COVID-19 Recovery and Return to Physical Activity

COVID-19 Recovery and Return to Physical Activity By: Dr. Laura Wenger, PT, OCS, FAAOMPT

As we move into spring of this year, I can’t help but feel a heavy wave of anxiety and stress when thinking about this past year and the realm of emotions it has brought into my life and the lives of most everyone in the world: uncertainty, fear, and worry to name a few. After speaking with family, friends, and patients, I know that I am not alone. Even with the efficacy of vaccinations and increasing percentages of adults in our community, nation, and world becoming able and willing to have the vaccine, I am still very nervously and hesitantly looking toward days where I don’t have to hyper-analyze nearly every decision made in daily life. Although we are moving slowly and carefully back toward some semblance of “normal”, COVID-19 continues to exist in our community and nation and is still affecting people we know with both new infections as well as some cases of long-term COVID effects, or “Long COVID”.

As more information is gathered about the exact effects of COVID-19 on our bodies, the profession of physical therapy has also been given more guidance on how to help our patients safely return to activity after they have been diagnosed and recovered from the disease. One thing that is evident is that COVID-19 affects surviving individuals in a large variety of ways, from a range of people that don’t have any symptoms present at all to some who feel effects from the disease for months following their active infection. Even for those individuals who have only mild to moderate symptoms and recover quickly with no long-term effects, research currently recommends waiting at least seven days after their symptoms are gone before starting a slow, progressive process of returning to exercise that should take approximately four to five weeks to return to their pre-COVID baseline.(1) Furthermore, for those individuals who experience a more severe case or have any prior history of cardiovascular diseases, specific testing by a cardiologist is recommended in order to return to exercise due to the higher risk of cardiac complications or blood clotting events after COVID.(1) These recommendations are based on the fact that this novel disease is demonstrated to affect all systems in your body, but especially the lungs and heart.(1)

I’m dreaming of summer hikes like this one that I took up to Columbine Lake last year for a socially-distanced exercise adventure!

Ultimately, physical therapists and all other health professionals are becoming more equipped to guide patients through post-COVID recovery as more information and data becomes available. As exercise specialists, physical therapists can successfully guide individuals through a progressive program to return back toward their baseline level of fitness after they have recovered from a COVID-19 infection, as long as they have been cleared by their physician. As our community continues to navigate this new world within the existence of COVID-19, I know I’m not the only one who looks forward to seeing more of you out on the trails that we all love to have in our backyard, and I’m looking forward to helping more people get out there safely.

1. Salman D, Vishnubala D, et al. Returning to physical activity after covid-19. BMJ. 2021;372:m4721

Integrating Pilates Exercises into Physical Therapy

By: Dr. Laura Wenger, PT, OCS, FAAOMPT

During this tumultuous past year, our clinic was fortunate enough to be able to go through with a planned remodel that included opening up our gym space (perfect timing in a world of physical distancing!) and updating our flooring. Along with updating our physical space, we have been able to update some of our equipment, as well! For those of you who have been patients of Tomsic PT in the past, you may have fond memories of the Shuttle machine. Now, in its place, we have a versatile clinical model of the Balanced Body Pilates Reformer, which has given us more ability to integrate Pilates exercises in our rehabilitation programs for many of our patients.

First, I’d like to explain a bit about what Pilates is. Names after its founder, Joseph Pilates, the exercise system created in the early 1900s is based on principles of core stability and strength through movement.(1) These exercises are performed on a spring-loaded machine, called a reformer, and there are also mat exercises that can be performed with no equipment necessary. Over the years, Pilates has evolved with many experts across the country teaching in Pilates studios, such as at one of the many esteemed studios that we have in our small town, as well as physical therapists and other health professionals integrating these exercises into the treatment of musculoskeletal problems from head to toe.

Christine teaching Jake the “Cleopatra” move for spine mobility

Nathan working on his spine mobility with guidance by Christine

We are lucky here to have the guidance of one of our PTs, Christine, to share her knowledge of a wide variety of reformer exercises that she has learned through her previous training. We were able to take some time in early January to have a few intensive skills sessions within our group to learn and practice these exercises. As we’ve been integrating various exercises on the reformer into our patient care, our patients have been seeing great results with more mobility, more strength, more function, and less pain. These results are in line with research articles that demonstrate the positive effect of using Pilates exercises as a rehabilitation tool for reducing pain and disability, such as the 2018 systematic review by Byrnes et al.(2)

Nathan cuing me on trunk stability during resisted arm exercises

Ellen giving Nathan feedback on his form during resisted leg exercises for core stability

We are excited to continue to learn more about the use of the reformer as an effective part of a rehabilitation program as we continue to explore its use on ourselves and our patients. If you are curious about how Pilates exercises can be integrated into physical therapy for a musculoskeletal injury or post-operative care, make sure to contact our office to discuss this with one of our therapists!

