Competitive Advantage Athletics

This lecture series will focus on outlining and detailing opportunities for physical therapists, physical therapy assistants, athletic trainers, strength and conditioning coaches and other healthcare personnel to delve deeper into current concepts surrounding the rehabilitation of athlete's status post anterior cruciate ligament (ACL) injury and/or surgery. An overview of the following concepts surrounding patients status post ACLr will be outlined in the following lecture series: the periodization of training and rehabilitation for the biomotor and bioenergetic abilities of athletes’, a hypothetical model for the ACLr rehabilitation process with regards to exercise variability and through progressive resistance exercise both in the weight room and through field activities, contributing societal factors for subpar return to sport rates, a proposed system in teaching athletes linear speed, change of direction, and agility mechanics for field and court sports, and a brief recap of alternative technologies to assist in the athletes return to sport. This self-paced lectures series will be approximately 36 hours in length.

While it's true that clinicians and providers have plenty of options with regards to continued learning when it comes to ACL pathologies…….as anything from non-operative to operative management and protocoling, to surgical means and methods, and recently, discussions regarding brace wear both operatively and non-operatively have taken place……none to my knowledge take the enrollee every step of the way through the patient's journey from the table to the turf from an APPLIED perspective while promising the interested learner accelerated recovery and injury reduction strategies for their athletes. This course consists of thousands of videos with corresponding interventions given under different contextual circumstances to best allow the athlete to not only return back to sport, but rather, back to performance at a level equal to that or ideally greater than that of where they were at pre-injury.

This course was designed and developed to give clinicians and all other associated members of the sports medicine team full access to my clinical toolbox from a therapeutic activity and exercise prescription standpoint so that they can best care for the individual in front of them. Drawing from my experiences both as a coach and clinician while working in professional sport, at world-renowned hospital systems, and from my time working with the special operation community from within the military health system, I can promise that every enrollee of this course will learn new strategies that they will be able to immediately implement into their clinical practices or performance models for the physical preparation of their athletes.

This course is a self-paced lecture series consisting of 30+ hours of video content. Downloadable materials such as a sample return to run program, a sample sprinting program which is biased towards a patient's acceleration mechanics, and a PowerPoint presentation outlining major themes of the course will also be provided. A 60-question quiz assessing comprehension of covered material will also await the learner at the conclusion of this course. To get a sense of what the videos within the course will look and sound like, please see the free preview option as multiple hours of free video content have been made available to interested enrollees.

This course is eligible for 36 Category A continuing education units (CEUs) for Athletic Trainers (ATs). CAA LLC is a BOC Approved Provider, number P12195.

For PTs and PTAs, this course is currently approved for 30 CE credits in the states located in BLUE at the link below.

https://www.redefinehealthed.com/ceuinfo

A link to the course participant will be provided after they have completed the course, the course evaluation, and passed the competency assessment. Once the participant fills out the required information a certificate will be emailed to the participant.

This course is subcontracted to Redefine Health Education. RHE is a registered CE approval agency of the PT Board of California as an approved sponsor of PT/PTA continuing education. In addition to the aforementioned jurisdictions, courses approved by other state boards & APTA chapters will be accepted for licensure credit in all the jurisdictions listed on this webpage, pursuant to regulation:

https://www.redefinehealthed.com/ceuinfo

If you have a specific question about CE credit for this course in your state, please direct your inquiry including the course title in which you are interested to [email protected].

I decided to create my own course detailing the methodologies I use for ACL rehabilitation in order to save other providers and coaches years of time and money that I personally subjected myself to in order to grow professionally. This course is an assemblage of my time and stays in various high-performance settings from within the sports medicine industry, as the perspectives I gathered and present here encompass elements of different learning opportunities I was a part of while working in the professional, private, military, and hospital settings. These perspectives are all very different and unique when compared to one another, but most importantly, tried and tested as they were instrumental in the ACL specific Bridge Program that I developed and oversaw for one of the top rated pediatric orthopedic hospitals in the country, Scottish Rite Hospital. It should be noted this program boasted many positive statistics for participant enrollees, including a 0% participant ACL re-injury rate upon discharge from the program when tracked for 2 years after the post inception mark of the program. However, no statistic was more important to me than having 87% of my athletes who were status post ACL reconstruction being able to pass their return to sport testing by at least 9 months from their date of surgery. That is because current norms cite this statistic at only 45-60% for the industry standard.

This masterclass I’ve created on ACL rehabilitation is also unique from other courses in that it is predominately application based as enrollees will immediately learn easily digestible therapeutic exercise progressions that can be implemented starting on post-op day 1 of an athlete’s rehab. Not only that, but these progressions also span the entire continuum of care for the athlete, as I take the viewer of this program through each and every phase of rehab, including the return to performance phases of rehab, so that by the end of the course, all enrollees can effectively coach and effectively prescribe training means and methods to best fit the athlete in front of them.

