Spent an Hour with a Top Physical Therapist

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Spent an Hour with a Top Physical Therapist

Post by Bram » Mon May 28, 2018 10:36 pm

Luckily, I'm feeling healthy, but I have a PT at my gym who works with a big array of professional athletes (Carson Palmer, Vincent Jackson, Darren Sproles and so on).

I wanted to see how he approached his training..

He was treating a former personal training client of mine with a severe knee injury (ACL reconstruction, arthritic) that I had failed to help due to lack of skill and knowledge (he came to me with the injury, I just didn't have the ability to rehabilitate him). The client has worked with him for a number of years and is back to training Brazilian Jiu-Jitsu and playing tennis after being completely incapacitated for a few years.

Part 1 - Mobilization

The client had come in warmed up from something or another (I think just doing a ton of biceps) and the PT spent about 15 minutes doing 3 different hands-on manipulations. One where he pulled the tibia down, over and laterally rotated it. Another where he moved the patella back and forth while focusing on tilting it, and another that looked like an indian burn (internally rotating the femur, externally rotating the tibia). All were in an attempt to maximize space for the joint to not suffer inflammation. After that he had him extend his leg isometrically with the back of the leg on a towel to fire the VMO (I'm assuming).

All this manipulation shit was way out of my scope - I'm not sure how the hell I would even know what would be useful or for what injury conditions, but it was interesting none-the-less.

Part 2 - Strengthening

He threw a resistance band above and below the knee and had him do wall-sits. 3 sets of 30 seconds or so, with 10-20 second rest...he mentioned that he starts basically all lower body work with a wall-sit variation to get the stabilizers to fire (VMO and glute medius)

The next exercises were done for 3-4 sets each and 10-12 reps a side with 20-30 seconds rest between sets generally.

KB Front-Rack Box Squat [with the same band set-up]

KB Front-Rack Reverse Airborne Lunge to Bosu. (bouncing his back knee off the top of the BOSU)

Bands at Waist Height - Walk Forward then Deadlift

*the PT mentioned that he always thinks "what does he want to accomplish with an exercise?" Then decides if he wants SHEAR or COMPRESSIVE force. The bands turn it into a shear exercise (he also mentioned that this guy also has a very screwy lower back).

Alternating Explosive Leg Press (push with one foot, switch feet as the exercise becomes weight-less)

TRX Hamstring Curls with Manual Eccentric Loading (the PT pulled the straps towards himself on each rep of the negative)

*PT mentioned that hamstrings are only contracting at 20% during concentric load, so you want to load them up eccentrically.

45 Degree Lower Back Isometric - Dropping and Catching a Medicine Ball
(hold a ball at chest, drop it and catch it at extension, repeat)

Medicine Ball Twist and Toss at an Angle to Wall and Catch x 10 each side
(patient is perpendicular to the wall, twist towards wall and throw with one arm, catch and repeat)

Part 3 - Mobilization

Thomas Stretch x 1-2 minutes each side x 2 sets

Patient lies on the end of a bench holding one knee to his chest, PT drives the other knee down and across to the mid-line.

Couple other things....

*he mentioned how important it was with plyo's to be extremely short on the rebound phase with his pro athletes. He said plyo's were important only for performance, but not for fitness, and had no business in most people's fitness programs.

*plyo's and bio-genics (stem cell therapy, PRP, etc.) were the two biggest revolutions in physical therapy in his career (20+ years)


I don't know if you guys will find this useful.

I hope to repeat this experience again and see what else I can pick-up. I'm glad my anatomy knowledge is somewhat serviceable because he was saying some highly technical shit.
Last edited by Bram on Wed May 30, 2018 8:27 pm, edited 1 time in total.
"When you seek it, you cannot find it.” — Zen riddle

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Re: Spent an Hour with a Top Physical Therapist

Post by terra » Tue May 29, 2018 11:26 pm

Thanks for taking the time to write that out Bram.
(VMO and medial glutes)
He probably meant 'glute medius'.
What lies behind us and what lies before us are tiny matters compared to what lies within us.
Ralph Waldo Emerson

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Re: Spent an Hour with a Top Physical Therapist

Post by Bram » Wed May 30, 2018 8:28 pm

Glad you found some value Terra!

I asked him and you are correct, I edited my original post with the change. <<<<q
"When you seek it, you cannot find it.” — Zen riddle

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