Latest / The ACL Athlete Podcast / 272 | Using AI in ACL Rehab: What It Can Actually Do For You (And Where It Starts to Break Down) - Part 1

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272 | Using AI in ACL Rehab: What It Can Actually Do For You (And Where It Starts to Break Down) - Part 1 · 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: Robbie 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.
1:00
SPEAKER_00: Hey, what is up everyone?
1:02
SPEAKER_00: Welcome back to the ACL Athlete Podcast.
1:05
SPEAKER_00: If you're new, I'm your host, Robbie Patel, performance physical therapist, ACL, all things that are my life, and a two-time ACL athlete myself.
1:17
SPEAKER_00: So before we get into today's episode, I just want to say thank you.
1:22
SPEAKER_00: Genuinely.
1:23
SPEAKER_00: This show has grown in ways I did not expect.
1:28
SPEAKER_00: And a big part of that is you sharing it, leaving reviews and sending messages about how it has helped you navigate your rehab.
1:35
SPEAKER_00: That means a lot to me, and it keeps me coming back every week to do this.
1:41
SPEAKER_00: And so this is episode 272.
1:45
SPEAKER_00: So 272 straight weeks of doing this podcast, and I have not stopped and don't plan to.
1:53
SPEAKER_00: And today, this is what I'm really excited about.
1:56
SPEAKER_00: This is something I've been thinking about a lot, and just something that I do want to share with you guys because I think it's important.
2:04
SPEAKER_00: And we're just gonna start something a little different.
2:07
SPEAKER_00: This is gonna be the part one of a two-part series, and this topic is one that I really have been sitting on for a while, but I wanted to do it right.
2:19
SPEAKER_00: We are talking about AI, artificial intelligence.
2:24
SPEAKER_00: We are here, we are there.
2:26
SPEAKER_00: Specifically, AI and ACL rehab, how athletes are using it, how parents or other supporting roles like husbands, wives, friends, anybody who might be supporting an ACL or might be using it, how clinicians and coaches are using it, where it actually helps, where it starts to go sideways.
2:47
SPEAKER_00: And in part two, we are going to get into the hard lines of using AI.
2:53
SPEAKER_00: The places where AI has no business being the decision maker.
2:58
SPEAKER_00: You know, I'm going to share exactly how we use it at the ACL athlete and why.
3:02
SPEAKER_00: So this is not a tech episode.
3:04
SPEAKER_00: I'm not going to geek out on the language models or talk about the future of medicine in this sense.
3:10
SPEAKER_00: Although it is going to get really, really crazy with the way that AI is going to evolve and the way that it's going to be used.
3:17
SPEAKER_00: This is a practical episode.
3:19
SPEAKER_00: And by the end of part two, you're going to have a three question filter you can use every single time you reach for AI, whether you're going to Chat GPT, you're going to Claude, whether you're going to Gemini, Grok, whatever model you might be using to ask questions to, it might be typing it into Google, right?
3:38
SPEAKER_00: Because Gemini runs Google.
3:40
SPEAKER_00: And so then, therefore, that might be something that you pull and you use the AI summary at the top or the resources.
3:47
SPEAKER_00: But anytime you reach for AI to have something answered, especially about your knee, your rehab, this process, these questions are going to be helpful and it's going to be worth your time.
3:59
SPEAKER_00: I promise.
4:00
SPEAKER_00: And so this is something that I think is just going to be very, very, very, very important for ACL rehab, for healthcare, for medicine, just the way that the world is going.
4:13
SPEAKER_00: And as much as I would love to say that it's going to be a pastime thing, it is here to stay.
4:20
SPEAKER_00: And I stay very updated in this world in terms of just world economics, in terms of what's going on in the AI space.
4:28
SPEAKER_00: I try to stay up to date on things.
4:30
SPEAKER_00: And it is crazy how much this is compounding right now in terms of the use of it and how much it is just being embedded into every single thing we do.
4:40
SPEAKER_00: Every single thing.
4:41
SPEAKER_00: And whether you know it or not, it is being embedded into a lot of what is happening in the world.
4:46
SPEAKER_00: So let us get into it.
4:49
SPEAKER_00: So here's what really prompted this.
4:51
SPEAKER_00: Over the past year or two, I have noticed something shifting in how athletes, parents, and even clinicians show up to their first conversation about ACL rehab.
5:03
SPEAKER_00: They come in more prepared than they used to.
5:06
SPEAKER_00: They have already read their MRI reports, for example.
5:10
SPEAKER_00: They know what graph type they might be getting if they're planning for surgery.
5:14
SPEAKER_00: You know, sometimes they might not be.
5:15
SPEAKER_00: They might be just kind of deciding, but it seems like they're more informed about this or have opinions about this versus just purely asking questions.
5:24
SPEAKER_00: And yes, they have a list of questions about their timeline.
5:28
SPEAKER_00: Some of them have already been on training programs that they may have done themselves, right?
5:34
SPEAKER_00: Or they put together resources, put together Instagram videos, YouTube resources, and they put it together and they try to do it themselves.
5:42
SPEAKER_00: And my first thing here is that I'm not going to fault anyone on this.
5:46
SPEAKER_00: I understand taking things into your own control.
5:48
SPEAKER_00: I think it's really important because of healthcare being very messy and not very proactive in this sense.
5:55
SPEAKER_00: It is a very basic process and a lot of gaps and cracks exist.
5:59
SPEAKER_00: And so I understand that also there's financial constraints, there's concerns about trusting other people.
6:06
SPEAKER_00: So there's a lot that goes on with this.
6:08
SPEAKER_00: So people are trying to be a little bit more intentional because we also have just so much information at our fingertips.
6:16
SPEAKER_00: And when I ask these people where they got their information, especially more recently, the answer is almost always some version of, you know, I put it into Chat GPT or I searched it and got an AI answer.
6:30
SPEAKER_00: Maybe they use Reddit or Facebook groups, which also could be very common.
