ACLR Incidence is increasing.
RTP Testing is flawed.
There is little focus on ‘‘how’ to do the ‘right’ drills to get
an athlete ‘ready’

Here’s a synopsis of each module…

Module 1 : ACLR Rehab, Where are we now?

• In this lesson, Carmen will discuss where we are currently at in terms of RTP testing and models of progressive exercise selection.

• Current clinical, functional assessments for RTP, are evolving without an agreed upon gold standard.

• Objective criteria for RTP must be rigorously evaluated for whether they accurately screen an athlete’s physical readiness.

• In the athlete population, RTP criteria must be expanded to include more sports specific movement analysis.

• There are no clearly defined exercise-based rehabilitation models to follow to effectively return athletes back to sport with the highest physical demands.

Module 2: Return to What? A Demand Analysis through the Lens of Load

• In this lesson, Carmen will discuss how to analyze the demands of the sport your athletes are involved in by looking specifically at biomechanical factors.

• Performing a demand analysis prior to designing a training programme is essential as it provides vital information on the demands of the sport.

• We will look closely at biomechanical factors related to LOAD such as accelerations, decelerations & ground reaction force, as well as ACL force & strain thresholds.

• Understanding these factors provide insight for the practitioner to create an appropriate and effective training programme.

Module 3: Early Stage Rehab Part 1: Hydrotherapy and Blood Flow Restriction

• In this lesson, Carmen will discuss the absolute necessity of hydrotherapy in RTP.

• Hydrotherapy has so many benefits to the healing process and can begin very early in the ACLR rehab process.

• Also, what is often forgotten is the importance of maintaining the cardiovascular conditioning levels as detraining can occur rapidly.

• Athletes are often unsure or scared of what to do for their ‘conditioning’ and the bike has almost zero transfer to land-based movements.

• In this module, we also have a guest: Jag Bains, PT. He joins us with a supplementary lesson on Blood Flow Restriction (BFR) Protocols for Early Stage Rehab.

Module 4: Early Stage Rehab Part 2:  Land-Based NWB Exercise

• In this lesson, Carmen overhauls the common (non-weight bearing) exercise protocols in early stage ACLR rehab to better optimize motor learning and adaptation that leads toward returning to sport.

• Exercise prescription and it’s acute variables such as sets, reps, intensity and rest periods as well as the technical execution of the drills dictate the adaptation.

• Carmen will cover early stage exercises with special attention paid to these acute variables based on advanced strength & conditioning principles.

Module 5:  Mid Stage Rehab Part 1 - A Focus on Strength

• In this lesson, Carmen will cover several ‘mid stage’ exercises with special attention paid to technical execution & advanced strength & conditioning principles related to Isometric and Isotonic Exercise Prescription moving away from generic, unfounded notions such as ‘3 x 10’

• Strength progression (objective) criteria is emphasized before the athlete is moved to the “Late Stage” of ACLR Rehab.

Module 6: Mid Stage Rehab Part 2 - Movement & Conditioning

• In this lesson, Carmen blends motor-repatterning with conditioning to optimize the mid-stage rehab process.

• Several unconventional ‘mid stage’ movement exercises & conditioning drills are taught in this module with special attention paid to technical execution

• Commonalities in ‘less risky’ biomechanical movement strategies are also outlined.

Module 7: Late Stage Rehab: Strength, Power & Plyometrics

• In this module, Carmen will cover minimal strength requirements, return to running and a tiered approach to both decelerations (eccentric strength) and plyometrics.

• She will visit the miserable stats again - ACL re-trauma’s often follow an incomplete rehabilitation process.

• Through the lens of load, Carmen will explain how to introduce your athlete to plyometrics, running, speed training and decelerations.

• She will also unveil some of her unique methods for ensuring athletes are ‘strong enough'.

Module 8: Return to Sport: Rapid Change of Direction and Agility

• In this lesson, Carmen will cover the Return to Sport process which involves higher intensity tiered plyometrics, change of direction progressions and incorporation of the sensorimotor system (vision).

• The Return to Sport Stage if often the longest stage as athletes need to build tolerance to higher and high ground reaction forces and move from planned change of direction and deceleration maneuvers to unplanned, competition-like demands.

• In this lesson, Carmen also covers her list of RTS tests and screens as well as 3 questionnaires and use of the CMAS screen to establish both physical and psychological readiness for RTS.

• Carmen does not currently endorse the current suggested test batteries suggested (Melbourne, Fowler Kennedy) due to their lack of emphasis on the following factors:

  • Reactive strength

  • Elastic strength

  • Body composition

  • In-depth concussion assessment

  • ‘Functional’ strength (free weight strength versus leg pressing)

  • Aerobic capacity or RSA testing specific to sport

  • COD mechanics using the CMAS analysis specific to sport movements

  • The length of time exposed to the precise mechanical loads and external training loads the athlete will face in their sport.

  • A de-emphasis of a collaborative decision from all invested parties: Surgeon, Head sport coach, S&C coach, sport med staff (AT, PT, Chiro), the athlete themself and possibly the parents as well.

  • The current suggested testing batteries put emphasis on an invalid measure: LIMB SYMMETRY INDEX