Latest / The ACL Athlete Podcast / 074 | Using Your "Dial" in ACL Rehab

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074 | Using Your "Dial" in ACL Rehab · The ACL Athlete Podcast

• 0:19
  SPEAKER_00: Welcome everyone to the ACL Athlete Podcast.
• 0:23
  SPEAKER_00: This is the podcast where we talk about everything related to the ATL, whether that's the injury itself, the rehab process, return to sport, and more.
• 0:33
  SPEAKER_00: I'm your host, Dr.
• 0:34
  SPEAKER_00: Ravi Patel, performance physical therapist and coach.
• 0:38
  SPEAKER_00: Between myself and fellow guests and experts, you'll learn through the lens of the patient, the healthcare professional, and the coach.
• 0:46
  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.
• 0:57
  SPEAKER_00: Thanks for joining.
• 0:58
  SPEAKER_00: Now let's dive into today's episode.
• 1:03
  SPEAKER_00: What is up, ACL athletes?
• 1:06
  SPEAKER_00: So today is quick, short, and sweet.
• 1:09
  SPEAKER_00: I know I always say it, and then we end up going for longer, but that's going to be the goal today.
• 1:13
  SPEAKER_00: We're going to get to the point.
• 1:15
  SPEAKER_00: We are building off of last week's episode, which was episode number 73, mechanics, consistency, intensity, and ACL rehab.
• 1:25
  SPEAKER_00: So if you have not listened to that, please do me a favor, go and listen to it because it'll be huge.
• 1:31
  SPEAKER_00: It's a concept that we will apply even into today's episode, and that will put you way ahead and allow you to have a very smooth ACL rehab.
• 1:42
  SPEAKER_00: If we can anchor ourselves in some of these principles and being able to apply them really well, man, you'll be way ahead of the game in terms of if something does come up or as you're progressing along in this process.
• 1:57
  SPEAKER_00: So we are talking today, episode 74, about using your dial in ACL rehab.
• 2:04
  SPEAKER_00: So what I want you to think about is like a turn dial.
• 2:07
  SPEAKER_00: And so this could be something like the probably the easiest thing you think of is the dial on the radio.
• 2:13
  SPEAKER_00: So think about your car radio or the volume in the car.
• 2:17
  SPEAKER_00: There's like a turn dial that you could go from essentially zero to max 100%, right?
• 2:24
  SPEAKER_00: The other thing you can think about is the volume on your TV, right?
• 2:26
  SPEAKER_00: You use the remote, you hit the up and down button.
• 2:29
  SPEAKER_00: Usually it's only by increments of one or whatever that is, it's pretty arbitrary, but usually a zero to a hundred is a very good idea of zero, it's on mute, nothing's happening, you can't hear anything to a hundred is max maxed out as much as you can hear, right?
• 2:47
  SPEAKER_00: And the other thing you can think about is almost like this DJ mix table.
• 2:51
  SPEAKER_00: And this is gonna apply pretty well because we're gonna talk about some certain categories here where you can kind of categorize each one has their own turn dial, and you're gonna want to make sure, depending on where you're at in your ACL rehab, you're gonna be able to turn these up, maybe only up to 10, maybe 50, maybe 100.
• 3:10
  SPEAKER_00: It just kind of depends, and we can even look at this as percentages of how much you're utilizing it, right?
• 3:16
  SPEAKER_00: So zero to a hundred.
• 3:18
  SPEAKER_00: So some of these categories that are gonna be really important that we talk about with a lot of my athletes is the range of motion, repetitions, the weight, the speed, these are all different categories that we're gonna use regarding this turn dial or the dial that you're using for your own ACL rehab.
• 3:39
  SPEAKER_00: So when you see a movement or an exercise or anything that you are going to do in the rehab process, what oftentimes I will see is that when athletes go to do something, if I tell them to squat, they'll do a squat, of course, right?
• 3:53
  SPEAKER_00: Like there's there's no parameters around it.
• 3:55
  SPEAKER_00: So if I'm like, hey, do a squat, you know, it's all gonna be based on their situation, what they feel comfortable with.
• 4:01
  SPEAKER_00: Maybe I'm telling them to do a box jump, or maybe I'm telling them to do some acceleration drills where they're taking off.
• 4:08
  SPEAKER_00: So these are all movements that we will incorporate with our ACL rehab.
• 4:12
  SPEAKER_00: And so one of the things that I always recommend, and going back to our previous episode, the mechanics, consistency, then the intensity.
• 4:22
  SPEAKER_00: And so going to this concept and using it, instead of doing any of these movements full speed, see if there's a way you can start with a very, very low dial and slowly turn it up.
