Do you know the post rehab scope of practice?

As post rehab fitness grows and gains acceptance by medical professionals it is important to make sure you understand the services and activities that fall within the scope of practice for the post rehab professional. The practice of all medical disciplines is closely regulated by a board of examiners usually appointed by the state or provincial legislature or governor. The board specifically outlines the educational requirements, licensing procedures, accepted treatment and procedures practitioners may use in their manage of patients. At this point, no state or provincial legislature has established a scope of practice for the post rehab professional. We have established a scope of practice for our Medical Exercise Specialists, Post Rehab Conditioning Specialists and Medical Exercise Program Directors. We teach this in every post rehab workshop we offer. Continue below to look review the post rehab scope of practice. Our next post will review the red flags indicating a client needs evaluation and/or treatment by a licensed medical professional.

Please click the link below to listen to our podcast titled "The Post Rehab Scope of Practice".

Dr Mike

The knee meniscus - Where is it and what does it do?

The menisci of the knee are the most important structures in the knee. The cruciates are important to knee stability but the menisci are most important because at this point, the menisci cannot be repaired or regenerated. There are two menisci, the medial and lateral, found in each knee. The larger of the two menisci is the medial. The most often damaged of the two is also the medial meniscus. For more more detailed anatomical review of the knee menisci, please click the link below to our video outlining the knee meniscus.

Dr Mike

ACL Graft - Hamstring or Patella Tendon?

Tiger Woods recently underwent an ACL reconstruction using a hamstring graft. But many professionals athletes have the ACL reconstructed using the patella tendon graft. Why use the hamstring tendon opposed to the patella tendon?

We know the patella tendon draft is 110% (research estimates) stronger than the original ACL but some surgeons still prefer the hamstring graft. This is because the hamstring is vascularized immediately and the hamstring does not cause as many issues with the development of scar tissue. The patella tendon is the stronger of the two grafts but the patella tendon is stronger but it must re-vascularize after the surgery. Re-vsacularization is vitally important to the stability and resiliency of the new ligament. The patella tendon graft does have a slightly higher incidence of scarring but the durability of the graft makes it very attractive for use with athletes.

The selection of the graft may be affected by the age of the client, the degree of knee instability and the preference of the surgeon. The outcome studies on the use of the two grafts doesn't show a significant advantage for either. Physician preference and comfort are usually the deciding factor in graft selection.

For you the PRP, the most important knowledge our need regarding the graft selection is the intensity level of progression the graft can tolerate. Usually the patella tendon graft and tolerate greater forces at the 4-6 month mark than the hamstring graft. But overall, the functional outcomes for both grafts are the same. With both grafts caution with the last 30 degrees of open-chain knee extension is important.

Dr Mike

The ACL - Where is it and what does it do?

The recent ACL rupture in Tom Brady's knee and the reconstructive surgery that Tiger Woods recently underwent has highlighted the ligaments of the knee. There are 4 primary ligaments of the knee. These include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). The cruciates are major stabilizers in the knee. The ACL is important in maintaining stability in the knee during dynamic activities such as cutting, turning, pivoting and changing direction. The ACL prevents the anterior translation of the tibia beneath the femur. The tear of the ACL allows the uncontrolled movement of the femur on top of the tibia. That uncontrolled movement may cause menisical damage. Meniscal damage may lead to arthritic changes in the knee. Click the link below to watch the review of the major ligament structures in the knee.

Dr Mike

Quadriceps Review

The quadriceps in the most important muscle group in the lower extremity. The four heads of the quadriceps are innervated by the femoral nerve. The quadriceps acts to extend the knee. Click the link below to watch the review of quadriceps function and anatomy.

Dr Mike

Post Rehab Programming to Increase Revenue

The summer is over and schools are opening. Thoughts now shift to education and getting back into the groove of work, study and exercise. This fall is a great time to offer group based post rehab programming such as the Dynamic Back School or Women's Fitness 101. These two programs are easily introduced in a club or private studio setting and they will allow you to capture a new group of clients. The group based approach to the client with medical issues will allow you to tap into the medical market at a lower price point but with an opportunity for significant revenue. We recommend a $180-225 fee per participant in the back school or Women's Fitness 101. These programs are delivered in six sessions over a 30-day period. The thirty day approach is very attractive to medical professional who are usually very reluctant to refer patients to long-term fitness programs. In my next blog post I will explain the Dynamic Back School.

Dr Mike