So, if you’re a sports medicine professional trying to get your patients back to sport while performing at a level equal to that or greater than that of where they were at pre-injury, then consider buying this course! It guarantees to improve upon the currently citied metrics of only 45% of sports medicine professionals being able to return athletes who are status post ACL repair or reconstruction back to sport and performance! Not only that, but it also guarantees to reduce ACL re-injury rates within the post-surgical athletic population that sports medicine providers work with as well, while also significantly improving time of discharge for athletes that are status post ACL reconstruction down to just 9 months! I say all this because if providing better outcomes to your athletes is important to you, and if getting a leg up on the competitive landscape that is our current healthcare system is important to you, then this course is a no brainer as the return on investment through the generation of new referrals and sports medicine collaborations afforded to providers who become ACL return to sport specialists by taking this course is our pledge. This is because this course will ensure that the enrollee will learn the systems, philosophies, means, and methods for bridging the gap from rehab to performance for post-surgical ACL patients in an array of contexts that can be easily extrapolated to the rehabilitation needs of other athletes suffering from different lower extremity injuries as well.

A link to the course participant will be provided after they have completed the course, the course evaluation, and passed the competency assessment. Once the participant fills out the required information a certificate will be emailed to the participant.

The personal goal I had when creating this course was to give each and every enrollee of this course not only the knowledge I’ve gained through my professional career as both a physical therapist and as a strength and conditioning coach with regards to ACLr rehabilitation, but the clinical reasoning skills and framework needed to improve upon from what are the currently citied norms with regards to outcomes for this surgery. I wanted to organize and impart this knowledge to the viewer of this course so that they personally had the means I used and implemented when creating Bridge Programs for ACL performance training that I was a part of both in the private sector and at one of the most distinguished orthopedic hospital systems in the United States. And I tried to do this in a manner that used strategies which scaled the entire care continuum, from the table to the turf, and that could be immediately implemented by sports medicine professionals so that they could more readily overcome the major milestones commonly experienced by patients’ status post ACL repair or reconstruction.

This course was designed with the intention of providing students with the clinical experience commonly encountered only by students within the fields of athletic training, physical therapy, and strength and conditioning who were lucky enough to serve in the high-performance model of sport. Typically, this requires students within these disciplines to work for free during their clinical rotations for months on end in order to learn how to apply the knowledge they gathered during their didactic coursework while in college or university. Even worse, this occasionally requires post-graduate clinicians who are interested in making the switch to sports medicine to volunteer what little and precious time they have outside of their full-time job to field coverage and internships so that they can gather the necessary experience to make the jump to a more fulfilling career. This course aims to fill that clinical void from an application standpoint as it serves as the instrument for mentorship so few of us working in sports medicine had during their graduate studies while at university.

This program is inclusive to anyone that is a part of the patient care team for patients’ status post ACL repair or reconstruction, including but not limited to physical therapists, athletic trainers, psychologists, nutritionists, mental skills coaches, strength and conditioning coaches, personal trainers, sport scientists/biomechanics, physician assistants, nurse practitioners, orthopedic surgeons, and so on. This course uses a hypothetical quadriceps tendon autograft or a BPTB autograft for an athlete that was status post ACL rupture so that the viewer could learn to integrate strength and conditioning principles within the rehabilitation disciplines from an APPLIED standpoint. The aim of this course was to provide the enrollee with an equivalent learning experience to that of a clinical rotation within the high-performance model of sport usually reserved for those working at major colleges and professional organizations when viewed from a physical preparation perspective.

Dr. Ian Wright Here……

And before I was recognized as an orthopedic and sports clinical specialist by the by the American Board of Physical Therapy Specialties, I was, and still am, a strength and conditioning coach first and foremost. And I am not talking about being that guy with the letters of “CSCS” or “SCCC” after my name without having the real-world experience to back it up……….. as prior to becoming a physical therapist I was a sports performance coach practicing in the real world, with real athletes, gaining real time experience within the profession of strength and conditioning at the intern, assistant, and head coach levels, respectively. And I think it’s important to highlight this fact as really my experiences both as a strength and conditioning coach, and later on as a physical therapist, laid the foundation for me building a Bridge Program tailored made to returning athletes back to sport, and then performance, who were status post ACL reconstruction for one of the top rated pediatric orthopedic hospitals in the United States. And as difficult as this Bridge Program was for me to create from scratch, in a lot of ways, it laid the foundations for the development of the Periodized ACL Course that I wish to talk about to everyone here today.