6:34
SPEAKER_00: But then they may have scraped information from those places and used an answer from AI, or maybe they used Claude, or I found this podcast through an AI search result.
6:48
SPEAKER_00: And that is the world we are operating in now.
6:52
SPEAKER_00: AI is not coming, it is here, as I shared, and I think the worst thing I could do is pretend it is not, or just tell you to stay away from it.
7:01
SPEAKER_00: That is not realistic, and honestly, that is not even the right call, especially with where we're at.
7:06
SPEAKER_00: So instead, I want to help you use it well because there is a real difference between using AI in a way that makes your recovery better and using it in a way that quietly works against you.
7:18
SPEAKER_00: And most people do not know where that line is, and we have to be very, very careful about this.
7:25
SPEAKER_00: And here's the thing that no one else really talks about.
7:29
SPEAKER_00: AI is trained on the internet, all of it.
7:32
SPEAKER_00: And the ACL content on the internet is overwhelmingly generic, protocol driven, and time-based.
7:40
SPEAKER_00: Six weeks for this, three months for that, nine months, and you're cleared, right?
7:45
SPEAKER_00: If you have listened to this show for any amount of time, you already know that is the framework that keeps failing athletes.
7:53
SPEAKER_00: Re-indjury rates are not improving, return to performance is at its lowest.
7:58
SPEAKER_00: Athletes are still being cleared by time instead of readiness.
8:02
SPEAKER_00: The criteria-based performance-driven approach that actually changes outcomes is underrepresented in the content that AI learns from.
8:11
SPEAKER_00: And that is so important, y'all, because these large language models, essentially, what these AI models are built off of, it's built off of information that it's fed, right?
8:22
SPEAKER_00: Tons, billions and billions of information all across the internet, things that it's pulling from, it is pulling from these things in order to gather a consensus of what it's going to share.
8:34
SPEAKER_00: And it depends on how deep you go, how long it processes information, what resources it pulls, whether it's contained in a certain area that you allow it to research from, or is it just open to the full world wide web?
8:47
SPEAKER_00: Is it pulling from social media, YouTube?
8:50
SPEAKER_00: There's so many different things that it's going to pull from.
8:53
SPEAKER_00: And we just have to know if you guys just I challenge you to go into Google and just type in ACL protocol or ACL rehab.
9:03
SPEAKER_00: You will see all the generic hospitals and you know different orthopedic centers, just general stuff pop up.
9:11
SPEAKER_00: It's the kind of WebMD type stuff that you typically see that you'll see pop up.
9:16
SPEAKER_00: Now they're starting to become more kind of specific resources depending on what you're searching.
9:22
SPEAKER_00: But in general, that is still going to be the thing that Google puts as priority because of the SEO search engine optimization.
9:30
SPEAKER_00: And so it's going to put all this stuff together to give you what you're searching for.
9:35
SPEAKER_00: So that's where we have to be very careful is the resources that it's pulling from in terms of the information that we're getting out of it, right?
9:45
SPEAKER_00: So when you are asking AI an ACL-based question, in a lot of cases, you're getting back the average of a generally like broken system, if you will.
9:56
SPEAKER_00: It's not necessarily the best resources, top-notch things.
10:01
SPEAKER_00: Yes, it might pull things from an aggregate, so then therefore you're gonna get some things that are helpful.
10:08
SPEAKER_00: We just have to be careful where this is coming from.
10:10
SPEAKER_00: And it can sound really good, it can sound very convincing, if you will, because it's very, very, very smart.
10:17
SPEAKER_00: But the thing is, is that this is not a small problem.
10:21
SPEAKER_00: This is the starting point for this entire conversation.
10:24
SPEAKER_00: And one more thing before we get into the tiers that I want to discuss today.
10:28
SPEAKER_00: I want to address the three different people listening to this right now because this episode is for all of you.
10:35
SPEAKER_00: If you're an ACL athlete in the middle of your recovery, maybe you're just starting the journey, you're just had an injury, you're gathering information, maybe you might be at the end of this, or maybe you are someone who is in a complex path that is one year out, two years out, years out, right?
10:53
SPEAKER_00: This is something where it's going to be super helpful for you.
10:58
SPEAKER_00: If you're a parent, a partner, a teammate, someone who loves an athlete who's going through this process and you're trying to help, this is also for you.
11:06
SPEAKER_00: And if you're a physical therapist, a performance coach, a strength coach, a clinician in general working with ACLers, this is also for you, too.
11:17
SPEAKER_00: Actually, part two is especially going to matter for how you think about your practice and what you're doing.
11:22
SPEAKER_00: But let me walk you through this framework because I'm really excited to share this.
11:26
SPEAKER_00: I think it's something very important.
11:29
SPEAKER_00: And we are going to cover three tiers.
11:31
SPEAKER_00: Tier one is where AI actually helps you.
11:34
SPEAKER_00: Tier two is where it actually starts to get risky.
11:38
SPEAKER_00: And part two, the next episode is tier three, which is the hard stuff, the places where AI should never be making the call.
11:47
SPEAKER_00: Plus, the three question framework you can keep forever that's going to help you with navigating through AI and searching and using it as a resource.
11:57
SPEAKER_00: And inside each tier, I'm going to give you a filter question, a simple thing to ask yourself before you use AI for something.
12:06
SPEAKER_00: So you're not just learning categories, but you actually have something that you can apply.
12:11
SPEAKER_00: Now, before we fully get into it, I do want to say that because the world is changing, that I have the right to reserve anything that I say in this series.
12:21
SPEAKER_00: Because this is something that we are in 2026, the early parts of it.
12:25
SPEAKER_00: And so this is something that you know we could be in a different place if you're listening to this.
12:30
SPEAKER_00: And later this year, 2027, 28, 29, who knows, in the 2030s, it's weird to think about.
12:38
SPEAKER_00: But there could be a lot of things that change.
