Dr. Sam Rauchwarter, PT, DPT, SCS

To tailor rehab for ACL tears, the best approach is to incorporate balance exercises as early as possible. This should include balancing on a foam pad, balance desk or hard ground, as soon as the patient can stand on the leg. Balance exercises should also be done at home.
 
Transcript: "More evidence is showing neuroplastic changes in the brain with ACL tears. As PTs, how can you tailor rehab for this? That's a great question. I would say the biggest thing that you can do is start to do work on those neuroplastic changes early. So, for example, adding balance. So whether that's balance on a foam pad or on a balance disc or even just on hard ground, getting some of that neuromuscular proprioceptive feedback in early, essentially as soon as they can stand on that leg. So, for example, if they have an ACL reconstruction, I will get them in and on a foam pad or just even on the ground as soon as they're able to weight bear, according to the surgeon and surgery. From there, then we'll go up to a balance or a foam pad and then onto a balance disc. And I'm doing this every single session. And as soon as they can do it, I'm having them do it at home as well. So that's one of the best ways I can kind of start to tailor that rehab for this. There's a lot of other things, but at a high level, that's the first thing that you can do, is make sure that you're balancing."

The best exercises to increase SI joint mobility are stretches and strength exercises for the low back and pelvis, including glute medius and glute Min. If you are experiencing pain related to your SI joint, it is best to consult a physical therapist for a proper diagnosis.
 
Transcript: "What is a good exercise to increase SI joint mobility? So that's a really tough question because the SI joint itself actually only moves a couple of millimeters. So there's not really a good exercise particularly to increase SI joint mobility. However, you can definitely stretch and strengthen all the muscles around there. You can stretch and strengthen the low back. You can stretch and strengthen the pelvis, including like glute med, glute min, and a whole bunch of other muscles within there, within that pelvis. But those are probably your best bets. If something like that is bothering you, the best bet is to probably go to a physical therapist and get a proper diagnosis on it. But in terms of good exercises, there really isn't any because the SI really doesn't move."

I use strengthening exercises, manual therapy, and muscle energy techniques to help athletes with muscle imbalances. For fatigue, I focus on sets and reps and how much rest to give the athlete.
 
Transcript: "What techniques do you use to help athletes with muscle imbalances and fatigue? So I use a variety of different exercises in helping athletes with imbalances and fatigue. The biggest one that I'll use is strengthening. So obviously as a physical therapist, our job is to try and identify weaknesses and strengths within the human body in terms of muscular and joint. And so with the muscles, we'll try and identify which ones are weak or which ones fatigue really quickly. And then we'll try and correct those with any either corrective exercises and or manual therapy. There are other things that we'll do as well to help correct muscle imbalance, such as like muscle injury techniques to try and help get a muscle firing that maybe isn't firing before. And in terms to speak more towards like the fatigue aspect of it, that's when we start diving into sets and reps and how much to do and how much rest to give a patient or an athlete and kind of go from there. So there's a lot of different techniques that we can do to use. But the biggest one that I use is essentially strengthening, identifying weaknesses and then strengthening that actual muscle."

No, there are no body types that are not conducive to endurance sports. Genetics and training play a role in how successful one is in endurance sports.
 
Transcript: "Are certain body types not conducive to endurance sports? Long answer short, no. I would say that there are multiple body types that are conducive to endurance sports. If you look at the pro professional side, say the men's side, Jan Ferdinand, very tall and lanky. Then on the opposite end of that spectrum you have Christian Blumfeldt who's built a little bit bigger guy, kind of more like a diesel. And I think you have everything in between. So are there certain body types that are not conducive to endurance sports? I don't think so. I think some of that is genetics, but also too I think a lot of it is just getting out there and training."

The best way to help athletes stay motivated and engaged in their physical therapy is to educate them on why they are doing the exercises, how it will benefit their body and how it can get them back to sport faster. Additionally, switching up exercises when needed and making sure they are challenging but not too difficult can help keep athletes engaged and motivated.
 
Transcript: "How do you help athletes stay motivated and engaged in their physical therapy treatments? I would say the best way to do that is really to educate them. So what I'm doing every session is I'm telling them why I'm doing the exercise, what the purpose of it is, and how that's going to, and essentially trying to relate that to them. So how is it going to affect their body? How is it going to affect their treatment? How is it going to get them back to sport faster? And that's probably how I keep athletes the most engaged. The other way that I keep people engaged is essentially just switching up exercises when they need it. Continuing to make exercises challenging, but not necessarily too hard that they can't do them."

The hardest part about treating endurance athletes is getting them to understand why I'm holding them back and then for them to also do that because often times they will want to just go, go, go.
 
Transcript: "What is the hardest part about treating endurance athletes? Oh man, that is a good question. There's a lot of things that are really challenging about treating endurance athletes. I think one of the most challenging aspects of treating that population is really getting them to understand why we're holding them back often. It's not because I'm trying to slow down their progress or I'm not trying to delay their return. It's really for the benefit of tissue and tissue healing. So I'd say the hardest part about treating endurance athletes is probably getting them to understand why I'm holding them back and then for them to also do that. Because often times they will want to just go, go, go, go, go. And so that's definitely the hardest part. There's a lot of other hard parts about treating endurance athletes, but that by far is the hardest part."