Introduction of today’s episode (1:05)
Dr. Paul Sethi Introduction (1:20)
Orthopedic and Neurosurgery Specialists (1:32)
Cornell University and Mt. Sinai School of Medicine and Yale residency (2:01)
Dr. Paul Sethi has been a consultant and an assistant team physician for the Los Angeles Dodgers, Los Angeles Lakers, and LA Kings (2:10)
What is an ACL injury? It is a major central ligament in the knee and maintains stability and not buckle (3:08)
When you cut like in tennis, it can give out and the knee will buckle (3:40)
ACL injuries often involve other structures like the meniscus (3:55)
Q-Angle (4:45)
Females are more likely to tear ACL (4:56)
Feel or hear a “pop” (5:55)
Difficult to return back to sport after you tear your ACL (6:15)
Diagnosis is confirmed by MRI (6:30)
What happens after an ACL tear (6:45)
Decreasing non-contact injuries (7:01)
Mitigating injury risk (7:10)
PEP program or Santa Monica Program was performed in soccer athletes (Prevent injury enhance performance) (7:20)
Lunges, inchworms, other exercises for strength to prevent risk of ACL tear (8:00)
Dynamic warmups (8:15)
FIFA 11 program among soccer athletes (8:45)
ACL injuries are prevalent in soccer players (9:00)
Females are higher risk than males for an ACL tear (9:34)
Prevention programs work and are real (9:49)
Weaknesses can be improved (10:01)
Athletes should be involved in one of these programs (10:12)
Ways to prevent an ACL tear (Balancing hamstring and quadriceps muscles) (10:21)
FIFA 11+ (https://www.fifamedicalnetwork.com/lessons/prevention-fifa-11/) (11:20)
Surgery or non-surgery and differences between the 2? (11:45)
Can I play through my torn ACL? No, it is not typically recommended (12:30)
Pre-surgery after an ACL tear and the need for range of motion and strengthening (13:32)
What is the recovery time for an ACL tear? 9-12 months (14:33)
Which type of ligament should be used to repair my ACL? (15:32)
Using the torn ACL as the new ACL does not have positive outcomes based on a Harvard study (15:45)
Most commonly used graft comes from the patella tendon (16:41)
Allograft vs autograft in the ACL (17:10)
Educating timelines and explaining importance of proper rehabilitation (18:00)
Is it okay to not repair my torn ACL? It depends on the goals but yes its possible (19:35)
How long is ACL recovery? 9-12 months is the most realistic timeline (21:45)
Returning too soon can risk a re-tearing of the ACL (23:12)
Rehabilitation of the ACL repaired knee (25:10)
Phase 1: Post-operative phase where we restore range of motion, decrease swelling, increase quadriceps function and get rid of crutches. (25:10)
Phase 2: longest and hardest phase and foundational strengthening. Hip and core strength and discovering what caused ACL tear in the first place. (26:15)
Phase 3: Return to sport which means more dynamic and plyometric exercises, being on a field in a controlled environment (27:02)
Using athletic trainers and strength coaches to training and returning to sport (27:44)
Psychological testing and how comfortable an athlete is with going back to sports (28:31)
Importance of setting realistic timelines and testing regularly before allowing clearance (29:06)
All ACL tears needs to have proper testing before being cleared (31:15)
Listening and understanding the patient is key (33:00)
Pre-habilitation and mitigating risks in the young athlete is where sports medicine should be going (35:07)
Wrap-Up (36:09)