12:40
SPEAKER_00: So, of course, there could be maybe a change over the years, and maybe my stance on this.
12:45
SPEAKER_00: And if that's the case, I will come back and I will share my experience because I think it's important to change with what information comes along.
12:54
SPEAKER_00: But I think that overall, with where we are today, a lot of this will really be based on principles, and a lot of this will be something that you can take with you for years and years to come.
13:06
SPEAKER_00: Now let's do this.
13:07
SPEAKER_00: The filter question for this tier, where AI actually helps you, is this.
13:14
SPEAKER_00: Am I using AI to get smarter and more prepared, or am I using it to make a clinical decision?
13:22
SPEAKER_00: If the answer is the first one, you're probably in good territory.
13:26
SPEAKER_00: This is AI doing what it genuinely is good at, helping you show up better for the humans who are actually responsible for your care.
13:35
SPEAKER_00: Let me walk you through the specific use cases, and I'm going to do this for each of the three audiences.
13:40
SPEAKER_00: For the ACL athlete who I know this is primarily for.
13:44
SPEAKER_00: The first one is understanding your diagnosis.
13:46
SPEAKER_00: You just got out of an appointment, your MRI report says something like complete rupture of the anterior cruciate ligament with bone contusion of the lateral femoral condyle and posterior tibial plateau.
13:58
SPEAKER_00: Your surgeon spent four minutes with you and moved on to the next patient.
14:02
SPEAKER_00: You're in the parking lot with a piece of paper and no idea what any of this stuff means.
14:07
SPEAKER_00: And this is, you know, fire hose in the face, right?
14:10
SPEAKER_00: You just had a major injury, you can't move, your knee hurts, and you're trying to process through what just happened.
14:16
SPEAKER_00: You're like, what the heck is an anti-acruciate ligament?
14:18
SPEAKER_00: And you might not even connect that that's the ACL until the surgeon says so, or you look it up.
14:23
SPEAKER_00: But this is something that is just coming at you a million miles a minute.
14:27
SPEAKER_00: And this is something where it's genuinely a great use of AI.
14:31
SPEAKER_00: You can paste that exact report into your AI model, whether it's Claude or ChatGPT or Gemini, and say, explain every term in plain language.
14:41
SPEAKER_00: Ask what the bone contusion means for your recovery.
14:44
SPEAKER_00: Ask what structures are involved and why it matters.
14:48
SPEAKER_00: What are the implications?
14:49
SPEAKER_00: What's the long-term outcomes to this?
14:52
SPEAKER_00: Ask whether the findings are what is typically seen with this injury or whether anything stands out.
14:58
SPEAKER_00: AI is functioning as a translator here.
15:00
SPEAKER_00: It is not making decisions for you, it is helping you understand what is actually happening in your body.
15:06
SPEAKER_00: So then that way when you sit down with your surgeon or your physical therapist, you have, you can have real conversations instead of nodding along to things you do not understand.
15:17
SPEAKER_00: And this is the biggest thing that I see is that patients will go in to their surgeon's office, they'll talk a bunch of gibberish, medical terminology, they won't break it down simply, and then they just leave being like, I okay, let's do this.
15:33
SPEAKER_00: But it's just someone with authority, with confidence coming in saying all these complicated things, and they're just like, I don't even know what's going on.
15:40
SPEAKER_00: And it's challenging because you don't also want to, you know, you kind of feel rushed.
15:45
SPEAKER_00: You don't necessarily want to ask these questions, you want to feel dumb.
15:49
SPEAKER_00: So it's all these things that people feel internally and they just kind of nod their head along.
15:53
SPEAKER_00: And so this is something that's so helpful in the sense of like being able to just make things in plain terms in order to understand, you know, what is going on, what is my imaging showing?
16:03
SPEAKER_00: You know, what does this mean of this radiologist reporting the MRI, right?
16:07
SPEAKER_00: The second use case is preparing for your surgical consultation.
16:11
SPEAKER_00: Most athletes walk into the surgeon's office completely cold.
16:14
SPEAKER_00: They do not know what questions to ask, they do not know what graph choice is something that they have to have real input on.
16:20
SPEAKER_00: A lot of times surgeons will just kind of assert they're like, this is what you should get.
16:24
SPEAKER_00: I'm not saying that's a bad thing, but I think it's very important to understand that surgeons look through a lens of their bias of what they prefer to do versus providing options, you know.
16:35
SPEAKER_00: So that is going to be something that is going to be very, very important in a case like this where a lot of times I will have calls with people and they will say, I didn't know I had a choice.
16:45
SPEAKER_00: They just told me to get the quad graft.
16:47
SPEAKER_00: They told me to get the hamstring graft.
16:50
SPEAKER_00: I didn't know it was a choice until after.
16:53
SPEAKER_00: And a lot of times people are like, I wish I would have just like known that so I could have maybe looked at a few different surgeons and maybe went a different route, especially people who are just struggling with maybe the choice that they made, right?
17:07
SPEAKER_00: And I think that that's really important that you need to be educated prior to making these decisions versus just nodding your hell your head saying yes, or just trusting them, or you know, word of mouth saying, like, oh, they're great, you know, just go with them, right?
17:21
SPEAKER_00: They're the pro team surgeon, they're awesome.
17:24
SPEAKER_00: These same athletes do not know that asking a surgeon about their ACL surgical volume, their philosophy on return to sport criteria, and their approach to potentially your graph selection for your specific demands is completely appropriate.
17:38
SPEAKER_00: It's not something that's being pushy or just like, how dare you ask this?
17:42
SPEAKER_00: It's necessary.
17:44
SPEAKER_00: Y'all, this is a major procedure.
17:46
SPEAKER_00: This is the biggest thing for some people in terms of surgery that they will have in their lives.