1. Balanced Body. Origins. 2018. Accessed Feb 9, 2021.
2. Byrnes K, We PJ, Whillier S. Is Pilates an effective rehabilitation tool? A systematic review. J Bodywork & Movement Therapies. 2018;22(1):192-202.

Staff Spotlight: Dr. Nathan Dailey, PT, OCS, CSCS

We have another relatively new staff member that we would love to have you know better here at Tomsic PT! In October of 2020, we welcomed Dr. Nathan Dailey onto our staff just days after he finished his service with the US Army.

– How did you end up in Durango and where did you live previously?
My wife was fortunate enough to get a tenure-track professor position in Marketing at FLC early in FEB 2020 before this COVID craziness began. I was nearing the end of my contract w/ the Army and was excited to move out here with her and our 4-year-old son. My wife was coming from a professor position at the University of Texas at San Antonio (UTSA) and I was finishing an assignment at Fort Sill, OK (one of 4 basic training posts for the Army in the US). We are so happy to now call Durango home and to have our son grow up where there’s snow!

Nathan and his son at Mount Scott outside of Lawton, Oklahoma

– What do you love about working in Durango/at Tomsic?
One of the first things I noticed after only a few days of working here is how incredibly fit so many of the Durango residents are into their later years. So often we see the poor health outcomes associated with inactivity and Durango is an incredible little microcosm, a testament to how powerful remaining active is. I love treating patients who tell me that they ABSOLUTELY MUST return to skiing, hiking 14’ers, mountain biking and playing 2+ hour games of pickle ball.

Regarding the staff, I have been overjoyed to find that not one of them is unkind, mean-spirited or attempts to undermine me or the other members of the team; this was definitely not the case with some of my previous jobs and it makes going to work every day a pleasure.

– What are your special interests in PT and how do you incorporate them into your clinical time at Tomsic?
Anyone who talks to me for more than five seconds will realize that I am incredibly passionate about incorporating traditional elements of strength training into my clinical practice. I love not just incorporating the loaded movements themselves, but geeking out about such minutiae as load progression, volume manipulation and periodization. As most of the patients who come to see me have athletic goals (return to hiking every week for at least 9 miles per hike, be able to run across Zion National Monument in a single day, return to swing dancing), marrying these patients’ rehab w/ sport performance makes sense to me. This is something I did nearly every day while in the military and I am incredibly excited to bring this treatment style to the Durango community.

Nathan deadlifting 500lb at Fort Sill, Oklahoma in 2020

– What’s one fun fact about yourself that you’d like to share?
I am incredibly afraid of heights, but that didn’t stop me from jumping out of a perfectly good airplane (skydiving) in the spring of 2014 w/ my wife or sitting in the hurricane seat (near the window facing the wind) on several Black Hawk flights in Iraq. I continue to try to face my fears.

– Anything else that you’d like to highlight, feel free to share!
I am passionate about reducing the risk of injury to athletes (tactical or civilian) through careful manipulation of training load and slow introduction of resistance training. I have a white board and plenty of dry erase markers and am all too happy to share the insights I’ve learned!

Nathan, we are so happy to have you on our team!

Staff Spotlight: Dr. Christine Richards, PT, OCS

We here at Tomsic PT have had the pleasure of having Dr. Christine Richards, PT, OCS join our team in July of 2020. She brings with her a lot of knowledge, skill, and passion for seeing people get better and achieve their goals! See below to learn a bit more about Christine and why she is a great asset to our clinic:

– How did you end up in Durango and where did you live previously?
My husband Tom and I were living and working in Telluride for the past three years. Before that we had spent many years working seasonally, going between Alaska in the summers and various ski towns in the winters. Though some of the most beautiful places in the country, resort towns always left something lacking, and we were looking for a year-round community that was (relatively) affordable but still had a vibrant outdoorsy element to it. We visited Durango a number of times while living in Telluride, and we knew we would make the move someday. A job opening at Tomsic PT was just the right catalyst to do it!

