ACL Rehab in Petaluma: How BaseCamp Physical Therapy Elevates Athlete’s Return to Sport

ACL injuries are among the most well-known and challenging setbacks for athletes. The mere thought of the injury gives some individuals PTSD, thinking of their rehab process and how they may have never been the same following this injury.

Fortunately, the ACL tear, and subsequent repair, have lessened in their consequence over the years. In fact, many athletes enjoy a full return to sport, at a similar level to before the injury. This is largely due to advances in surgical approaches, as well as more robust return to sport rehabilitation.

At BaseCamp Physical Therapy in Petaluma, we specialize in ACL rehabilitation that ensures a full return to sport through advanced sports physical therapy techniques In this article, we’ll discuss how our approach to the rehabilitation process following an ACL tear differs from the “typical” experience.

The Current Standard Of Care

It’s no secret that an athlete will require an extended period of physical therapy following an ACL repair. Just how long, however, is dependent on many factors.

For example, the type of graft that the surgeon uses can influence treatment and recovery times. Athletes may receive a patellar tendon or hamstring tendon autograft (designating the tendon came from their own body), or an allograft (the tendon came from a cadaver). In fact, it’s even possible these days to receive no graft at all!

Regardless of the graft, any rehabilitation program will focus on first re-gaining range of motion (ROM), re-establishing normal gait/walking patterns, and building back foundational levels of strength. From there, the athlete will be reintroduced to foundational strength-building movements, such as squats, stairs, and jumping.

Unfortunately, this is where many physical therapy programs end.

The Real Problem

In order to return to sport, athletes should be receiving a robust return-to-sport pathway in their rehabilitation. This would include running, sprinting, cutting, twisting, and simulating the specific demands of the sport itself.

Far too often, however, this part of the rehabilitation program is cut short. More often than not, it’s due to stipulations from insurance companies.

Many insurance companies will only cover care that allows athletes to return to their “functional daily activities”. Unfortunately for athletes, this doesn’t include sport-specific movements, such as sprinting, changing direction, and jumping.

Because there is no financial incentive to excel in this portion of the rehabilitation, most physical therapy clinics don’t spend precious time or resources on training their therapists to handle this portion of the rehabilitation process.

Additionally, the structuring of their schedule doesn’t allow for the appropriate time to take an athlete through sport-specific training. Instead, their schedule is geared toward simple treatment modalities, followed by exercise instruction from an unlicensed individual, such as a physical therapy aide.

As a result, athletes recovering from an ACL tear are put in a challenging position. They are often “discharged” from physical therapy at this point, and instructed to reintegrate into their sport’s weight training program, or to find a personal trainer that can help them prepare for sport.

An Ugly Truth

While there are several high-level strength & conditioning coaches in Sonoma County, the vast majority of fitness professionals, including personal trainers, lack the education and training needed to help an athlete return to the rigors of their sport following an ACL repair.

Disappointingly, this doesn’t stop some trainers from advertising their services to help athletes return to sport.

As a result, many athletes in Sonoma, Marin, and Napa Counties recovering from an ACL Repair end up returning to sport unprepared. This happens due to a lack of objective testing, and instead basing their return on the sheer amount of time following a surgery.

Because there is a wide range of what can happen in the 7-9 months following an ACL repair, simply operating off of a time-based approach neglects the athlete’s functional level. They may still have significant asymmetry present in their strength or movement.

This places them at high risk for reinjury, which is all too common an occurrence.

How BaseCamp Physical Therapy Differs In Their Approach

At BaseCamp, we’ve disconnected from the fundamental shortcomings of the “typical” experience for athletes recovering from an ACL repair. We’ve done this through 3 simple steps:

1. Registering as an Out-Of-Network Provider

2. Receiving extensive training on return-to-sport programs

3. Taking an objective, data-driven approach to return-to-sport

4. Forming relationships with local sports organizations

Let’s dive into how each of these 3 steps differentiates the level of care, and the outcomes that athletes receive at BaseCamp.

Out-Of-Network Care

Being an out-of-network provider means BaseCamp Physical Therapy has complete freedom in what services they provide to their athletes. This means our physical therapists can spend the entirety of our sessions focused on getting results.

At in-network offices, patients will work with a physical therapy aide for 50-70% of each session. Some of this time will be spent on exercise instruction, followed by application of passive modalities, such as ice and electric stimulation.

