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Time is money, but when it comes to ACL rehabilitation, the calendar alone does not determine readiness for return to play. On this episode of BackTable Bone & Sport, host Dr. Larry Balle is joined by returning guest Dr. Andy Glidewell to discuss modern protocols for anterior cruciate ligament (ACL) rehabilitation. They cover the ACL’s role in knee stability, common injury mechanisms, and why moving beyond timeline-based milestones is crucial for optimal recovery. Glidewell emphasizes that while surgery reconstructs the ligament, rehabilitation is what restores true knee function.
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Timestamps
00:00 - Introduction
05:55 - Collaborative ACL Protocols
09:56 - Anatomy Review: The Role of the ACL
14:41 - ACL Rehab Misconceptions
19:04 - Rehab Goal Metrics: Time vs. Subjective Measures
28:55 - Early Post-Op Priorities
36:26 - Tweaking ACL Protocols Based on ACL Reconstruction Graft
42:30 - Use of Orthobiologics in Surgery
47:15 - Progressing BFR to ARPE to Hypertrophy in Rehab
56:38 - Incorporating Plymometrics and Agility Training in ACL Rehab
1:00:19 - The Mental Hurdles in ACL Rehab and Return to Sport
01:08:00 - Clinical Pearls in ACL Rehab
01:10:20 - Wrap Up
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More about this episode
The conversation explores early post-operative priorities, the importance of progressive strength and functional testing, and the need for closer collaboration between surgeons and physical therapists. Additional topics discussed include shifting from time-based to subjective and objective criteria for return to sport, and evolving approaches to open-chain knee extension to address persistent quadriceps deficits and reduce anterior knee pain.
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Resources
Dr. Andy Glidewell
https://www.trainrecovermove.com/andyglidewellpt
https://uamshealth.com/provider/michael-a-glidewell/
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BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists.
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