• 4:34
  SPEAKER_00: So imagine the zero to a hundred type mentality, and you at zero is not moving, right?
• 4:40
  SPEAKER_00: You're on the couch chilling, not doing anything.
• 4:43
  SPEAKER_00: 100 is all you got, the best movement and max intensity, max weight, max speed.
• 4:50
  SPEAKER_00: The thing about ACL rehab is that we are trying to learn so much about our body again.
• 4:55
  SPEAKER_00: We're trying to learn how to move, how to do it consistently, and to be able to be confident in it.
• 5:00
  SPEAKER_00: And when we add a lot of weight or load or any type of speed to it, that can get kind of lost because we're just trying to execute the movement, and sometimes how we do it or where we feel it doesn't matter as much.
• 5:14
  SPEAKER_00: And so when you take this dial type mentality, or you can even think of it as like kind of like that dimmer switch that I've talked about, where you're slowly brightening up the light instead of an on and off, that's gonna be really crucial here, and it can help you to get confident in movement, something that we really struggle with in ACL rehab.
• 5:34
  SPEAKER_00: I remember in my own movements, I would kind of jump the gun and I would try to really try to execute the movement instead of really focusing on how to do it well because we just want to, at the end of the day, be ourselves, move as well as we can, and kind of just get back to the activities and sports.
• 5:51
  SPEAKER_00: We don't really care necessarily about training as much as what that is the vehicle to.
• 5:56
  SPEAKER_00: But with ACL and rehab, we got to slow things down and we got to build back from the foundations and up.
• 6:04
  SPEAKER_00: So, why use this turn dial style mentality?
• 6:08
  SPEAKER_00: And it allows us to build, build good mechanics and technique.
• 6:12
  SPEAKER_00: So, think about if someone's doing a squat instead of doing 10 really fast, you do a tempo, it'll allow us to notice any type of compensations, it'll allow you to key in on the pain a little bit more, and then it'll allow you to build up the rhythm, build up the coordination of the movement, that consistency that we're talking about, and then build up the confidence ultimately to execute it, especially when we start to add load and speed to it, and that'll be super, super key.
• 6:42
  SPEAKER_00: So, a great example of this is that when I start working and integrating things with a lot of athletes, jumping tends to be very daunting.
• 6:50
  SPEAKER_00: I know a lot of you listening, you're probably like, I'm never gonna jump, or I'm terrified to jump.
• 6:55
  SPEAKER_00: So there has to be some sort of bridge in order to get you there.
• 6:59
  SPEAKER_00: It doesn't need to be this massive box jump in order to make it happen.
• 7:03
  SPEAKER_00: Instead, what I want you to think about is this small little progression to get you towards maybe the bigger box jump that you want to get to.
• 7:11
  SPEAKER_00: But we got to make sure that we build it up slowly and consistently.
• 7:16
  SPEAKER_00: So, a great example of jumping is what we'll do is we'll slow down the intensity, we'll even just kind of work through the movements, through the pattern of it.
• 7:25
  SPEAKER_00: We'll work through the finish position, we'll work through the start position, and then we will make sure the patterning of it feels very consistent and solid of where we want to be, and then we'll start to slowly add up the intensity, and in this case it would be speed.
• 7:41
  SPEAKER_00: So, what I'll say is instead of going all max effort, how about we just do a nice and easy jump to a lower platform?
• 7:49
  SPEAKER_00: And then what we can do is slowly ramp up that dial over time.
• 7:53
  SPEAKER_00: So instead of it being, let's say at 25%, we're gonna move towards 50% and then 75%, and then eventually at 100%, if the comfort and the positions and everything looks really good, and so instead of feeling like you got to go all out on that first movement, let's make sure we ramp it up or slowly turn up that dial.
• 8:15
  SPEAKER_00: And so anything that might seem a little bit more like we need some coordination or you know, the positions that may feel almost a little riskier, if we take this type of approach, then you can slowly see, okay, I'll go 50%, 60%, 70%.
• 8:32
  SPEAKER_00: Turning that dial up slowly with each and every single rep will help a ton.
• 8:37
  SPEAKER_00: And the same thing happens when we talk about these other categories, not just speed or intensity, but let's take this for the example of putting load or weight on a bar or some sort of movement.
• 8:49
  SPEAKER_00: You could slowly turn that up instead of feeling like you gotta, like I had an athlete the other day who was like, I bugged my knee out, and I asked him, Well, did you warm up or do this?
• 8:57
  SPEAKER_00: He was like, No, I put a hundred pounds on the leg extension machine and went hard on it on the first rep.