So, I think most coaches and clinicians who work with athletes know that the integration and application of theory and best available evidence to clinical practice and sports performance is difficult, especially when we are missing pieces of the puzzle as health care providers and/or sports medicine professionals. When I first started off in strength and conditioning, I interned for free, ORRR DO I dare say I paid for the privilege to learn from what I perceived to be some of the most reputable names in the industry, names like Anthony Donskov of Donskov Strength and Conditioning. This took me at the time from the typical egomaniac meathead of a student who thought he knew it all, to a humbler and more grounded professional that realized he had a lot to learn from within the industry and the names that dominated it, guys like Mike Boyle. And while I became less mediocre in retrospect from intern opportunities like that that I experienced from Donskov Strength and Conditioning, and then later on during the refinement of my skills from other part-time and full-time assistant coaching positions that I held in the private sector of my strength and conditioning career, this process of refinement for developing my coaching style and skills culminated in what I thought at the time to be the peak of my coaching career when I landed a position within the NHL for the Columbus Blue Jackets. And I think it’s important to point out that this experience of working in high performance afforded me the opportunity, and set me down the path, for gaining the necessary hands-on experience of coaching and directing team workouts for BOTH injured and healthy scratch players on a daily basis, for designing in-season and off-season athletic development programs in collaboration with the head coach, and for developing and implementing training protocols during this time for the rehabilitation of injured athletes…. all while working closely with team physicians, physical therapists, and athletic trainers.

Now while I am grateful for the experiences that I just laid out….. as I gained a lot of hands-on experience seeing the high-performance model of training in action due to me witnessing the various sports medicine disciplines working and collaborating together in the professional ranks, if I am being totally honest with everyone as I self-reflect here, I still was an incomplete coach at best. Sure, I could command a weight-room and make it flow, or I could write long term athletic development programs while communicating effectively with others, or I could perform data collection while screening athletes, and really so many other of the other essential and critical day-to-day functions of a strength and conditioning coach, there was still a lot I couldn’t do, however.

For instance, I was still very ignorant of teaching skill work and field work within a lot of the major sports as I had established no philosophy or system from which to do so as I relied exclusively on skill coaches for this task accomplishment. I also had almost a nonexistent knowledge of conditioning means and methods, let alone a teaching blueprint for me to improve athletes change of direction and agility mechanics. And obviously I couldn’t diagnose an athlete while crafting a plan of care for their rehabilitative needs for the life of me, I was totally dependent on sports medicine professionals like athletic trainers and physical therapists to tell me what I could and could not do with an athlete. Essentially, I gathered a toolset like so many others within the profession of having essentially a PhD in weight-room movements while simultaneously having a GED is all other aspects of human performance, and I did this all while believing the lie that if I got athletes bigger, stronger, and to a degree, faster…….. that I did my job. I effectively ignored the most basic of principles, the dynamic correspondence principle, with regards to programming S & C work for transferability to the athlete’s sport, let alone the refinement it. I felt that if I could justify “X” amount of increase in a clean, or squat, or bench press, or “Y” amount improvements in sprint times or jump heights, that I did my job. Essentially, I felt that if I measured all the things I could manage within the prototypical weight-room environment, I justified my existence and place for remaining within the sporting organization…….. where I should have instead focused on how I could have better served my athletes in their ability to become the best at their position from within their sport for the longest time possible. I knew I had to do better, and I knew I was unfit to continue in the position I was in, so I made the rational decision most people would probably make in my position, I went back to school.

So, I think it's no secret that on the application side of things for colleges and universities here in the United States from at least a kinesiology or rehabilitative perspective, things are lacking, and to a degree, in a word…… dysfunctional, especially in sports medicine. You learn cool things like conducting VO2 Max tests, lactate threshold testing, body composition testing using various means and methods like calipers, BodPod, and so on in your undergraduate studies for kinesiology or exercise science. Then In grad school, at least in physical therapy curriculums, you get a generalist education in performing evaluations and assessments for diagnostic and prognostic purposes of the common orthopedic, neurologic, and acute care setting conditions, with some additional surface-level treatment options sprinkled in the mix there as well. But really in both instances, schools assume you gain the real-world experience in the refinement and application of the skills you learned during the didactic portion of your studies during your internships or clinical rotations,…….. and of course, this assumes you had a good mentor, coach or clinical instructor who learned these skills so that they could teach them to you in the first place.

And I found out this disappointing fact the hard way, as after I graduated from PT school, I still had none of the answers I sought when enrolling in the first place. In higher education’s defense, it was a big ask, and why I thought I would find my answers to optimizing human movement for success in sport from within a single profession was narrow-sighted thinking to begin with. However, good things did come from my studies in physical therapy, namely my gaining of a greater appreciation of the performance-injury conflict all athletes invariable sit on when competing in their respective sports. It allowed me to see that different professions and disciplines within the sports medicine field all sit on a continuum from one another, and that all these professions face or are trying to solve overlapping problems that no one individual profession can solve. Finally, my graduate studies also allowed me to really gain an appreciation of taking an athlete, who is in a lot of ways at their worst functionally after they sustain an injury that requires major orthopedic intervention and subsequent surgery, through that rehab – performance continuum. It allowed me through a whole lot of trial and error, and really failure, to gain an appreciation and better understanding of the sporting qualities I needed to develop, and the systems I could implement, for this task accomplishment within a wide range of athletes in order to best physically prepare them to handle the demands of their sport. This realization eventually led me down an unconventional path, where ultimately, I got to draw upon my experiences from both my strength and conditioning background where I functioned as a sports performance or physical preparation coach, and from my background as a sports physical therapist, in order to build separate Bridge Programs within both the private sector and at one of the highest ranked orthopedic pediatric hospitals in the United Stated, Scottish Rite for Children.

