Envelope of Load Acceptance

This is a term used by Scott Dye, MD used to describe the etiology behind patellofemoral pain/injury. It describes why the same load may lead to patellofemoral pain in one person and not in another, or even lead to pain in the same person at one time but not at another. A loss of patellar and peripatellar tissue homeostasis if you will.

This concept can be applied to any joint in the body, no? Every athlete begins a sports season with a personal envelope due to their anatomy, level of sport specific fitness, previous injury, and what Janda described as "pattern overload". In other words, too much of the same thing; whether it be running in straight lines, or playing video games.

With all the scientific stuff I talk about, the manual therapy, functional exercise et al, never forget program design. In my opinion, I've never met anyone better at it than Vern Gambetta. I think all A.T.'s should own his book, "Athletic Development: The art & science of functional Sports Conditioning". I really think this is the scaffolding that builds a great rehab program. Without it, all you are doing is throwing pancake batter at a wall and hoping it sticks. I'm trying to convince him to get a weekend course going that will focus on just this.

I believe there is too much cook booking going on with strength coaches, and with athletic trainers (by way of treatment protocols). Working with a team or teams is a lot tougher than working in a private clinic. We deal with multiple athletes all at once in the concept of a team or teams- all with different envelopes of function. If we are not expanding those envelopes, we may be heaving pancake batter.