• 9:03
  SPEAKER_00: And I was like, dude, let's warm it up a little bit and like do some build-up sets in order to get there.
• 9:10
  SPEAKER_00: And then the next time he went in and did it, he was like, Oh, that felt much better.
• 9:14
  SPEAKER_00: And I was like, Yeah, there's lots of value to building up to the actual working sets or the intensity you want to be at, and that's again using this turn dial in order to get there.
• 9:26
  SPEAKER_00: Another thing that I want to throw in there is the range of motion.
• 9:30
  SPEAKER_00: So this could be looked at a little differently.
• 9:32
  SPEAKER_00: So, with let's say at the beginning of your ACL rehab, you're learning to squat or even do lunges, um, certain positions where the depth of it will play into executing the movement.
• 9:45
  SPEAKER_00: So, at first, squatting is difficult because we got to load the knee.
• 9:48
  SPEAKER_00: A lot of times we'll start with like something like a mini squat with your hand assisted, and then hopefully start to move towards like a target, like a box or a chair.
• 9:56
  SPEAKER_00: And then eventually, as range of motion comes along, strength comes along, you're hoping to get deeper towards your normal squat.
• 10:02
  SPEAKER_00: Same thing with like a split squat or a lunge, you start up pretty high, and then you're gonna slowly start to lower.
• 10:10
  SPEAKER_00: And this is using that intensity dial.
• 10:12
  SPEAKER_00: So if you imagine zero kind of being standing, and then 100% is the bottom position of where you want to be, then you can modify this and still get a very good outcome from this from a strength standpoint by only going 25%.
• 10:28
  SPEAKER_00: And then as the strength and the range of motion comes along, the confidence in the movement, you can learn to increase the depth, and that's gonna be essentially turning that dial more towards 100 because you're getting towards your 100% range of motion or self, and that's gonna be another good guide or a good rule of thumb.
• 10:48
  SPEAKER_00: And so we do this for all of our athletes as progressions, and then let's say something's bothering you and your knee is really bugging out, and the full depth or even the half depth is bothering you, then maybe it's something where you only go to 30% or a quarter of the depth, and that way you could still get a little bit of an effect and you're still doing the movement instead of just you know putting up all of your weights and then instead going to sit on the bike for 30 minutes, you can still get something out of it, and that's all gonna be based on the gray area as opposed to the do it or don't do it all or nothing mentality.
• 11:25
  SPEAKER_00: So whether you're going to start squatting, deadlifting, lunges, step ups, any movements in the gym, a good example is a leg extension, maybe full zero to 90 degrees is not going to feel comfortable for you.
• 11:40
  SPEAKER_00: Go for 90 to 45 degrees, only do the half arc.
• 11:44
  SPEAKER_00: That's a 50% on this turn dial, but you're still gonna get an effect from it, and that's still a way to use this.
• 11:51
  SPEAKER_00: But overall, if you can apply this to your strength movements, to your rehab, and then especially towards your dynamic movements where intensity might be something that is gonna be needed to develop more strength and power and some of the elastic capabilities that we're looking for, that's gonna be super key in terms of being able to use this intensity dial or this dial in general, in order for you to be able to progress, and more so build the confidence and be able to do it really well repetition after repetition.
• 12:26
  SPEAKER_00: So remember that remote control or the radio button or the DJ mix table with these dials on it, and they have these different categories, whether it's range of motion, the number of reps you do, maybe it's the weight or the speed, the intensity of it.
• 12:42
  SPEAKER_00: You can remember that there's a zero to a hundred, and that will help so much to slowly ramp up as opposed to going literally zero to a hundred, which I see a lot of times, and then it can make a movement really daunting.
• 12:55
  SPEAKER_00: So find the gray in that that will help a ton in building up the confidence in movements.
• 13:02
  SPEAKER_00: And if you have any questions, you know where to find me.
• 13:06
  SPEAKER_00: Alright, gang, short and sweet.
• 13:08
  SPEAKER_00: That's what I promised you.
• 13:09
  SPEAKER_00: So that's where we're at today.
• 13:12
  SPEAKER_00: Episode 73, mechanics, consistency, intensity, building on to today, using your dial in your ACL rehab.
• 13:21
  SPEAKER_00: If you guys can lock these two in, it will make a massive, massive difference in your recovery.
• 13:27
  SPEAKER_00: And even if something comes your way, you'll be able to pivot and not feel like you just gotta throw in the towel.
• 13:33
  SPEAKER_00: All right, team, thanks for hanging out with me today.
• 13:36
  SPEAKER_00: This is your host, Robbie Patel, signing off.