17:51
SPEAKER_00: It will influence them getting back to sport, potential re-injury, getting their strength back, and most importantly, being able to do the things they care about in a certain time frame, and then also just making sure that from a metabolic disease standpoint, they don't stop being as active because they just didn't have a good surgeon or good rehab.
18:11
SPEAKER_00: And so all this stuff is very important, and you're not just you know stepping on toes or being someone who's being extra.
18:18
SPEAKER_00: This is the standard, it should be the standard.
18:22
SPEAKER_00: And so this is something that's really important in terms of being able to fill out these surgical consultations because it's like buying a house, right?
18:31
SPEAKER_00: Like we're trying to decide like, okay, do we just pick the first house we go and see?
18:36
SPEAKER_00: Absolutely not.
18:37
SPEAKER_00: You're gonna go and see a few houses if you're buying a house to see what your options are, and you're filtering through different factors that are gonna influence the decisions that you're making.
18:47
SPEAKER_00: AI can help you build this question list or at least like filter through what you need to talk through before you walk in the door.
18:55
SPEAKER_00: Ask it what are the most important questions to ask my orthopedic surgeon before ACL reconstruction.
19:00
SPEAKER_00: You're going to get a solid starting point, then bring those questions into the room with the actual human who can answer them based on your imaging, your anatomy, and their clinical judgment.
19:11
SPEAKER_00: Here's a concrete example of this.
19:14
SPEAKER_00: Ask AI to explain the difference between a patellar tendon graft, a hamstring graft, and a quad tendon graft, and an allograft in plain language.
19:25
SPEAKER_00: What are the trade-offs?
19:27
SPEAKER_00: What populations tend to do better with each?
19:30
SPEAKER_00: Use that as your foundation going into the console.
19:33
SPEAKER_00: Then when your surgeon recommends one, you can ask why that one for you specifically.
19:39
SPEAKER_00: That is a more useful conversation than just showing up and saying, okay, that sounds good, right?
19:45
SPEAKER_00: Because again, this is such an important decision that a lot of times people they just don't know.
19:52
SPEAKER_00: And it's not to your own fault, it's just something that is just so challenging because this world in and of itself is so complicated.
20:00
SPEAKER_00: And y'all, I've spent my life mission to dedicate to ACL injuries, surgeries, rehab, returning to sport, all the things.
20:09
SPEAKER_00: And majority of physical therapists have no idea how to answer most of these questions, to be honest.
20:17
SPEAKER_00: We go to school and we're trained on the human body, rehab, you know, you want to say return to sport and these things.
20:23
SPEAKER_00: Like we learn this stuff.
20:24
SPEAKER_00: We are the rehab providers of this, and I would say majority of physical therapists can't answer these questions.
20:30
SPEAKER_00: So I'm not expecting for ACLers to get injured and all of a sudden know the answers to these.
20:36
SPEAKER_00: So we need to equip and educate ourselves in terms of what these are and how to ask the right questions, especially for someone who is going to go in and change the architecture of your knee.
20:48
SPEAKER_00: That is gonna be really important because it's gonna really impact the long-term outcomes of what things are gonna look like.
20:55
SPEAKER_00: And the other thing that I'm just gonna add here is that we also have a document where it's asking certain questions of surgeons, the top questions.
21:05
SPEAKER_00: So that is something in our resources that is on our website.
21:09
SPEAKER_00: So if you go to the ACL athlete and go to resources, they're the top surgeon questions that ask them.
21:15
SPEAKER_00: And guess what?
21:16
SPEAKER_00: You could take that and you could also build off of that and be like, okay, what are some specific things that I can talk about or ask based on these questions that I have gotten from the ACL athletes, and you can have a starting point and start to educate yourself on some of these things, right?
21:33
SPEAKER_00: The third thing I want to talk about is decoding clinical language after appointments.
21:38
SPEAKER_00: Your physical therapist tells you your quad index is 68% and you need to hit 90% before you progress.
21:46
SPEAKER_00: You nodded, you had no idea what they meant.
21:49
SPEAKER_00: To be honest, y'all, your physical therapist should always explain this in very simple language.
21:54
SPEAKER_00: Every single one of our athletes knows exactly what LSI and quad index, if they see a percentage, they should know exactly what.
22:00
SPEAKER_00: Exactly what that means, specific to them.
22:02
SPEAKER_00: That's just a side note.
22:04
SPEAKER_00: You should always have your PT explain that.
22:06
SPEAKER_00: But let's say you have someone who just kind of throws this stuff at you, more medical jargon, doesn't break it down in simple terms.
22:12
SPEAKER_00: AI can help explain limb symmetry index, what it measures, why it matters more than you know, weeks post op, what the research says about the relationship between quad strength and re-injury risk, what the gap between 68 and 90% actually means in practice.
22:29
SPEAKER_00: And I can also tell you the pitfalls of what using limb symmetry index can be, right?
22:35
SPEAKER_00: Comparing one weak limb to another weak limb can be challenging because we have two weak limbs that we're comparing to each other.
22:43
SPEAKER_00: The percentages look great, but at the same time, it's not necessarily going to be accurate because they're both essentially like semi-flat tires, if you will.
22:51
SPEAKER_00: And I know some people throw a shade at the flat tire analogy, but it is helpful to visualize versus one full tire and one that's maybe half full, if you will.
23:00
SPEAKER_00: That understanding changes how you approach your training when you understand these things.
23:05
SPEAKER_00: Like, oh, I have a difference of you know 22%.
23:08
SPEAKER_00: I need to get this up.
23:10
SPEAKER_00: You're not chasing a timeline anymore, you're actually chasing a specific target, and that shift matters, especially for the ACLR.
23:18
SPEAKER_00: Fourth, understanding the psychological side of recovery.
23:22
SPEAKER_00: This one is underutilized, and I think it's because most athletes do not know it is a legitimate thing.
23:28
SPEAKER_00: It's called kinesiophobia, which is a fear of re-injury.