So as a new grad student just out of PT school I sought what I knew, and I began my career by looking for opportunities that allowed me to work with athletes. I eventually ended up in the Baltimore area where I worked for a private practice owner who rented out space from within various gym and fitness centers as that allowed him to cultivate access pretty immediately to a varied sports population. This in turn allowed me to work with athletes from not only the recognizable sports of football, baseball, basketball, and soccer, but also some of the more niche sports as well, such as lacrosse, MMA, swimming, and so on. So really, yet again, I jumped back into the sports performance world this time not as a coach, but as a clinician.

And I think at the time, being a new grad who was just freshly minted with his Doctor of Physical Therapy license, this was the best thing that could have happened to me because I got to approach human performance from a completely different viewpoint and with clinical reasoning and critical thinking skills that were much further developed when compared to my time as just a coach. Additionally, here I got to meet strength and conditioning coaches, physical preparation coaches, and skill coaches from the Baltimore area who had a lifetime of knowledge that they could impart to me, with none more influential than the owner of Sweat Performance, Kyle Jacobe.

While Kyle did not particularly care for my physical therapy employer to whom he rented out space for rehabilitation purposes from within his sports performance facility, for some reason we seemed to click. Maybe it was because of my background as a strength and conditioning coach, or maybe because it was the way I approached rehab and sports performance, but whatever the reason, we eventually cultivated a relationship which was mutually beneficial to the both of us----- and really, this relationship led to the development of my first Bridge Program that I oversaw within the private sector.

Personally, I think Kyle and I clicked because he knew that when I referred him a patient athlete after I completed their rehabilitative plan of care, THAT:

A. the patient athlete was firmly ready to be re-introduced into a group physical preparation setting with other like-minded athletes who were attempting at a minimum of returning back to sport, and ideally, reach the next level from a performance standpoint,

THAT B. I would articulate to him or his staff in detail any precautions or training modifications that they needed to make when working with injured or post-surgical patients from a time-line perspective,

AND THAT C. and this is really the most important factor here, that I had the best interests of the athlete in mind. This was actionably demonstrated by me not keeping an athlete in rehab longer than I had to. I was still a generalist at this time as both a coach and clinician, so I immediately made a referral to coaches who I thought were specialists, and frankly, better suited than I was at the time in helping the athlete achieve their performance and long-term athletic development goals for their sport.

And truth be told, these facts I just detailed were frankly not even remotely feasible between the coaches at Sweat Performance and at the private physical therapy practice I worked for BEFORE I arrived. The norm at the practice I worked for was definitely to be territorial and to keep athletes as long as possible from a plan of care perspective, all while being able to justify to insurance companies the need for continued PT through a short-sighted narrative of putting practice needs before patient needs. And I can confidentially say that the culture changed quickly and lucratively for everyone involved once I began implementing what I knew best from my previous experiences in high performance, which was a TEAM approach to patient care and athletic development.

Ultimately, over time my relationship with Kyle and the coaches at Sweat Performance grew into a mutually beneficial one for everyone involved as learning opportunities like in-services were provided to one another, along with company outings, and so on, but it eventually developed to the point of when athletes got injured while training or competing in their respective sports during in-season activities, the Sweat Performance coaches would make an introduction to me day of injury because of the direct access privileges allowed for physical therapists in Maryland, and I in turn got those individuals back into the hands of their coaches as safely and quickly as possible so that they could continue training. Essentially, I became their preferred provider, and this relationship eventually blossomed into one that occurred for all levels of sport, as the needs of athletes were addressed in this fashion, using the tactics I just described, anywhere from the high school, college, and professional’s ranks.

Toward the end of my time in Baltimore, the trust between the Sweat Performance staff and I eventually developed to the point of where they too were assisting me in the rehabilitative needs of athletes who were performing “prehab” prior to them undergoing major orthopedic surgery, which was in addition to them also assisting me in the rehabilitation and subsequent return to sport and performance needs of athletes who were status post ACL reconstruction anywhere from the 3 month postop mark and after. So just like they expanded my skillset and understanding of speed development both linearly and curvilinearly, let alone from a change of direction and agility perspective, I increased their knowledge and skillsets as strength and conditioning and skill coaches from a rehabilitative and responsibility of care standpoint as they now had the opportunities to work with injured athletes. Essentailly, their scopes of practice were enhanced to that which were typically reserved for professionals like assistants and technicians in physical therapy. And of course, the relationship between the coaches of Sweat Performance and I also opened up plenty of personal training opportunities for the staff to take advantage of as well…… but in the end with me following my now wife to Texas in order for her to finish her surgical residency, I decided to leave Charm City. And this was despite Kyle throwing in the generous offer of financing my own private practice with him and his staff, and at no risk to me, all the way to the point of where I didn’t need to make a penny for a full year!

