Advances in ACL Rehabilitation and Injury Mitigation A Movement Based Approach

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with a duration of 7 Hours

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Lesson Plan

Advances in ACL Rehabilitation and Injury Mitigation
A Movement Based Approach

There are >250,000 ACL injuries in the US every year resulting in ~$5B health care cost (AAOSM Annual Conference 2016). Current research indicates that only 63% return to sport (Webster et al Am J Sport Med 2019) and 1 in 4 youths re-injure upon return to sport “RTSport” (Wiggins et al Am J Sports Med 2016).

With reinjury rates at an all-time high, and the impact on future performance it is no wonder that 63% of players quit within 2 years upon return to sport. Research indicates there are movements that put an athlete at risk that can be identified during squatting motions, during single limb performance and more prevalent during cutting tasks.

Traditional ACL rehabilitation protocols are not significantly impacting these movements which is why they remain present at 9 months post op and at 2 years despite being returned to sport.

In this 7-part series, Dr. Nessler will layout the latest research related to ACL injuries, rehabilitation, contributing factors to the movements we see and how to address these movement patterns throughout the rehabilitation process.

Learning Objectives:

The following are the objectives for this 7-part course on Advancements in ACL Rehabilitation and Injury Mitigation – A Movement Based Approach.

Lesson 1: The Latest in Sport Biomechanics and ACL Research
• Current research on ACL injury rates and reinjury rates.
• Impact of ACL injuries on future performance and career length.
• Current research on ACL reinjury rates and impact on biomechanics by graft type.
• Impact of concussion on ACL risk.

Lesson 2: Impact of Pelvic Motion on Limb Biomechanics and LSI

• Impact of pelvic motion on ACL loads and risk.
• Current research on the FMS as a movement prediction tool.
• Neuroplastic changes that occur post ACL injury and why.
• Impact of PT on biomechanical risk factors at 9 months and 2 years.
• Measurement of LSI – is it predictive.

Lesson 3: Impact of Core and Pelvis on Single Limb Stability
• Impact of pelvic motion on knee and hip.
• Impact of core stability on upper extremity injuries in overhead athletes.
• Importance of single limb stability and impact on overhead athletes.
• Movement patterns in tactical athletes.
• Impact of movement on length-tension relationships and joint/soft tissue loading.

Lesson 4: What Do I Address First – How to Determine Weak Link
• How to determine the weak link in the system.
• What factors of dynamic valgus are the most predictive.
• What are the motions of the pelvis we are assessing for and impact on lower kinetic chain biomechanics.
• How to assess and measure a lateral shift in a squatting motion.

Lesson 5: LSI, LQI, Kinesiophobia and so much more
• How pathological movement patterns impact each link in the chain.
• The importance of single limb testing vs. bilateral.
• The diUerence between limb symmetry index (LSI) and limb quality index (LQI).
• The impact that kinesiophobia has on joint loading and stability.
• The impact that fatigue has on movement quality and stability.

Lesson 6: Does Fatigue Matter & If So, How Do We Train
• How fatigue impacts lower kinetic chain biomechanics.
• How implementation of the functional agility short term fatigue protocol or FAST-FP can be used to assess athletes.
• The athletic position that is used in single limb testing & research behind.
• How planks and side planks can be used to test core and research behind how poor core increases ACL risk.
• What is rapid neuromuscular response and how to train it.
• Basics of BFR, research behind, how it works and how we can optimize results.
• What neuroplastic changes occur in the higher centers post ACLR and how we train it.
• What is the ViMove+ AMI and what it measures.

Lesson 7: Lessons Learned
• What is the 5 biggest things we have learned about human movement.
o Dynamic valgus magnitude and speed
o Pelvic stability – magnitude & speed
o LSI in power output
o Rotational control
o Concussion – the full impact
• The importance of valid and reliable technology and importance of objective vs. subjective data.
• The importance of LSI, LQI and IPA when doing return to play following ACLR.
• Importance of kinesiophobia and how to address right away.
• Importance of pelvic motion and COM displacement.
• Importance of controlling speed of movement – dynamic valgus, hip stability and rotational stability.

Course Preview

You can start and stop the course at any time. The course is available in your account for 6 months of date of purchase. A test is provided at the end of the course 75% score required. You have 5 attempts.

Please contact support@webexercises.com if you have questions regarding courses, subscriptions or Continuing Education Approval.

Disclosure: No relevant information to disclose.
Course Access: 6 months, course can be stopped and started at any time. Course is available in your account, no download required.
Content disclosure: This course does not focus on any product or service.
Materials / prerequisite needed: No prerequisite or materials needed.
Refund/cancellation policies: All online course purchases are final, no refunds will be given. Contact us if any problems, questions.

