The Ask Mike Reinold Show

Swelling and quadriceps muscle weakness are not uncommon after ACL reconstruction, and can even persist for several months. Athletes want to get back to running and eventually their sport as fast as they can. But sometimes using time-based criteria is not optimal. In this episode, we answer a question about whether an athlete should start running 5 months after an ACL reconstruction, even though t...

Over the last several years, the PT community has grown more convinced that athletes should not return to sport earlier than nine months. Research reports suggested that 9 months was a magic number. But what if your patient looks amazing at 8 months? In this episode, we review a recent article that showed that athletes returning earlier than 9 months were not at more risk if they met the proper ob...

The debate over postoperative rehabilitation after rotator cuff repair continues to evolve. In this episode of the podcast, we review a recent article that looked at outcomes between two groups, one that was stiff and one that wasn’t. Here are our thoughts on the paper. To see full show notes and more, head to: https://mikereinold.com/ does-stiffness-lead-to-better-outcomes-after-rotator-cuff-repa...

It's important to have objective test data to safely progress patients and return them to sport after injuries like ACL reconstruction. Isokinetic testing is still the gold standard. However, the machines are large and expensive, and they are used much less frequently. We don’t even have an isokinetic machine at Champion. Here’s what we do instead. To see full show notes and more, head to: ht...

Internal bracing is becoming a very popular procedure with orthopedic surgeons. Repairing ligaments and then augmenting the tissue with an internal brace has shown to be promising throughout the body, including the MCL of the knee. But, what do you do if there is prolonged stiffness? To see full show notes and more, head to: https://mikereinold.com/ knee-mcl-repair-with-internal-brace / Learn our...

Oblique injuries are common in baseball players, and not so common in other sports. With baseball players training so much more in the offseason with high volume and max intent, it’s no wonder these injuries are rising. Here’s how we approach these injuries and how to progress them back to hitting. To see full show notes and more, head to: https://mikereinold.com/ oblique-injuries-in-baseball-play...

Restoring range of motion after a rotator cuff repair is one of the most important factors in long-term patient satisfaction. Internal rotation is especially important, as a loss of IR can really limit their functional movements. There are many variables to consider when rehabbing a rotator cuff repair patient. Several factors will alter our speed of progression. Unfortunately, protocols vary grea...

Rehabilitation after ACL reconstruction is a long, sequential process. We look for specific criteria before progressing our athletes back to running. Here are the criteria we look for and the progression we follow for plyometrics, running, sprinting, and agility work to help athletes get back to competition after ACL surgery. To see full show notes and more, head to: https://mikereinold.com/ retur...

Little League Elbow is a common injury in youth baseball players.  Little League Elbow is a growth plate injury typically seen in baseball pitchers around the age of 13. At this age, the bone is typically the weak link, not the ligament. This is why we see more bony growth plate injuries than Tommy John injuries in youth athletes. These often take longer to heal than you think, so we don’t usually...

Over the last decade, the amount of sports physical therapy residency programs has skyrocketed. There are so many great programs now. Our students ask us all the time if they should do a residency. Our answer is always, “It depends.” They aren’t for everyone. Here are our current thoughts on sports PT residencies, who should consider them, and who shouldn’t. To see full show notes and more, head t...

Ah, the diagnosis of biceps tendonitis. We’ve all seen it so many times on script from doctors. Is all anterior shoulder pain coming from the biceps? How can you tell? How does this change your rehab? We’ll answer all this and more in this episode. To see full show notes and more, head to: https://mikereinold.com/ evaluation-and-treatment-of-biceps-pain / Learn our proven system for sports PTs who...

It’s so awesome to see so many cash-based physical therapy businesses starting around the country. It’s really been an amazing experience for us at Champion to be out-of-network with health insurances for over 10 years. In this episode, we have some advice, pros, and cons for those looking to succeed with this model. To see full show notes and more, head to: https://mikereinold.com/ what-it-takes-...