Christine with her husband, Tom, and dog, Choyu, on some formations in the backcountry in Utah

– What do you love about working in Durango/at Tomsic?
I love Durango’s location, with close proximity to both the mountains and the desert, and plenty of ways to get out into quiet, expansive nature without going far. I enjoy the people I’ve met so far and look forward to getting involved in a variety of community activities once it’s safe to do so again. As for Tomsic PT, I feel very fortunate to be a part of this team. I love the collaborative nature of the group, with every person playing a vital and defined role in the workings of the clinic, and every opinion and person valued. The focus on education and growth is also a huge draw for me; the opportunity to be a mentor to physical therapy students, while at the same time receiving mentoring from experts in our field, is invaluable and a lot of fun!

– What are your special interests in PT and how do you incorporate them into your clinical time at Tomsic?
One of my primary interests in PT is manual therapy. I have a background of 10 years as a massage therapist before becoming a PT, and I have always felt an affinity for working with my hands through therapeutic touch. Furthermore, manual therapy in combination with exercise is consistently supported in our professional literature as producing good outcomes for various conditions in orthopedic physical therapy, and I am interested above all in producing good outcomes for my patients! I am actively pursuing further education in this area and the clinical reasoning directed toward its most effective use, and I utilize these techniques in the clinic whenever appropriate. My other special interests include chronic pain and pain neuroscience, reducing fall risk in seniors, yoga, and mindfulness.

– What’s one fun fact about yourself that you’d like to share?
Ever since childhood, I have been a singer, and that was my first profession. Massage therapy was just supposed to be a day job while I was trying to “make it”, but I’m glad life took me in a different direction! These days (or at least in non-COVID times), my husband and I enjoy singing in community choirs and for other small events. We look forward to getting involved in the music scene in Durango when it is safe to do so.

Christine on a ridge in Denali National Park, Alaska

We are so happy to have you here, Christine!

What We Learned During Our 14-Day Quarantine- Telehealth in PT

By: Dr. Laura Wenger, PT, OCS, FAAOMPT

Recently in November, our entire clinic staff voluntarily quarantined after we ultimately had three staff members test positive for COVID-19. This decision was made after extensive discussions with San Juan Basin Public Health staff and within our clinical staff, as we all felt that it was the right thing to do in order to best protect our patients and ourselves. While, thankfully, the majority of us continued to stay healthy while we were isolated in our homes (and the employees who were positive for COVID-19 all had full, swift recoveries) and no patients were found to have exposure from our staff cases, we were forced to pivot to utilizing telehealth for our current patients in order to keep them moving with their rehab. Although we have been providing telehealth visits since the beginning of this pandemic nine months ago, it was a big pivot for our clinicians to go from providing sporadic telehealth visits 1-2 times per week to providing multiple telehealth visits per day. 

With this swift change to telehealth came a quick adaptation to continuing to provide quality PT through a computer screen. While the manual therapy component of physical therapy can’t be performed through a screen, we continued to empower patients in self-mobilization techniques so that they could still benefit from the positive effects of imparting mobility on specific joints. The real winners of telehealth proved to be exercise and movement therapy, where we were able to continue our guided progression of movement and resistance training for each of our patients within the context of their injury. And, though I talk about these visits in past-tense, our work continues via telehealth as many of our patients decided to stay in that format because they still felt the positive effects of physical therapy from the convenience and safety of their homes. 

During our quarantine in November, I was providing telehealth from home with my assistant off-screen in the background!

To be completely honest, as a provider who is trained in manual therapy (i.e. a lot of “hands on” work), I was skeptical about my own ability to provide physical therapy through a computer screen at the same quality as an in-person visit. I’ve been pleasantly surprised, as have my colleagues, at our ability to continue to help our patients via telehealth at the same level of excellence that we strive to deliver each day in the clinic. 

We are again operating full-time in the clinic, with continued rigorous screening and mask policies for our patients and staff, as well as continued diligence in physical distancing within our clinic. That being said, we are also continuing to serve a portion of our current patients via telehealth as well as accepting new patients in the telehealth format so that we can ensure that our patients, both new and established, can work toward meeting their goals of moving better with less pain. If you are interested in how physical therapy can help you via telehealth during this time, please call us at (970) 259-0574 for more information and to set up an appointment with one of our specialized physical therapists! 

What is the NEUBIE?

