKER_00: Another example is the week, right?
• 4:40
  SPEAKER_00: Maybe this particular week for a different athlete is let's get the swelling down.
• 4:44
  SPEAKER_00: That is our MIT for this week.
• 4:46
  SPEAKER_00: I don't care about anything else.
• 4:48
  SPEAKER_00: Sure, like we're gonna do some other rehab stuff, but maybe our main focus because it's the main bottleneck, is getting our swelling down.
• 4:56
  SPEAKER_00: Session.
• 4:56
  SPEAKER_00: Maybe your MIT for a session is achieving terminal knee extension.
• 5:01
  SPEAKER_00: You've been after this thing.
• 5:02
  SPEAKER_00: So instead of trying to focus on being able to do some hamstring work or knee flexion, or maybe you're doing some squatting, whatever that might be, you're still after terminal knee extension and you are, you know, three months out, right?
• 5:18
  SPEAKER_00: And so maybe for a particular session, you're like, my MIT is let me get this terminal knee extension.
• 5:23
  SPEAKER_00: And it might be for sessions and sessions after that, but at least you have something to really focus and hone in on.
• 5:30
  SPEAKER_00: It allows us to get very focused on that one thing.
• 5:35
  SPEAKER_00: If we can move the needle on this one thing, everything else will fall more in line.
• 5:39
  SPEAKER_00: It is usually that bottleneck, so that's what this MIT can be focused on in this process as well.
• 5:46
  SPEAKER_00: That rate limiting factor, as I had mentioned.
• 5:49
  SPEAKER_00: It also allows us to reduce the noise since we can be working on 10,000 different things and exercises and movements and goals.
• 5:57
  SPEAKER_00: Um, it's just like these athletes who come to us from somewhere else and they're like, Yeah, I've been doing 30 to 40 exercises in a session.
• 6:05
  SPEAKER_00: Like we've had people who have literally said they're doing two to three hours worth of work in a session, and they might even be post op ACL and they're doing 30 exercises.
• 6:14
  SPEAKER_00: I'm like, what is happening?
• 6:16
  SPEAKER_00: This is madness.
• 6:17
  SPEAKER_00: How about we cut this down and only do five to 10?
• 6:20
  SPEAKER_00: And let's make sure every single one of these is so freaking effective because the likelihood of 30 to 40 exercises, you're probably having tons of redundancy and not putting a much intent behind any of those.
• 6:32
  SPEAKER_00: So, what if we can reduce this and reorganize this and make it, you know, uh 25 to 50 percent of the time you're actually spending?
• 6:41
  SPEAKER_00: What if you can make this 30 minutes an hour, even 10 minutes to be able to move the needle on certain things?
• 6:48
  SPEAKER_00: Like, for example, maybe it is that knee extension that we're working on, and then we build that up over time.
• 6:54
  SPEAKER_00: So, this is something that is really important to help reduce the noise and make sure we're not working on so many different things at the same time.
• 7:02
  SPEAKER_00: And this brings up another quote I like to use the man who chases two rabbits catches neither.
• 7:08
  SPEAKER_00: This is by Confucius, and this is basically just the adage of you know, if you are after two rabbits, you're not gonna get both of them because they're gonna be running in different directions and you're not gonna be able to capture them.
• 7:20
  SPEAKER_00: And so if we are focused on one rabbit, then hey, we can follow that rabbit and we can be able to catch that rabbit.
• 7:27
  SPEAKER_00: But the thing is, is when we're after too many goals, it starts to get really diluted in our plan and the way that we're navigating our movements and our exercises.
• 7:37
  SPEAKER_00: So we need to try and find signal within the noise.
• 7:40
  SPEAKER_00: How do you find that?
• 7:41
  SPEAKER_00: Through evidence-based testing.
• 7:43
  SPEAKER_00: So that is what's gonna create this honesty around where the athlete is, and then we're going to make sure we're targeting goals that are not only long-term but short term.
• 7:53
  SPEAKER_00: And then, therefore, we have a starting point, and then we have this next point we're working with, what we would say from A to B, and the long-term goal is Z.
• 8:01
  SPEAKER_00: So we just need to focus on this next step, and then we're gonna create a plan around that, prioritizing the MIT as numero uno.
• 8:09
  SPEAKER_00: And that way, as you move forward, and if things get overwhelmed, or maybe you have limited time and need to work on one thing, it's the MIT.