25:38
SPEAKER_00: It's one of the most documented and under addressed parts of ACL rehab.
25:43
SPEAKER_00: Athletes who score higher on fear of movement measures have worse return to sport outcomes regardless of their physical metrics.
25:51
SPEAKER_00: That is in the research.
25:53
SPEAKER_00: It is not an opinion.
25:54
SPEAKER_00: I've studied this a lot.
25:56
SPEAKER_00: There's a lot of fear of re-injury and correlation between returning to sport.
26:01
SPEAKER_00: And y'all, it's real.
26:03
SPEAKER_00: Even if you're hitting physical metrics, it's real.
26:06
SPEAKER_00: Like there is a lot of fear there.
26:08
SPEAKER_00: And until you go through it, and especially if you go through it twice, that this heightens even more.
26:14
SPEAKER_00: When you injure it once, you're like, okay, maybe it was a one-off.
26:17
SPEAKER_00: When you injure it a second time, whether it's the same side or the other side, that heightens more.
26:22
SPEAKER_00: The fear of reinjury.
26:23
SPEAKER_00: So that can influence essentially people getting back to their sports and activities.
26:29
SPEAKER_00: So that is something that's really important.
26:31
SPEAKER_00: Most athletes going through this do not know that.
26:34
SPEAKER_00: They think that they are being mentally weak when they feel anxious about loading their knee or getting back to sport.
26:41
SPEAKER_00: They think that something is to push through and not talk about necessarily.
26:46
SPEAKER_00: And that is way too common in this process, which I hate, but is something that really kind of takes to the side is the mental and psychological side and a lot of the physical focus.
26:57
SPEAKER_00: And don't get me wrong, it's a physical rehab.
26:59
SPEAKER_00: I get it.
27:00
SPEAKER_00: But the mental side of this is way harder than the physical side ever is.
27:05
SPEAKER_00: And I can promise you that.
27:07
SPEAKER_00: And this is talking to all my ACLers, our team, myself going through this.
27:11
SPEAKER_00: It is just so hard, y'all.
27:13
SPEAKER_00: And it's something that we need to make sure that we keep front of mind for our ACLers to make sure that this is both moving in the right direction mentally, psychologically, and physically, right?
27:26
SPEAKER_00: And emotionally, you know, but especially these, we've got to make sure that we are moving these in the positive direction.
27:33
SPEAKER_00: The thing is that AI can help clearly explain some of this stuff.
27:38
SPEAKER_00: It can normalize it, it can help an athlete understand why the psychological side deserves the same attention as the quad strength, for example, and why showing up to that part of their recovery is not optional.
27:49
SPEAKER_00: That is genuinely valuable.
27:53
SPEAKER_00: Fifth thing that I want to touch on is navigating the healthcare system.
27:59
SPEAKER_00: And y'all know how I feel about this.
28:01
SPEAKER_00: Healthcare system, I'm not gonna go on tangents here.
28:05
SPEAKER_00: I'm just gonna try and stick to the point because this episode is already long enough.
28:09
SPEAKER_00: This is the one that is an underrated use case on this list.
28:13
SPEAKER_00: The system is so freaking confusing.
28:15
SPEAKER_00: Insurance is confusing.
28:18
SPEAKER_00: Most athletes do not know how to work it and they get lost.
28:21
SPEAKER_00: What is your deductible?
28:23
SPEAKER_00: What is your added network cost?
28:25
SPEAKER_00: Is my surgeon in network?
28:27
SPEAKER_00: Is my PT in network?
28:29
SPEAKER_00: There's just so much confusion, and it's all across the world, right?
28:34
SPEAKER_00: Like different healthcare systems, even socialized healthcare, like it's messy.
28:39
SPEAKER_00: And so then, therefore, this could be something that can really help you to understand how to lay things out and just understand and educate yourself.
28:47
SPEAKER_00: It can help you to know what insurance should cover, what an appeal process looks like when your PT visits get cut off before you are ready.
28:55
SPEAKER_00: And y'all, it happens all the time.
28:58
SPEAKER_00: I have seen where someone who was four weeks post op got cut off from their insurance.
29:05
SPEAKER_00: Even though they were allowed 60 visits, they had maybe like six visits already.
29:10
SPEAKER_00: And I saw someone get cut off from their insurance.
29:12
SPEAKER_00: They stopped allowing them to submit to insurance and cover it.
29:16
SPEAKER_00: Med deductible, all the things.
29:18
SPEAKER_00: And they stopped because they were like, oh, well, they don't, it's not medically necessary.
29:22
SPEAKER_00: It's wild.
29:23
SPEAKER_00: And I will say, because of how complicated insurance and healthcare is, AI is honestly such a beneficial tool to help with this.
29:33
SPEAKER_00: You can blur out your name, you can blur out your ID information, don't put any personal sensitive information on these platforms, but just give it your deductible, give it what your plan is.
29:45
SPEAKER_00: It can look this stuff up and give you more information on like, okay, well, this is what this looks like.
29:51
SPEAKER_00: And if you need to appeal for something, it can build you out like an appeals process letter.
29:57
SPEAKER_00: It can talk to you about like how you talk to your PT.
30:00
SPEAKER_00: You can give your PT the appeals process letter to help them move along with things.
30:05
SPEAKER_00: It's just gonna be super helpful because there's a chance that it gets cut off or it it cuts you short.
30:11
SPEAKER_00: And the thing is, is that you know, the another thing that could be used is like what it means to be clinically cleared versus actually cleared, right?
30:20
SPEAKER_00: Are you graduating or cleared from physical therapy because you ran out of visits or they can no longer help you?
30:26
SPEAKER_00: Are you actually ready and cleared because you actually graduate based on the proper criteria of what it means to return to sport and activity in ACL rehab?
30:36
SPEAKER_00: So here's a specific example.
30:38
SPEAKER_00: An athlete gets discharged from PT at four months because their insurance runs out.