Upon arriving to Texas in 2019, I accepted a pediatric sports physical therapist position at the Frisco branch of Scottish Rite Hospital. Now coming from an environment in Baltimore where I was predominately working with returning higher caliber athletes back to sport and performance from the high school, college, and professional ranks while in a direct access setting…… there was an adjustment period for me that was needed when setting foot in this establishment. For instance, diagnostics from a physical therapy perspective was nonexistent here as all admitted individuals came with a complete diagnostic workup in the form of advanced imaging and already have seeing one of two individuals ------ either a sports medicine physician or a sports medicine physician assistant. Now while convenient for me because I got the opportunity to really experiment with my interventioning and treatment means and methods on athletes of all different sports, as that was allllll I was allowed to see was athletes within this division of Scottish Rite, I also felt uneasy about this aspect of the job. Afterall, diagnostics and prognostics is half the job of a physical therapist, and these skills I effectively shelved during my time here because they weren’t needed.

Additionally, here I had to adjust to the fact that the sporting division of this hospital wasn’t what I was accustomed to. Athletes here were treated quite frankly with low-level therapeutic exercises and activities that were not graded progressively as demonstrated by the weightroom and turf fields sitting empty throughout most of the clinics working hours, as the “go-to” interventions therapists and technicians performed with patients here largely consisted of those that were either bodyweight in nature, or those that utilized theraband. The demands of these rehabilitative interventions also in no way, shape, or form prepared athletes to meet the demands of returning back to their sport at a performance level equal to that or greater than that from where they were at pre-injury. And upon this rather quick realization of mine within the first week of my employment at Scottish Rite Hospital, I thought to myself there is opportunity here.

Afterall, at SRH I had access to collaborative opportunities that easily enabled me to engage with a wide variety of other sports medicine services and personnel, anything from a fracture clinic, to a prosthetics and orthotics division, to a movement science laboratory, and so on. I also had the ability here to being able to work with, and collaborate with, ancillary staff members comprising that of a typical hospital system ---- so things like orthopedic surgeons, PAs, NPs, nurses, PTs, OTs, ATs, and so on. Essentially, I realized I was not in too different of an environment from that of where I was at pre-PT school, as most of the pieces for a high-performance model of sport at Scottish Rite Hospital were already in place, they just needed someone to fill in the gaps and make them come together.

So, if we fast-forward a year, the culture at Scottish Rite Hospital within the sports division at the Frisco Campus changed dramatically for the better as I demonstrated a number of my philosophies and systems to my peers that utilized an assortment of rehabilitative means and methods from a therapeutic exercise, therapeutic activity, and from a strength and conditioning viewpoint. I introduced my philosophies for different athlete’s rehabilitative needs and for their overall LTAD for their respective sports from a linear, curvilinear, CoD, agility, and neurocognitive standpoint as well during this time. Patients who were status post ACL reconstruction during this time started as a whole to pass their return to sport testing more consistently, and by all measures, the quality of rehab provided by the sports division at Scottish Rite improved. It improved to such a degree, that a Bridge Program initiative, which was floated years before I arrived by the staff at SRH, eventually even turned into a reality.

Now, at this point, I was not running the Bridge program at SRH as I had no interest in launching this new initiative due to me knowing the amount of work it would take to implement this program correctly, being that I just created a program of similar caliber in the private sector just a few years earlier. I didn’t fell the compensation offered to me initially by SRH matched the workload, so I declined the offer and deferred it to one of my colleagues who was a former assistant S & C coach collegiately. Afterall, it was his idea long before I arrived to the scene to create a Bridge Program from within the Scottish Rite Hospital system. And for whatever reason, he too decided to not put his words from the last few years into action as he deferred the programs creation to outside resourcing by the hospital in the end as well.

This led the hospital to hiring a new grad with his masters in kinesiology or exercise science for the first Bridge Program Coordinator position in Scottish Rite Hospitals history. On paper, he had a lot of experience with coaching different college teams from within the UNT system, and he was a qualified candidate overall as this individual was a lifelong athlete himself that was also practicing what his resume preached as he was striving to become a future CrossFit games athlete too.

So as a PT, it became my job during this time, along with my PT co-workers as well, to fill in the gaps of clinical knowledge for our new Bridge Program Coordinator so that he could design, organize, facilitate, implement and ultimately engage through coaching performance training for classes comprised of a varying number of pediatric and adolescent patient populations that were transitioning back to return to play and/or sport as a compliment to, and in conjunction with, traditional sports physical therapy. Essentially, this individual had to design a program like the coaches at Sweat Performance did and at the same time, make it successful.

Now, due to our Bridge Program Coordinators comfort level, most post-op patient athletes weren’t admitted into the program until at least 9 months from their initial surgery date. AND this was obviously 100% understandable as SRH wanted all patient athletes to remain safe during their stay while they were using the hospitals facilities and resources. Additionally, everyone at the time thought the program would fill with ease regardless of any accommodations that needed to be made due to the volume of patients seen by the sports PT staff at SRH, as hundreds of post-op patients alone were seen yearly just from a lower extremity perspective by the staff – as things like post-op ACLs, MPFLs, OCDs, hip scopes, and so on were all too familiar to the staff even at the 9-month mark.