Lesson 1 Outline:
0:00 – 5:00 – Introduction
5:00 – 20:00 – Current research on ACL injuries and reinjury rates
20:00 – 35:00 – Impact of ACL injuries on performance and career length
35:00 – 45:00 – Factors leading to reinjury rates and sports biomechanics based on graft type
45:00 – 60:00 – Impact of concussion on ACL injury rates and pelvic stability

Lesson 2 Outline:
0:00 – 10:00 – Impact of pelvic motion on LE biomechanics and ACL load
characteristics
10:00 – 20:00 – Current research on FMS as a movement assessment and injury prediction tool
20:00 – 40:00 – Neuroplastic changes that occur in the higher centers post ACL injury
40:00 – 50:00 – Impact of PT on sports biomechanical risk factors at 9 months and 2 years post PT
50:00 – 60:00 – LSI as a reinjury prediction method – flaws and challenges

Lesson 3 Outline:
0:00 – 20:00 – Impact of pelvic motion on the hip, knee, loss of balance and injury risk
20:00 – 30:00 – Impact of core stability on upper extremity injuries in overhead athletes
30:00 – 40:00 – Importance of single limb stability for ACL risk and for UE injuries in MLB players
40:00 – 50:00 – Movement patterns in tactical athlete – biomechanics is the same
50:00 – 60:00 – Impact of pathokinematics on strength and loading of soft tissue and joints

Lesson 4 Outline:
0:00 – 20:00 – How to determine the weak link in the system – how do you know where the movement is coming from?
20:00 – 30:00 – Factors of dynamic valgus and what is the most predictive for ACL/LKC injury
30:00 – 50:00 – Movement patterns of the pelvis and impact on LKC loading patterns
50:00 – 60:00 – Lateral shift, what is it, how do you assess and importance of measured components

Lesson 5 Outline:
0:00 – 20:00 – Pathokinematics, what are they and how do they impact each link in the chain
20:00 – 30:00 – Importance of single limb testing vs. bilateral testing – what is the difference?
30:00 – 40:00 – Limb symmetry index vs. limb quality index – what is better predictor of sports biomechanical factors that impact injury and performance?
40:00 – 50:00 – Impact of kinesiophobia has on joint loading and stability
50:00 – 60:00 – Impact of fatigue on sports biomechanics and athletic performance

Lesson 6 Outline:
0:00 – 10:00 – Impact of fatigue on lower kinetic chain biomechanics
10:00 – 20:00 – What is the functional agility short term fatigue (FAST-FP) protocol and how is it used to assess sports biomechanics
20:00 – 30:00 – Is there more to planks and side planks than just the core?
30:00 – 40:00 – What is rapid neuromuscular response, why is it important and how do you train it?
40:00 – 50:00 – How to address the neuroplastic changes that occur post ACL injury and how do you train?
50:00 – 60:00 – What is the ViMove+ AMI and what does it measure?

Lesson 7 Outline:
0:00 – 20:00 – What are the 5 biggest things that mass data has taught me about human movement
20:00 – 25:00 – Importance of reliable and valid technology – just because it looks cool, does not mean it works.
25:00 – 35:00 – Limb symmetry index, limb quality index and initial peak
acceleration – what are they and why they matter more than you know
35:00 – 40:00 – Kinesiophobia – it is really not that complicated if you address it…Sport Locus of Control.
40:00 – 50:00 – Hip stability is the unspoken risk factor for ACL injury
50:00 – 60:00 – Speed matters, why controlling speed of pathological motions may be more important than magnitude

Continuing Education regulations may change. Please verify requirements with your licensure board for license renewal.

Doctor of Chiropractic course approval:
(see approval information below) *The licensed Doctor of Chiropractic shall be responsible for verifying the board requirements for license renewal.
Alaska, Colorado, Connecticut, Delaware, District of Columbia, Idaho, Illinois, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, Wyoming.

CCE accredited Chiropractic College:
WebExercises is sponsored by a CCE accredited Chiropractic College, Cleveland University-Kansas City. This course meets the appropriate standards for continuing education and qualifies for 1 CEUs (hour) in the following states:
Colorado, Delaware, Illinois, Michigan.

Athletic Trainers: WebExercises (BOC AP #10199) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of Category A 1 hour/CEU. ATs should claim only those hours actually spent in the educational program.
Topic: Essential

Physical Therapy Approval for this course: This course has been approved by the Arkansas Board of Physical Therapy. The course abides by regulatory guidelines for continuing education or is approved by virtue of approval by the Arkansas Physical Therapy board. Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Georgia, Idaho, Iowa, Kansas, Kentucky (Category 1) Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire,  North Carolina, North Dakota, New York, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, Wisconsin, Wyoming.

Course Instructor

Trent Nessler, DPT Trent Nessler, DPT

Trent Nessler, PT, MPT, DPT is owner of The Athlete Laband co-founder | developer of the ViMove+ AMI. A sports medicine physical therapist with 25 years’ experience, he has worked with professional athletes, first responders and military personnel his entire professional career. Dr. Nessler is an author, published researcher and internationally recognized expert in injury prevention. In partnership with DrosaVi, Dr. Nessler co-founded | developed the ViMove+ AMI.  This assessment leverages wearable sensor technology to capture 3D movement to capture 3500 data points with lab quality on how a subject moves. The ViMove+ AMI has been used in the NFL, NBA, NHL, US Military and in first responders to assess movement on >90,000 tactical and sport athletes in 5 countries. The mass data sets collected has created the largest database related to human movement and is being used in several national and prestigious research projects. Data, knowledge and programming from this system is being used to prevent injuries in sport and tactical athletes across the globe.  Dr. Nessler is a published researcher on injury prevention in peer reviewed journals and author of a 350 page textbook "How To Build A Badass Firefighter". Dr. Nessler has developed several nationally recognized injury prevention products and programs including ACL Play It Safe, Run Safe and ACL Safe and Strong. He is also a nationally recognized speaker presenting over at 30+ conferences and continuing medical education courses a year on the topic of injury prevention. Dr. Nessler is also an accomplished Brazilian Jiu Jitsu black belt, specializes in treating the combat athlete and has launched several research projects on BJJ injuries and training in law enforcement.