30:43
SPEAKER_00: They feel nowhere near ready.
30:45
SPEAKER_00: They ask AI, what should ACL rehab include before discharge and what test should have been completed?
30:50
SPEAKER_00: They get a list.
30:52
SPEAKER_00: Might say single-leg hopping test, quad strength symmetry, movement quality assessment, psychological readiness screening.
30:59
SPEAKER_00: Their PT did not do any of those.
31:02
SPEAKER_00: Now they have the language to advocate for themselves, seek a second opinion, or go find someone who actually specializes in this.
31:10
SPEAKER_00: Also, y'all, if your PT hasn't done any of that at four months, any of this stuff, you guys need to find someone anyways.
31:17
SPEAKER_00: Like that's it's ridiculous.
31:19
SPEAKER_00: But this is AI helping someone access better care.
31:23
SPEAKER_00: That is a good outcome in a situation like this.
31:27
SPEAKER_00: Next, I want to talk about for the parent and the supporting role.
31:30
SPEAKER_00: This is super short, but the first 48 hours after a diagnosis are pure chaos, especially for my parents.
31:37
SPEAKER_00: I feel you guys so much.
31:38
SPEAKER_00: It's hard, it's tough.
31:39
SPEAKER_00: You're trying to kind of work through this with your child, um, it's tough.
31:45
SPEAKER_00: Or maybe you're a wife or a husband or someone who is supporting, it's hard.
31:49
SPEAKER_00: You're in the parking lot or a waiting room, and you have two weeks before this first surgeon console, and no idea what you are actually facing.
31:57
SPEAKER_00: AI is the right tool for that gap.
31:59
SPEAKER_00: Not to make a decision, to get oriented.
32:02
SPEAKER_00: What does this injury mean?
32:04
SPEAKER_00: What is the general process?
32:05
SPEAKER_00: What should you be asking?
32:07
SPEAKER_00: What is realistic?
32:08
SPEAKER_00: I had a parent who had no idea what was going on in this process.
32:14
SPEAKER_00: He was a busy person.
32:16
SPEAKER_00: His daughter had already injured her ACL, went back to sport too soon, and then injured it again.
32:23
SPEAKER_00: And we got on a call together with his dad and his daughter, and they found a surgeon who can do an accelerated, this very unique ACL process that is not really proven in the research, but said that it can get her back to sport in four to six months.
32:40
SPEAKER_00: And she was about to hit four weeks post-op and she was about to start running.
32:46
SPEAKER_00: And I just wanted to scream because I was just like, there's no way in any situation for a girl under the age of 18, second ACL injury, needs to have an accelerated ACL surgery.
33:01
SPEAKER_00: Whatever surgeon promised her that is lying, currently, based on the research.
33:07
SPEAKER_00: And no athlete should be running a four months post-op ACL if it's a reconstruction.
33:11
SPEAKER_00: It just doesn't make sense.
33:12
SPEAKER_00: It doesn't make sense, y'all.
33:14
SPEAKER_00: And so the thing is, is that like the it sucks because the dad didn't know any better, but this is something that he just kind of came in asking, you know, my help in terms of like, okay, what should we do here?
33:26
SPEAKER_00: Where are we at?
33:27
SPEAKER_00: And it was a tough conversation.
33:29
SPEAKER_00: It was a tough conversation.
33:31
SPEAKER_00: And the thing is, is that it allows the parent to use AI in a situation like this to build a question list for the surgeon to understand what return to sport clearance should actually require versus what sometimes gets rubber stamped, if you will, and to understand maybe a growth plate consideration if you're navigating this with a young athlete who is still developing.
33:54
SPEAKER_00: One thing I want to say directly to parents one of the most protective things you can do for your kid right now is understand what legitimate return to sport criteria looks like.
34:04
SPEAKER_00: Because a lot of younger athletes get cleared because the calendar says so, not because they passed any objective testing.
34:11
SPEAKER_00: If you know what the process should include, you're in a much better position to ask the right questions when a surgeon says cleared in six months.
34:19
SPEAKER_00: And while I would love to say nine to 12 months is the common, it's still happening so much, y'all.
34:25
SPEAKER_00: So much.
34:26
SPEAKER_00: And especially with no testing or very minimal testing.
34:29
SPEAKER_00: And it breaks my heart, but it is just the reality.
34:32
SPEAKER_00: And this is why we have such high hyper injury rates.
34:35
SPEAKER_00: So we have to be informed, we have to be educated, and I think this is a place where we could help set a better foundation.
34:44
SPEAKER_00: That way you can ask better questions, be more informed, and say no when you need to.
34:48
SPEAKER_00: Or let's get a second opinion, or let's go find someone who actually knows what this injury is, the surgery, the rehab, and getting back to actual return to sport and performance.
34:58
SPEAKER_00: Now, for the clinician and coach, a few use cases here that I want to be specific about because this is how we actually use it at the ACL athlete.
35:07
SPEAKER_00: Research support.
35:09
SPEAKER_00: You have an athlete presenting with quad inhibition that is not responding to your typical approach.
35:14
SPEAKER_00: You have 20 minutes before your next session.
35:16
SPEAKER_00: AI can give you a synthesized starting point from current literature faster than a manual pub med research lit review can do.
35:25
SPEAKER_00: You still evaluate what it surfaces and apply your judgment.
35:29
SPEAKER_00: Check the resources, look into the papers that it shows, but the starting point is faster and broader.
35:35
SPEAKER_00: This is legitimate leverage.
35:36
SPEAKER_00: Open evidence has an amazing research ability that you can use with AI to be able to look up certain things.
35:43
SPEAKER_00: And so this is something that it aggregates like a lot of the papers and evidence out there.
35:48
SPEAKER_00: And it's amazing.
35:49
SPEAKER_00: There are a lot of other ones.
35:50
SPEAKER_00: Scholar C is another one.
35:51
SPEAKER_00: There's a bunch of awesome research-based AI apps out there.