Really, any accommodation that needed to be made in order to meet the Bridge Program Coordinators wants, the physical therapy staff and the administrators at SRH were happy to make as everyone was just excited to alleviate the access to care bottlenecks presented to the hospital, as clinically, the surgical volume offered to the therapists by the surgeons was overwhelming, and this resulted in a lot of referrals out to the network. Obviously, this need to refer out also resulted in the hospital losing money by them not being able to capture all surgical patients clinically. So, between potentially alleviating the patient care bottleneck clinically that was created from massive operating volumes at SRH, and the potential extra revenue stream offered through performance training itself with the creation of this new Bridge Program, everyone was incentivized to say the least for the program to succeed.

Unfortunately, while everyone expected slow growth with the launch of any new initiative, after 6 months, the program was limping along to say the least. With no more than 9 participants in the program for any given month, or no more than 4 individuals in any class, the programs existence looked to be in question. Then, in March 2020, a global pandemic hit, and a few short months after that, in the Summer of 2020, the program officially closed.

So, what went wrong? A reexamination needed to occur of the facts. The first question became did everyone at SRH agree for the need of a program to be developed for athletes who completed their physical therapy sessions, but who still needed focused training in helping them return safely back to their sport? And the answer was yes, everyone at SRH knew and agreed for the need of a program to be developed to “bridge” the gap so to speak, between discharge from therapy and safe return to sports.

The second question became did everyone at SRH also agree for the need of a program to be developed for “healthy” athletes who needed specialized training for injury reduction or prevention reasons that also sought to optimize their sport performance? And the answer was yes, everyone at SRH knew and agreed for the need of a program to be developed to improve athletes’ movement quality and efficiency through their training and development of the following areas: their hypertrophy, strength, power, ability to handle plyometrics, speed and pivoting or change of direction ability, and so on. So, the third question became then why did this program fail if the answer to the previous two questions were yeses?

The answer was obvious to me. It’s a big ask for any one professional to successfully implement a Bridge Program accomplishing all of the goals that I just laid out. In hindsight, to me at least, no one individual can usually successfully implement a program as diverse as a Bridge Program because of the team model that is required as demonstrated by the high-performance model of sports. Simply put, a single degree, with experiences limited to the scopes of practice of that degree only, in any of the health professions, cannot prepare any one individual for success in the creation of such a large initiative as a Bridge Program that aims to comingle and house both healthy and “injured” athletes while additionally attempting to return them back to performance, or ideally, improve upon it while simultaneously reducing injury reoccurrence and incidence rate in the first place. It’s a huge ask, and as I previously detailed, it was the reason I went back to school in the first place as I figured this out during my time as a strength and conditioning coach. It’s the reason I sought out the experiences I did in my professional career to this point as well, as all these experiences I gathered led me next to getting my opportunity to become the next Bridge Program Coordinator at SRH.

Out of desperation due to the pressure she was under by the administrators at SRH to build this Bridge Program successfully, my boss re-approached me with the offer for the Bridge Program Coordinator position as she knew my skills as both a clinician and coach. Afterall, she witnessed my clinical skills everyday while I was at work for SRH as a physical therapist, and she also knew I just brokered a partnership with Texas Scottish Rite being the preferred medical provider for one of the wealthiest private schools in the area, Greenhill School. And she knew I did this not based on my skills as a physical therapist, but rather, based off of my skills and reputation as a strength and conditioning coach as I also worked part-time at Greenhill School during this period of my life as a sports performance coach where I was responsible for the offseason, pre-season and in-season design, implementation, training and coaching of various sports teams, including the American football, women’s soccer, women’s tennis, men’s lacrosse, JV baseball and the track and field team.

But despite her desperation, I declined yet again because of what they offered me as compensation. After further rounds of negotiations that took months, SRH eventually offered me an acceptable salary on my terms, so I accepted, and thus, the Bridge Program was attempted again. Given only about 6 weeks to design all facets of the program as the board of directors at SRH wanted it operational “yesterday” so to speak, I had my work cut out for me. In this time, I had to design the structuring of enrollments, establish the criteria of admittance into the program, establish a payment scheme, design the long-term athletic development programs for all the major sports within the area, make known the schedule for the times and days of class offerings, come up with marketing materials, and so on. Being that this program was attempted already once and ended up as a total failure, I had no blueprint to go off of either, so I was given the “go ahead” so to speak to act within my best discretion using the limited resources I had available to me. Which honestly, wasn’t much, as between 8 therapists, each seeing two patients every hour, we had the following equipment for both the Bridge Program and the entire Sports Physical therapy division at SRH to share:

1 Pair of Dumbell’s ranging from 5 5-50 lbs

4 KB’s that were 48 kg each

1 KB of each of the following weights: 2,4,6,8, 10,12, 14, and 18 kg’s

3 open trap bars, 2 closed trap bars

3 Kieser’s with standard attachments included

1 slideboard

2 TRX’s

4 benches

4 battle ropes

11 sandbags ranging from 30-60 lbs

2 prowlers’