For those of you who have been around in the clinic recently, you may have observed (or been part of yourself!) a treatment session where a patient is doing exercises and movements while hooked up to a machine via electrodes. Just this past March (right before the COVID-19 shelter-in-place requirements began), Ellen was able to go to Florida to be trained on a machine that uses a new version of an old technology, direct current electrical stimulation, called the NEUBIE. You may be wondering what NEUBIE stands for: Neuro Biological Electrical Stimulation. Ellen became intrigued in bringing this technology into our clinic after learning more about it at a national conference in January of this year.

The timing was not ideal, as Ellen could not have anticipated that there would be a dramatic drop in patients as folks stayed home in those initial months of the global pandemic. However, with the few patients that remained coming into the clinic in a safe manner for their high-priority rehabilitation (which consisted of a majority of people who had just had surgery before the shelter-in-place requirements began), Ellen and the other therapists began working with the NEUBIE machine and seeing the prospective benefit of this piece of equipment as an integral part of getting many of our patients to meet their goals. Once I returned back to the clinic in late April, I was also introduced to the NEUBIE machine and began learning about it’s practical uses.

Now, I’m not going to lie, I’m a bit of a skeptic by nature when it comes to “gadgets” that are supposed to enhance physical therapy. As a PT that has been trained in the specialty of manual therapy, I have a hard time thinking that our patients would need anything beyond my hands and my brain (to come up with beneficial exercises and activity progressions) to improve toward reaching their goals. However, although my uptake was slow in utilizing this technology within my patient care, I have been finding an outstanding benefit for many patients when I have used the NEUBIE machine to enhance their current exercise program. I’m not going to lie, I have been surprised to hear from many of our patients, especially those with chronic pain, how beneficial they have felt this addition to be by impacting their pain and quality of life in a positive way.

Though clinical research with this device is still in its infancy due to its relative novelty in use, we have seen many anecdotal cases of our patients in real-time benefit from the use of the NEUBIE as part of their rehab program. In order to understand a little more about how the the technology works to address the nervous system and aide in the brain to muscle connection that we often speak so fondly of when prescribing exercises, I think this video does the best job at explaining the basics:

As one of only three clinics in Colorado that have this technology available (with the other two located on the Front Range), we’d love to have you come in and learn more about how the NEUBIE can enhance your return to everything you love with better mobility, less pain, and improved quality. With an individualized approach to examination and coming up with a treatment plan and progression, we can discuss if the NEUBIE might be a good fit for your rehabilitation plan!

COVID-19 Recovery and Exercise

With the continuing threat of COVID-19 world-wide, it seems as if new information is coming out nearly daily. From trying to understand how the virus is transmitted to who is more susceptible to getting the virus and having serious health impacts from it (and everything in between), we are working our hardest to stay up-to-date with the latest information about COVID-19 and how it impacts ourselves, our patients, and the clinic. As we continue to remain open through the pandemic, we continue to use screening and cleaning techniques along with proper hygiene (friendly reminder- face masks required!) from our staff and within the patients as ways to stay safe and healthy during this time.

That being said, it is clear that this virus will be sticking around for a while and many questions will continue to arise as more people in our community are affected by COVID-19. In the physical therapy realm, one of the questions of interest to us is “when is it safe to start exercising again after recovering from COVID-19?”. This question was recently discussed in the open-access article “Exercise and Athletics in the COVID-19 Pandemic Era” on the American College of Cardiology’s website.(1)

COVID-19 Virus in Durango CO | Tomsic Physical Therapy

The article provides an interesting discussion, from the perspective of cardiologists, regarding COVID-19’s effects on the heart, the inflammatory-reducing effects of exercise, and what the recommendations are for returning to exercise and sport after recovering from COVID-19.(1) Knowing that, based on early data and observations, “COVID-19 infected patients with hypertension, diabetes, cerebrovascular or cardiovascular disease are more likely to require hospitalization, ICU level care, and die from the infection,” these pre-existing conditions must be taken into account when considering a return to exercise after being infected.(1) Ultimately, the current recommendations from the authors were as follows:

  • “… the recreational exerciser seeking to resume activity for general physical fitness after COVID-19 who experienced only mild to moderate symptoms, were not hospitalized, and had no concerning cardiac symptoms should be able to resume recreational exercise at moderate intensity once completely recovered.”(1)
  • “However, patients with pre-existing cardiac disease who are potentially at higher risk of complications with COVID-19 may require additional testing and risk assessment prior to return to regular exercise levels.”(1)
  • Based on two recently published statements quoted by the authors, it is suggested that athletes who tested positive for COVID-19 who were either asymptomatic or had mild symptoms and were not hospitalized take a rest period of 2 weeks from either the time of the positive test for asymptomatic individuals or from the time of symptom resolution for those people who had symptoms before considering return to exercise in a slow, progressive manner with guidance by their doctor.
  • Furthermore, for athletes who tested positive for COVID-19 who had significant symptoms and were hospitalized, a recovery period of at least two weeks after symptom resolution followed by further cardiac assessment and monitoring is recommended. Those with known myocardial injury need to wait 3-6 months before re-evaluation by a cardiologist before considering a return to exercise.