35:56
SPEAKER_00: And it allows you to be able to tackle that a bit more efficiently.
36:02
SPEAKER_00: Some things can be around patient education.
36:04
SPEAKER_00: Writing some materials can take some time, explaining why quad strength matters more than time post-op, why re-injury rates are higher than most athletes expect, why a 90% LSI is not the same as being ready.
36:18
SPEAKER_00: AI can draft some things like this or help us to make things a little bit more relatable.
36:23
SPEAKER_00: We review them, we refine them, and of course, we're going to make sure that we are being very intentional about how this can be beneficial to them, especially if we're squeezed for time and we want to make sure we could provide as much as we can for our ACLers.
36:38
SPEAKER_00: It's a workflow that helps us to just provide more value.
36:42
SPEAKER_00: Translation is another one.
36:43
SPEAKER_00: We work with athletes from all kinds of other countries.
36:46
SPEAKER_00: Getting an MRI report in German or Mandarin, like I you would be surprised at the number of MRI reports I have seen that I do not even understand the language, or a surgical note in Portuguese, right?
37:00
SPEAKER_00: And trying to interpret it accurately is a real clinical challenge for us.
37:04
SPEAKER_00: AI handles that well.
37:05
SPEAKER_00: It is not replacing the clinical judgment, it's just removing the language barrier so we can actually apply our clinical judgment.
37:13
SPEAKER_00: It might do a complex report analysis, imaging reports, surgical notes, detailed testing data.
37:19
SPEAKER_00: AI helps us to work through the complex documents faster so we could focus on the clinical interpretation rather than spending 30, 45 minutes parsing through language and stuff that probably isn't relevant.
37:33
SPEAKER_00: It helps us with our coaching feedback.
37:35
SPEAKER_00: It allows us to summarize some things.
37:37
SPEAKER_00: We give people video analysis feedback and feedback about their training, about their testing, about their data.
37:43
SPEAKER_00: We're able to take detailed notes for this by being able to translate things and be able to create summaries for our athletes that are clean, that have a reference document as well that we can utilize.
37:55
SPEAKER_00: The coaching happened, the relationship happened.
37:59
SPEAKER_00: The AI is just helping us package the output more efficiently.
38:03
SPEAKER_00: Finding surgeons is another one.
38:05
SPEAKER_00: We work with athletes all over the country and internationally.
38:08
SPEAKER_00: We don't always know people in every single place.
38:11
SPEAKER_00: We have developed an incredible network, but it can be sometimes challenging.
38:14
SPEAKER_00: So then, therefore, we want to help our athletes find proper surgeons, do some research, and we're able to tease out things based on our knowledge of like maybe their backgrounds, things that they've done in certain regions.
38:28
SPEAKER_00: And AI helps us search and identify options faster sometimes.
38:32
SPEAKER_00: We still vet those recommendations, of course.
38:34
SPEAKER_00: It's not a blind, like, okay, here's what you know this AI provided for us.
38:38
SPEAKER_00: Now go, right?
38:39
SPEAKER_00: Like we're still gonna vet these, we're gonna look into the details, but the search is faster, and it's crazy how much helpful it is.
38:45
SPEAKER_00: And there's a lot more here.
38:47
SPEAKER_00: The through line across all of those is this.
38:51
SPEAKER_00: We use AI to be more efficient so we can deliver more value to our athletes, our ACLers, our coaches, our mentees, our PTs, our clinicians we work with, our community as a whole.
39:03
SPEAKER_00: It's not to replace the important things, and that is so near and dear to my heart.
39:08
SPEAKER_00: In a place where social media is just filled with AI repeats and copy and writing, that is important to me.
39:15
SPEAKER_00: This is something that is so valuable, even with these podcasts, that I am helping to make sure that like I am creating these episodes and making sure that we are being very genuine in terms of the delivery of a lot of this information.
39:30
SPEAKER_00: We are not just using it plug and play and putting in on autopilot.
39:34
SPEAKER_00: That is so important to me as a company, as an owner, and just the values we have as a team as well.
39:42
SPEAKER_00: And so we're not replacing the important things, it's not taking shortcuts on the testing or programming or the actual coaching, big foundational pieces of what we do, the human work is still human work.
39:54
SPEAKER_00: AI just helps us to do the surrounding work faster and better.
40:00
SPEAKER_00: Here is where it starts to get risky.
40:02
SPEAKER_00: The filter question for this tier is if AI gets this wrong, what is the actual consequence?
40:08
SPEAKER_00: Wrong about what a term means and you ask your PT to clarify?
40:13
SPEAKER_00: Fine.
40:15
SPEAKER_00: Wrong about whether your symptoms are normal and you miss a red flag, that is a different situation.
40:20
SPEAKER_00: I want to talk about two failure modes before I go into the specific use cases because understanding these mechanisms is more useful than just a list.
40:30
SPEAKER_00: The first is the confidence gap.
40:32
SPEAKER_00: AI sounds certain, a careful clinician says it depends a lot.
40:37
SPEAKER_00: AI gives you a clean, fluent, confident answer.
40:41
SPEAKER_00: The confidence is not accuracy, it is a feature of how language models work.
40:46
SPEAKER_00: They are generating the most statistically likely response based on their training data, all the data that they pull in, right?
40:53
SPEAKER_00: That is not the same as the clinician who has examined you, tested you, and is integrating your specific information.
41:01
SPEAKER_00: The second failure mode is more insidious.
41:05
SPEAKER_00: Insidious?
41:06
SPEAKER_00: Insidious?
41:07
SPEAKER_00: Confirmation bias.
41:09
SPEAKER_00: Here's how it plays out.
41:10
SPEAKER_00: An athlete at seven months asks AI if they are ready to return to sport.
41:15
SPEAKER_00: AI says most athletes return between nine and twelve months.
41:19
SPEAKER_00: They do not like that answer.