1 vertimax

An assortment of medballs and stretch elastic bands

A 45-yard track, 60-yard outdoor track

6 airex pads

2 gymnastics mats

1 plyo box set ranging from 6-36’’

4 eight-inch steps

7 treatment tables

5 BOSU’s

5 Theraballs

2 Agility Ladders

Standard hurdle set of small, medium and large hurdles

10 Straight Barbells

2 Squat Racks

1 rebounder

1 treadmill

1 skill mill

So, with most of the equipment I just listed being used by the sport’s physical therapists in a small shared space, which got tight as I eventually grew the program to class sizes of 20+, I had to get creative, as in addition to being the Bridge Program Coordinator during this time, I was also the head strength and conditioning coach being that I was a program of just myself. So, I worked on the floor and coached daily a wide variety of sporting participants from all different backgrounds and sports, especially being that the restrictions for admittance into the program were minimal under my leadership, as for instance, I eliminated any time restrictions for post-ops.

So, in the programs first month, I ended up seeing only 46 total visits for the month. Fast Forward 8 months later, I was up to 450 visits per month, and I had the justification I needed for adding two more additional strength and conditioning coaches to my staff, who I also trained and developed as they had no experience in the field prior. The program itself also garnered a great track record for returning participants back to sport at or before 9 months, as 87% of athletes who were status post ACL reconstruction were able to pass their return to sport testing by this timepoint. And while I coached classes that were composed of a variety of diagnoses, who were also of differing lengths of duration from their date of initial surgery, these classes were also comprised of participants of various sports and ages as well, so these results I just listed really flew in the face of the odds my team and I were delt. For instance, a smaller class that I coached and had other interested applicants coach who were interested in being my replacement as Bridge Coordinator during my out-processing, included the following:

Class Composition:

Participant 1: A healthy 10.5 y.o. male with no significant medical history.

Sport: none, will play periodic recreational games @ School/with friends

Participant 2: A 17 y.o. female with idiopathic scoliosis and R bicep tendonitis with episodic flare-ups for past 7 months

Sport: none, engages in fitness weight-room activities for enjoyment

Participant 3: An 18 y.o. male with Bil Hip impingement (FAI) status post L hip arthroscopy 7 months ago.

Sport: Baseball. Attempting to return for senior year

Participant 4: Patient is a 15 y.o. male basketball player s/p R knee arthroscopy with debridement and bone grafting and fixation of medial femoral condyle OCD 6 months ago.

Sport: Basketball

Participant 5: Patient is a 15 y.o. male s/p R ACLR and meniscus 4 months ago. CAN PERFORM NO IMPACT ACTIVITIES currently. Pt also s/p ORIF of right scaphoid nonunion on 8/30/21

Sport: Football and Basketball

Participant 6: Pt is a 15 y.o. healthy female with history of R mid tibial stress fracture 7 months ago

Sport: Track

Participant 7: Pt is an 18 y.o. male Football player 6 months status post medial meniscus repair

Sport: Football – Linemen

Participant 8: Pt is a 16.5 male Football player 7 months post ACLR and meniscus repair

Sport: Football- D-Line

Participant 9: Pt is a 16 y.o. male status post ACL/MCL and meniscus repair 6 months ago

Sport: Soccer

Other notable statistics from the program include that 100% of all athletes were able to return to sport at 11 months post-op as well, and that we had a re-injury rate within our ACL reconstruction population of 0% at the 2 years post- inception mark of the program, as after that time, tracking of the programs data by me stopped as I ended up leaving Texas to become the clinic director of the human performance and rehabilitation center in Hawaii. Overall, by all accounts and measures, the program was a success as even the admins and orthopedic surgeons at SRH were talking to me only a year later about expansion opportunities of the Bridge Program into different satellite clinics or facilities around the state. And this was obviously because I accomplished a lot of the objectives the hospital had in mind in the the first place when agreeing to fund and support the Bridge Program that I created, which namely consisted of me and my team off-loading patients from the sporting division of physical therapy to the Bridge Program, thus allowing for increased access to medical care by the local community, the generation of multiple streams of revenue for the hospital through the offerings of performance training, the improvement in return to sport rates seen in the post-operative ACL population seen at SRH, and the inter-collaboration of hospital staff, as the hospital itself became less siloed as I actively involved our Movement Science lab into my Bridge Program for data tracking and research purposes.

Now while I am proud of the above statistics and experiences I’ve laid out thus far within this video, the only reason I mention them is because it laid the foundation for the program I wish to speak of in this video. In my time as both a clinician and coach, I’ve completed the plans of care from the early acute phases through the performance phases when viewed from a rehabilitation perspective of just over 300 separate patient athletes who were status post ACL reconstruction. Average discharge times for those 300 individuals by me was roughly 8 months, and I’ve only had 1 re-tear in my professional career as a sport’s physical therapist. Thus, the tracking and comparing of my outcomes to the citied norms of the literature showed me that I was achieving results and outcomes that were much improved when compared to that of my colleagues. This is because normative results citied in the literature for return to sport are currently at only 55% for patients who are status post ACL reconstruction, and this statistic also accompanies a 30% re-injury risk to the repaired or reconstructed ACL of the athlete within 2 years of their return to sport release as well.

