Wednesday, March 3, 2010

Brian's MCL question

Hi Joe I know this is an old post
but could you comment on what your response would be from someone who does feel that the pictures are putting early stress on the MCL? Additionally could you comment on bracing in the acute phase of MCL injury in relation to preventing motion beyond 30 degrees extension and or 90 degrees of flexion. Some would suggest that knee position close to full extension early after injury is putting undue stress on the MCL as would some of your pictures. Perhaps an explanation how chain reaction biomechanics actually offloads tissue that have been injured. Personally I don't see anything wrong with what the athlete is doing in the photos and I do some similar movement patterns. Thanks again for such a good blog...!


Good questions Brian. Actually, this athlete was wearing a functional brace that blocked those very movements. If my memory served me right, the doc removed the stops on the 3rd or 4th day. Happens to be my orthopedist also, very familiar with my stuff.

You & your colleagues are both correct. The healing properties of a particular tissue is one of the factors that will determine what you do & when. That is, what is appropriate for one athlete would be inappropriate for another at any point in time. This particular athlete has a slight genu varum which affected how I sequenced my upper & lower extremity drivers. Perhaps the same drivers on someone else WOULD inappropriately load that MCL. An athlete with a genu valgum would have definitely been a challenge.

Now what you didn't see with this athlete was what he didn't do well- movements on the posterior vector like posterior lunges & backpeddling. That was the last thing we got back & took the most time to do it. He was doing lateral & rotational lunges before he could lunge backward on the injured leg. Go figure. But I couldn't rush it, as it was outside his envelope of function.

Overall though, I'd say MCL ligs heal very well; and I think surgeons feel the same way.

But that is G2's thing, doing your rehab or training right at the functional threshold, which is different for everyone.

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