In-Network offices use physical therapy aides to allow for higher total billing to insurance companies. Even though the patient only spent 20-30 minutes with the physical therapist, the office can bill the insurance company for 60-75 minutes of care.

A physical therapy aide spends much of their time cleaning. They are not yet trained on the nuances of coaching athletes through high-performance exercise.

Ultimately, this results in less progress for the patient, as they spend less time with the trained expert.

At BaseCamp Physical Therapy, the patient will spend 60 minutes with an expert sports-trained physical therapist at every session. Both the therapist, and the patient, benefit significantly from this increased time.

Athletes make faster progress because they have more time with the trained expert. And the therapist has more time to observe and challenge the patient’s current level, allowing for better overall care.

Extensive Training In Return-To-Sport

Physical therapists receive nearly the exact same schooling, regardless of which physical therapy school they attend. It is their continued education following graduation that largely differs between therapists, allowing for excellence in various disciplines.

At most physical therapy practices, the therapists are free to choose their own continuing education focus. Most commonly, they will pursue techniques that improve their diagnostics or treatment for the most common ailments they see. This typically encompasses low back pain, arthritic conditions, and the occasional class in exercise instruction and selection.

The primary focus in a traditional physical therapy clinic is to help individuals reduce their pain. Much of the continued education that physical therapists choose to participate in will be geared toward this goal.

At BaseCamp Physical Therapy, each physical therapist has pursued extensive training in the fields of sports medicine and strength & conditioning. With this expertise, they are better educated on the advanced techniques that athletes require to prepare for sport. This, along with the high prevalence of athletes that we see, allows us to provide a higher level of care for to our athletes.

Rather than focus solely on pain-relief, the physical therapists at BaseCamp Physical Therapy are trained and equipped to focus on the variables that matter most to their athletes’ return to sport: speed, power, conditioning, and confidence.

Data-Driven Approaches to Returning to Sport

The conventional approach to an athlete returning to sport following surgery is centered around the amount of time passed since the athlete’s ACL repair. This is referred to as a timeline approach, and following ACL repair, it typically puts the athlete back at 9-12 months following surgery.

The challenge with this approach is that it completely neglects the athlete’s strength, movement, confidence, and exposure to sport-specific activities.

As a result, confidence is typically low when returning to sport. This can lead to higher incidence of re-injury for the athlete; a crushing blow after a long rehabilitation process.

At BaseCamp Physical Therapy, we take a different approach centered on objective data. Our athletes are put under a microscope throughout their rehabilitation, with an emphasis on restoring symmetry.

We use technology to measure quadriceps and hamstring strength, as well as other important muscles that assist in providing support for the knee. We also look at their ability to perform explosive jumping, on 2 legs, as well as 1 leg, to screen for asymmetry.

We progress athlete’s into sport-specific movements, including change of direction, sprinting, and chasing. Our focus isn’t just on drills, but also replicating the uncertainty and chaotic environments that embody sport. We also ensure their conditioning represents sport-specific time demands, so that athletes can be prepared for the aerobic and anaerobic demands of their sport. An athlete returning to American football will receive vastly different training than an athlete returning to soccer.

Relationships with Local Sports Organizations

Over the years, we’ve worked with athletes from almost every sport imaginable. Our athletes come from all over the North Bay Area, including Petaluma, Cotati, Santa Rosa, Rohnert Park, Windsor, Sonoma, Novato, Mill Valley, and beyond.

Through the opportunity to work with such a diverse population of athletes, we’ve formed relationships with many of the sport organizations in the area. We’ve worked hand-in-hand with clubs, such as North Coast FC and Redwood Empire Gymnastics, as well as schools, such as St. Vincent de Paul High School and Casa Grande High School.

These relationships allow us to have a personal connection with many of the coaches in the area. Through these relationships, we gain in-depth knowledge of the expectations for each athlete once they return to their sport.

We also communicate directly with many of these coaches, providing both our athletes and their coaches strategies for how to reintegrate into sport.

In addition, we routinely provide screening opportunities to these organizations, to help athletes avoid injury altogether.

This commitment to our local community is just one of the many ways in which we go above and beyond in our care for our athletes.

Summary

In summary, BaseCamp Physical Therapy takes a unique approach to the needs of the athlete following ACL repair. Our unique clinical environment, which allows for prolonged direct care with expert sports physical therapists, gives athletes the opportunity to fully rehabilitate and prepare to return to sport at the highest level. Our data-driven approach, and rich understanding of strength & conditioning principles, allow for athletes to regain their confidence and form.