Upon this realization, I decided to create my own course detailing the methodologies I use for ACL rehabilitation which were influenced from my time learning from the leading experts from within the industry during my stays in various high-performance settings, as the perspectives I gathered are from the professional, private, military, and hospital settings that I’ve worked in. These perspectives are all very different and unique when compared to one another, but most importantly, tried and tested as they were instrumental in several different programs that I’ve developed, including the Bridge Programs that I spoke of earlier. This masterclass I’ve created on ACL rehabilitation is also unique from other courses in that it is predominately application based as enrollees will immediately learn easily digestable therapeutic exercise progressions that can be implemented starting on post-op day 1 of an athlete’s rehab. Not only that, but these progressions also span the entire continuum of care for the athlete, as I take the viewer of this program through each and every phase of rehab, including the return to performance phases of rehab, so that by the end of the course, all enrollees can effectively coach and effectively prescribe training means and methods to best fit the athlete in front of them.

The personal goal I had when creating this course was to give each and every enrollee of this course the knowledge I’ve gained through my professional career both as a physical therapist and as a strength and conditioning coach. I wanted to organize and impart this knowledge to the viewer of this course so that they personally had the means I used and implemented when creating the Bridge Programs for ACL performance training that I was a part of both in the private sector and at one of the world’s most distinguished orthopedic hospital systems. And I tried to do this in a manner that used strategies that scaled the entire care continuum, from the table to the turf, and which could be immediately implemented by sports medicine professionals so that they could more readily overcome the major milestones commonly experienced by patients’ status post ACL repair or reconstruction. Not only did I try to detail these strategies, but I also provided them as downloadable materials in both print and video formats as well within this course, as I give the world’s first long-term athletic development program which was tailored made for most of the major field sports out to all enrollees of this course. This blueprint for ACL rehabilitation comes with over 2000 separate and individual videos that are logically programmed from a frequency, intensity, time and type perspective in order to best return the patient athlete not only back to sport, but beyond pre-injury levels. Additionally, the course comes with over 35 hours of voice-over videos by me where I provide the complete context for why the patient is performing what was programmed, complete movement progressions or regressions to use when scaling interventions to the patient, and an assortment of verbal and visual cues to use for the athlete when cleaning up the commonly experienced movement faults for their different phases of the rehab. Simply put, this is the most complete course from an applied perspective currently on the market for the topic of ACL rehab.

Everything from strength training to load integration when performing field work, to teaching philosophies on safe and effective development of a patient’s plyometric, speed and agility mechanics, to recovery enhancement methods and injury reduction strategies are discussed, and more importantly, demonstrated and walked through progressively in order to enhance the enrollees’ clinical skills and expertise with regards to ACL rehab. Additionally, broadened opportunities for career advancement through the earning of 30 hours of continuing education credits are also offered with the purchase of this course, as well as the guarantee by me to you that the knowledge and skills the enrollee will learn upon purchase of this course demonstrate the highest commitment in providing your athletes with the best possible care currently available for this pathology. With a full money back guarantee, I am confident that the purchaser of this course will see value delivered back to them that exceeds their expectations and that results in opportunities that would have otherwise been unavailable to them. I can say this because the skills learned within this course will best allow the motivated learner to take actionable steps in either climbing the corporate ladder like I did towards a more lucrative job position within sports medicine through the enhancement of their applied clinical knowledge, or better yet, students who complete this course will have opportunities to successfully open their own private sports training centers where both rehabilitative and performance services are offered. Much like how Andrew Do, a former employee of mine and fellow strength and conditioning coach did just this past year.

And while this course provides exercise selections in the form of trainable menus, with more anchored decision making occurring through my giving of the viewer of this course an entire 68-week athletic development program tailored made for either the BPTB or quad tendon autograft choices for ACL reconstruction as well. This was also done to ensure that this course is the most comprehensive guide or blueprint on the market when navigating the vastness of physical preparation for ACL reconstruction when it came to bridging the gap educationally between rehab and performance and really throughout the entirety of the rehab to performance continuum.

Because of the scope of this course, the interested enrollee can either purchase it in its entirety, or through separate modules as well. Regardless of what method the enrollee chooses to use when enrolling in this course, they can still expect to be educated in applying the best available research and evidence while utilizing the systems, philosophies and methods I developed when building separate Bridge Programs both in the private and public sectors which supported patients in their quest for return to performance who were status post anterior cruciate ligament repair or reconstruction.

So, if you’re looking for the fastest way to build your clinical skills, to provide better patient care, and to navigate the return to sport process with improved confidence in your ability to consistently deliver superior outcomes to your patients, come experience the competitive advantage today in returning your patients to peak performance!