• 8:18
  SPEAKER_00: And you can finish that day, that session, even that week, for example, and all you did was the MIT every day, then you can be happy and feeling successful in that.
• 8:30
  SPEAKER_00: And that's the 1% better we're looking for in this ACL rehab process.
• 8:34
  SPEAKER_00: That next brick we need to lay down for the foundation, and you feel clarity in what your plan and programming is targeted.
• 8:42
  SPEAKER_00: And this is something that we do find a lot, especially with just the overwhelming nature of ACL rehab.
• 8:48
  SPEAKER_00: As I had mentioned, it feels like this part-time other job that you are doing, especially early because you are doing a lot of range of motion work, you're working on this thing repeatedly, and it's limiting your life a lot more.
• 8:59
  SPEAKER_00: So you're wanting to put more work into it.
• 9:01
  SPEAKER_00: And then as you go, hopefully, it's turning into this performance, strength and conditioning type program.
• 9:08
  SPEAKER_00: That way, it's looking more like you're going to the gym and rehabbing and training stuff versus this constant daily grind, which does start to slow up, but it is the long process, right?
• 9:20
  SPEAKER_00: We're playing a long game here, and so this is something that's really important to consider with so many variables in ACL rehab.
• 9:29
  SPEAKER_00: And one of the things, too, is especially for our younger athletes, we like to make sure that they know what it is that they are focusing on because it's easier for distractions and for things to come into play.
• 9:41
  SPEAKER_00: So then, therefore, maybe there's not as much intent and effort behind everything.
• 9:46
  SPEAKER_00: Because even if they're coming to the clinic two to three times a week, for example, there's so much time outside of that.
• 9:51
  SPEAKER_00: And so, therefore, there needs to be a lot of intention behind knowing what are we chasing and what are our goals.
• 9:58
  SPEAKER_00: And so that's where the plan comes into place, what we're after with these milestones and criteria, having these goals set up, but most importantly, making sure that we do have an MIT and these priorities that these athletes know.
• 10:12
  SPEAKER_00: So try it for yourself.
• 10:13
  SPEAKER_00: And a lot of times you'll find you're wasting a lot of time chasing a bunch of different rabbits and catching none of these.
• 10:20
  SPEAKER_00: Instead, you have an MIT, ensure some secondary goals with that, and your one rabbit you're chasing is the MIT, right?
• 10:30
  SPEAKER_00: That's the thing, the most important thing that we are after.
• 10:33
  SPEAKER_00: And this can help really streamline things while you're going through ACL rehab, because we just want to make sure we don't get confused with trying to tackle, you know, 10 different goals.
• 10:45
  SPEAKER_00: We want to make sure we have especially our top three, but then pick that number one.
• 10:50
  SPEAKER_00: If you say, if I can accomplish this number one, this will move the needle forward, this will help with the bottleneck of this process.
• 10:57
  SPEAKER_00: And a lot of times athletes are like, well, maybe it's this extension, maybe it's this pain that I'm dealing with in the front of my knee, maybe it's quad strength, sometimes it's a combination, but usually we can tease out what it is is that that specific bottleneck and that MIT that we can focus on.
• 11:14
  SPEAKER_00: So then that way you can keep rolling in your ACL rehab.
• 11:18
  SPEAKER_00: So I hope that this was something that you can put into play.
• 11:21
  SPEAKER_00: So think about your rehab now and think about what is your MIT and what are you focused on in this phase in this week, for example, maybe in a particular session.
• 11:31
  SPEAKER_00: So this is something that we try to communicate to our athletes and something I want to use more and more with our athletes because it just helps to really simplify things and eliminate some of the noise that can be with ACL rehab.
• 11:45
  SPEAKER_00: And I know you all feel me on this because it does feel like a lot many times.
• 11:50
  SPEAKER_00: So this is something that I hope can be helpful to you.
• 11:53
  SPEAKER_00: If you have any questions or if you need any assist, you know where to find us.
• 11:59
  SPEAKER_00: There's information in the show notes.
• 12:01
  SPEAKER_00: We are always here to help respond to any questions that you may have.
• 12:06
  SPEAKER_00: Um, otherwise, I will catch you guys next week.
• 12:09
  SPEAKER_00: This is your host, Robbie Patel, signing off.