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Honest Dialogue About The Rehab Process

At one point, I believed I was anti-protocol. Now, I’ve come to realize I’m actually anti-processless. Without a process most of our established rehab programs reek of incompetency. Competent rehab is a craft involving a high-level process. Too often, we are asleep behind the wheel to effectively track the craftiness of the kinetic chain


Most of the time, we are moving too fast, too generic, too conventional, and too de-humanistic_ using the process of elimination instead of the process of customization. We like to think in rears, instead of pioneering. More on this later. Back to the process of elimination: follow the checklist of tests (this is the gold standard and safe path). The process of customization involves constructing and deconstructing kinetic chain function. This takes time, competency, and individualization


Kinetic chain function is crafty and kaleidoscopic. Not in colors but in patterns, moveable parts, and connected layers & mechanisms shifting things on while shifting things off, synergizing one element while neutralizing another. It is the ultimate survival mechanism which means it is very proficient at disguising what’s deficient


Here’s my dilemma: I am not sure if we are actually having a rise in sports injuries or if we just have 10x more athletes participating in sports, more so than at any other time period in history? Which simply implies there will be an appearance of seemingly higher injury rates


Current numbers suggest: 500,000 athletes are seen by Ortho's per year, 2 million high school athletes are injured per year, 1.5 million athletes between the ages of 8-13 are injured per year. Our retreat numbers are approaching 50% per year. I do not believe there is a fail proof system, simple yes or no model, do or don’t do logical answer. In contrast, I do believe their is a folly proof approach when it comes to the rehab process


Pioneering The Rehab Process


In the military we had a simple rule: every battle plan is perfect until it meets the enemy. Protocols are highly effective on the basis of how to start the rehab process, not finish it. Depending on the injury type: first 4 to13 weeks is the exclusive domain of the protocol [old reliable] everything afterwards then becomes the process [customization]


Rehab should literally be translated as: workable outcomes standing on the shoulders of multiple series of non-workable micro failures. This hits hard like a car bomb! If you actually stopped to take account covering the entire rehab process, you would be astonished how many micro failures are required along the path toward a successful rehab outcome


Athletes use their kinetic chains in both predictable and unpredictable patterns. Both are correct. Athletes are complicated and messy beings which means our approach must be highly innovative and sophisticated to compete


No two injuries with the same injury label, map out the same way. This is where we get into trouble being cookie-cutter. Cookie-cutter is never a legit solution because it supersedes being situational


Listen to me: rehab is not just about the repair. This is where most rehab approaches fail! Pioneering hypothesis: the rehab process must involve identifying/optimizing the repair plus the preexisting kinetic chain dysfunctions. This is where the hidden complexity comes into play because usually the repair is a little more clear-cut


Protocols address the anticipated whereas the process addresses the variables which leads to an pioneering outcome

The rehab process has a mandate: make athletes strong not safe. There is a huge distinction. Both are not possible, which means one must be better than the other. We want to make athletes strong because it is impossible to keep them safe. Ego will put up a strong resistance to this concept but I will let you chew this up: Adam & Eve where in the safest place known to human beings, the garden. Chaos still entered, yet they were not strong enough to withstand


This is where I have noticed analyzing muscle function has become more vital to surgeons, coaches and athletes. Measuring kinetic chain movement is definitely pioneering by providing instantaneous data about hidden dysfunctions, weaknesses in real-time. More importantly, identifying hidden dysfunction not directly associated with the repair but will influence the repaired segment once higher stabilization, higher force and higher velocities come into play. Muscle Check is one of these pioneering tools available to surgeons capable of adding an edge to help accelerate the decision-making tasks by customizing the rehab process for the patient-athlete population

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