The authors of this article are quick to point out that this information is based on expert opinion, due to the fact that there are no higher level research studies performed on this topic because of the novelty of this virus. However, their concern for the impact of COVID-19 on the heart came through in their recommendations. Ultimately, if you have tested positive for COVID-19 (regardless of whether you were asymptomatic or had such significant symptoms that you were hospitalized), you should make sure to discuss how to safely return to exercise with your healthcare time. As information is quickly evolving, these recommendations may change as further research can be performed and observations are made, but the bottom line for now is that you should REST for at least a two week period regardless of how severely you felt impacted by the virus. Stay safe, stay healthy, wash your hands, and wear your mask!

  1. Emery MS, Phelan DMJ, Martinez MW. Exercise and Athletics in the COVID-19 Pandemic Era.

The Importance of Movement During the COVID-19 Pandemic

I’m sure I’m speaking for everyone when I say- It’s been quite a month. A month full of different emotions including anxiety, fear, hope, gratefulness, and worry to name a few. Sometimes, all of those emotions are experienced within an hour, depending on the day. Like many of you, my previously defined version of “life” has changed wholly during this COVID-19 pandemic. Where I used to pride myself on being able to separate out my different roles- physical therapist, wife/mom, individual- into nice boxes, I found myself all of a sudden dealing with the fact that my boxes all completely melded into one, with a continuous flow of trying to figure out how to be a PT, wife/mother, and individual (as well as a new role of homeschool teacher and stay-at-home mom) all simultaneously. The first few days, weeks, of this were rough: Learning telehealth and how to still provide quality PT via a video platform instead of face-to-face, learning how to help my son best with remote learning, learning how to provide my daughter with the time and attention she needs especially with working on her PT as she is experiencing some gross motor developmental delays, learning how to help support my husband emotionally while we are both home from work and out of our usual routines. And, oh yeah, learning how to continue taking opportunities to take care of myself through all of the uncertainty and evolving roles. However, I find that day-by-day, a new sense of understanding and “routine” emerges, at least as best as it can during such a tenuous time.

Continuing Movement in Durango CO | Tomsic Physical Therapy
Continuing my weekly dance class in my living room!

One thing that has been crucial to my sense of staying grounded has been finding continued opportunities for movement. Sure, we all know that exercise is the best medicine- something that I teach my patients day in and day out. When in doubt, MOVE! But, now more than ever, finding opportunities for movement is my best recommendation for helping our minds and our bodies during this time. I implore anyone who reads this to find ways to continue to move safely: maintaining social distancing guidelines while on the trails or in your neighborhood, getting that yoga mat out and finding a free online yoga class to try (I love, still participating in your favorite dance class or pilates class with your friends and teachers that you used to see on a weekly basis, or even trying something new as the world of online exercise guidance has exponentially increased in the past few weeks with many free offerings! MOVE for your brain, your body, your health, your family… I hope you all are staying safe and healthy out there. Remember, Tomsic PT is still offering appointments both via telehealth (including new evaluations and ergonomic assessments!) as well as in the clinic where we are following all of the CDC and San Juan Basin Health recommendations for cleanliness, hygiene, and safety during this time. Don’t hesitate to reach out to us for more information on how to reach your physical therapy goals- we are here to help you!

CrossFit and Stress Urinary Incontinence

CrossFit, or CrossFit-style classes, have gained popularity in the past 10 or so years for a good reasoning: they are challenging, fun, and create camaraderie around strength and health. There are a number of great gyms in the Durango area that provide these kinds of classes, and many of our patients are regular participants. Although I have not yet ever participated in a strength and fitness class like CrossFit, I’ve recently become particularly interested in learning more about these workouts so that I can better serve my patients. I’ve also had a recent string of patients that happen to be pregnant or in their postpartum period, so I was especially excited to partake in a continuing education course called “Clinical Management of the Fitness Athlete: Pregnancy and Potspartum” that focuses on these specific types of patients.