We’re starting to see more and more ACL reconstruction procedures with an LET, or lateral extra-articular tenodesis. Especially in revisions and younger female athletes. In this episode we talk about the technique, how it changes the rehab progression, and some tips on what to watch out for. To see full show notes and more, head to: https://mikereinold.com/ acl-reconstruction-with-lateral-extra-ar...

If you want to help your athletes maximize their potential, you need to have a system to assess athletic qualities. This is important to individualize programming and monitor progress. We follow a few steps in our system: 1. Identify the athletic qualities needed in a sport 2. Identify an assessment to measure this quality 3. Determine the technology needed Here are the athletic qualities we value...

One of the most common questions we tend to get over time is how to return athletes back to sport after an injury. This is one of the main topics in our online Champion Sports PT Mentorship, and probably the most popular portion of the program for past students (BTW, our next cohort starts in January… click here to learn more ).  In this episode, we talk about the criteria to start a return to spo...

Limb symmetry index is often used to measure performance and determine return to play. Makes sense, but what if the other side isn’t perfect? We prefer to look at more than just LSI, but there’s a bunch that goes into it. We discuss in this episode. To see full show notes and more, head to: https://mikereinold.com/ is-limb-symmetry-index-our-goal /   Learn our proven system for sports PTs who want...

Rotator cuff tears are becoming more common in younger active patients in their 40s and 50s. Typically, they are small tears at this time, but what should we do with them? Should we consider surgery? Should we avoid it at all costs? We talk about some of the things to consider in this episode. To see full show notes and more, head to: https://mikereinold.com/ rotator-cuff-repair-surgery-in-younger...

There are a ton of scientific and medical journals these days. Seems like there are more and more each year. We’ve talked over the years about how there are actually some journals you want to avoid, and others that you want to follow. In this episode, we talk about our current favorites plus some other current thoughts on how to stay current. To see full show notes and more, head to: https://miker...

Blood flow restriction training has been such a great addition to what we do in physical therapy. Just like everything else, the more we use it, the more we refine what we are doing. Here are our latest thoughts on how we are using BFR at Champion. Check out the show notes below to see our latest recommendations on BFR cuffs. To see full show notes and more, head to: https://mikereinold.com/bfr-up...

We’ve all had the patient walk in the door with acute low back pain. It’s awful. They’re in a ton of pain and can’t function. In this episode, we discuss our strategies for working with people with acute lumbar radiculopathy to get them on the right path as soon as possible. To see full show notes and more, head to: https://mikereinold.com/ how-to-treat-acute-lumbar-radiculopathy /   Learn our pro...

We all know it’s important to challenge our patients with load during the exercise progression of a rehabilitation plan. Many people like to poke fun at the concept of 3 sets of 10 repetitions, probably because some abuse it, but there is a time and place for everything. In this episode, we discuss set and rep schemes and how we periodize our exercises during physical therapy and even the gym. To...

Rotator cuff repair surgery is one of the most common procedures in physical therapy, yet the recommended postoperative guidelines vary significantly. Different doctors worldwide disagree on what’s best. Some want to be conservative and delay range of motion and physical therapy to maximize the chance that the repair does not fail. But is that best? Are there negatives? In this episode, we discuss...

Our understanding of SLAP tears, or superior labral tears of the shoulder, continues to evolve. In the past, we often rushed to surgical repair of a SLAP lesion, but now we understand that not all SLAP tears need to be repaired. In fact, repairing some types of SLAP tears in the wrong person could make them worse! In this episode we talk about the difference between a “good” SLAP tear and a “bad”...

Rate of force development has become popular in the strength and conditioning world, but not so much in rehabilitation. After an injury, we often work on strength and power, but we must also work on producing force as quickly as possible to benefit athletes. In this episode, we discuss how to measure RFD and how to incorporate it into the rehabilitation process for an injured athlete. To see full...

The future of ACL reconstruction and repair is evolving. One of the newer techniques to try to repair the native ACL ligament rather than needing a graft is using a bridge enhancement. This is called the BEAR technique for Bridge-Enhanced ACL Repair. This procedure has specific indications, contraindications, and rehabilitation guidelines. In this episode, we discuss this procedure and the differe...