41:20
SPEAKER_00: They ask again, what with a slightly different framing.
41:23
SPEAKER_00: I'm seven months post op.
41:25
SPEAKER_00: My knee feels great, I've been training hard.
41:27
SPEAKER_00: Is it possible to return to sport at this time?
41:30
SPEAKER_00: Now AI says yes.
41:32
SPEAKER_00: Some athletes return at six months with proper rehab.
41:34
SPEAKER_00: They ask a third time.
41:35
SPEAKER_00: The answer is more permissive.
41:37
SPEAKER_00: They found what they are looking for.
41:40
SPEAKER_00: No one in that entire exchange examined them, no one tested their quad strength, and no one watched them decelerate, no one took responsibility for the outcome.
41:51
SPEAKER_00: They just asked a question until they got the answer they wanted.
41:54
SPEAKER_00: AI has no mechanism to protect you from that.
41:58
SPEAKER_00: And that is really, really important here, y'all.
42:01
SPEAKER_00: And this is something I told the team like garbage in is garbage out.
42:05
SPEAKER_00: And so the thing is, is like whatever you put into this, it is going to kind of give that out to you.
42:11
SPEAKER_00: And the big thing with AI is that it is technically a quote unquote yes man, where it's like, yes, tell me what I want to hear.
42:19
SPEAKER_00: And it's the biggest knock that it has is that it has a hard time disagreeing with you.
42:24
SPEAKER_00: And so then, therefore, it's going to tell you what you want to hear, it's going to give you confidence.
42:29
SPEAKER_00: And this is where you have to be careful with the certainty, the confirmation bias, because it will give you what you want.
42:35
SPEAKER_00: It's like searching for certain answers, like you can find the answer if you want.
42:40
SPEAKER_00: You can find if smoking is good for you.
42:42
SPEAKER_00: I promise you, there is information out there.
42:44
SPEAKER_00: There has been a research study to show the flawed just process of research that has showed the benefits of smoking for you.
42:51
SPEAKER_00: So you can find the answers in that bias if you want.
42:55
SPEAKER_00: The thing is, is that it's gonna be really important, especially with AI, to be careful about what you're asking it in in these risky cases.
43:03
SPEAKER_00: And so here's some specific risky cases that I want to share with you some use cases.
43:09
SPEAKER_00: Interpreting symptoms without context.
43:11
SPEAKER_00: Asking AI whether your pain or swelling at a specific stage of the recovery is normal.
43:16
SPEAKER_00: AI can give you a population level answer.
43:19
SPEAKER_00: It cannot examine you, it does not know your surgical specifics, your baseline, or whether what you are describing warrants a closer look.
43:28
SPEAKER_00: Normal and abnormal look very different from person to person and from case to case.
43:32
SPEAKER_00: Using AI timelines as your personal timeline.
43:36
SPEAKER_00: Careful here, y'all.
43:37
SPEAKER_00: The nine-month, twelve-month numbers are everywhere online and therefore everywhere in AI training.
43:44
SPEAKER_00: We use it, we talk about it.
43:46
SPEAKER_00: If you're using AI to confirm you're on track because the calendar lines up, you're using the wrong tool.
43:53
SPEAKER_00: You need criteria, not a calendar, and AI is not going to confirm that.
43:57
SPEAKER_00: It will tell you it will, but be careful here.
44:01
SPEAKER_00: Researching your way into or out of a surgical decision.
44:05
SPEAKER_00: AI can help you understand the options.
44:07
SPEAKER_00: It shouldn't be the deciding voice on whether you have surgery, when you have it, or which graph your surgeon uses.
44:13
SPEAKER_00: That conversation requires your imaging, a physical examination, and a surgeon who has actually seen your knee.
44:19
SPEAKER_00: Evaluating whether you are ready to return to sport.
44:23
SPEAKER_00: This one we are going to go much deeper in on part two because it is the most consequential one on the list.
44:31
SPEAKER_00: AI can explain what their criteria should be.
44:34
SPEAKER_00: It cannot tell you whether you met them truly or not.
44:37
SPEAKER_00: Those are completely different things, and the decision-making process is so important, y'all.
44:43
SPEAKER_00: So important to every step of this process, but especially when you're about to put your car back into traffic.
44:49
SPEAKER_00: You have to make sure that everything is weighed appropriately based on your specific context.
44:54
SPEAKER_00: But this is going to do it for part one.
44:56
SPEAKER_00: We covered why this conversation matters, where AI is genuinely useful across all three audiences, and we are starting to get into where it becomes unreliable.
45:08
SPEAKER_00: Part two is where we go into the hard lines of this program building, return to sport decisions, what happens when there is no human in the loop at any point in the process, the specific real-world patterns I have seen gone wrong, and the three question framework you can use every single time going forward.
45:26
SPEAKER_00: That episode is coming out for you next week.
45:28
SPEAKER_00: Do not skip it.
45:30
SPEAKER_00: The second half of this is where the stakes get real.
45:33
SPEAKER_00: And likely the most important part of this.
45:36
SPEAKER_00: I'd rather you guys know how not to use it than to properly use it, to be really honest.
45:42
SPEAKER_00: If you're navigating your recovery right now and you want actual human experts in your corner some help, you can reach out to us.
45:50
SPEAKER_00: You can connect via the show notes.
45:52
SPEAKER_00: We have email, we have the website.
45:55
SPEAKER_00: This is what we do, this is what we love, and we're here to help you guys.
45:58
SPEAKER_00: And if this episode was useful to you, share it with someone who needs it.
46:03
SPEAKER_00: Another athlete, a parent, a coach, a PT.
46:07
SPEAKER_00: This conversation is one I think the ACL community really needs to have.
46:12
SPEAKER_00: And the more people who hear it, the better.
46:14
SPEAKER_00: See you guys in part two.
46:16
SPEAKER_00: This is your host, Ravi Patel, signing off.