CrossFit and Stress Urinary Incontinence in Durango CO | Tomsic Physical Therapy
Picture of strong, weight-lifting mama-to-be (Photo Source: CrossFit Training During Pregnancy)

One statistic that came out from a recent study that was shocking to me was that 84% of female CrossFit athletes that participated in the study reported urinary incontinence, otherwise known as leakage.(1) This was in comparison to another group of women who participated in non-CrossFit fitness classes of which only 48% reported urinary incontinence.(1) This leakage was most common with jumping and weightlifting actions, which of course are very common staples of CrossFit workouts.(1) This also makes me wonder about all of the other Durango athletes I see that do jumping or weightlifting as part of their exercise routine whether or not they are participating in CrossFit style classes. How many women might be out there that are leaking when they do activity that just think it is a “normal” part of life, especially after pregnancy, labor, & delivery?!?

CrossFit and Stress Urinary Incontinence in Durango CO | Tomsic Physical Therapy
A picture that was recently circulating the web and sparking a big discussion in peeing while weightlifting. (Photo source The Great Fitness Experiment: Bodily Functions Fitness 101)

The big takeaway from the course that I took is that, although it may be common, urinary incontinence is certainly not normal, and there are many tools that physical therapists can use to help you with this problem if you are experiencing it! Also, even as a physical therapist that is not certified in pelvic floor therapy that includes internal examination and treatment, there are a lot of assessments and treatments that I can do to address this problem as well as guide patients that are pregnant or postpartum through their exercise programs in order to continue being active as safely as possible given the stage they are in along their journey. Of course, check in with your physician or midwife to ensure you are cleared for exercise both during pregnancy and postpartum. If you’ve been cleared for exercise and you are not sure how to best navigate activity and exercise during and after pregnancy (even many years after pregnancy!), don’t hesitate to schedule an evaluation appointment to figure out the optimal treatment plan for you.  Babies are always welcome at appointments if childcare is a challenge for you, too!

1. Elks W, Jaramillo-Huff A, et al. The Stress Urinary Incontinence in CrossFit (SUCCeSS) Study. Female Pelvic Med Reconstr Surg. 2020 Feb;26(2):101-106.

Return to Sport after ACL Reconstruction

Many people in Durango know someone who has had an anterior cruciate ligament (ACL) injury of their knee if they have been lucky enough to have not had one them self. Much of the time, these injuries end up needing a surgical reconstruction depending on the severity of the sprain or tear to the ligament. One of the most common questions that we hear after an ACL reconstruction is when returning to sport activities is safe. The surgeon will often give strong recommendations to wait as long as possible, especially depending on the type of sport that the individual is getting back into. This is especially true in sports that require any twisting or pivoting of the knee, such as soccer, skiing, and football. In general, most people don’t love hearing this and I have often encountered patients who push back into their sport fairly quickly. 

A recent study published in one of my favorite peer-reviewed PT journals, the Journal of Orthopaedic & Sports Physical Therapy (JOSPT), sought to find out what the implications are of returning to sport too soon.(1) The study specifically looked at young athletes (late teens to early and mid-20s) in regards to how quickly they returned to sport and how this impacted their rate of re-injury to the affected ACL.(1) Ultimately, this study found that “returning to knee-strenuous sport before ACL reconstruction was associated with an approximately 7-fold increased rate of sustaining a second ACL injury.”(1) “Knee-strenuous sports” included baseball, snowboarding, skiing, volleyball, basketball, football, soccer, and ice hockey” among others.

Something also very interesting that the researchers found was that the risk of re-injury was unaffected by whether or not the person achieved symmetrical muscle function or quadriceps muscle strength.(1) So, even if the person did everything they could to get strong and their strength of the surgical leg was equal to the non-surgical leg, they still had a significantly higher chance of reinjuring their ACL if they returned to sports before that 9 month mark.(1) The take away from all of this: if it is at all possible, you should WAIT to return to sport after an ACL reconstruction if you are a young athlete. Even though this study was not performed in older athletes, the argument may be made that this advice applies to them as well. If you have experienced an ACL injury and subsequent surgery and you want more information about when and how to safely return to sport, make sure you talk to your PT and surgeon about this timeframe. 

  1. Beischer S, Gustavsson L, et al. Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return. J Orthop Sports Phys Ther 2020;50(2):83-90. doi:10.2519/jospt.2020.9071