Residents of the Round Table

Episode 10: Tendon Neuroplastic Training

Welcome to episode number 10 of The Residents of the Roundtable Podcast. Join Joey, Rayce, and Robert, as they discuss the topic of Tendon Neuroplastic Training and the article "Tendon neuroplastic training: Changing the way we think about tendon rehabilitation: A narrative review." Tendon rehabilitation has primarily consisted of exercise based interventions, with a focus on isometrics, eccentrics, or heavy slow resistance training with the goal to strengthen the musculotendinous structure. Little has been done to address the cortical excitation and inhibition changes that occur with tendinopathy. Utilization of externally paced exercises/movements can help address some of the motor control changes. Lastly, we address application of externally paced exercises to other conditions/pathologies to address cortical changes. Let us know what you think! For more episodes, subscribe and tune in to our podcast. You can also follow Joey Scambia, Rayce Houser, and Robert Santana on Instagram. @joeyscambia.dpt @the_frontsquat_doc @santana_dpt Rio E, Kidgell D, Moseley G, et al. (2016). Tendon neuroplastic training: Changing the way we think about tendon rehabilitation: A narrative review. British Journal of Sports Medicine.

Episode 9: UCL Reconstruction Rehabilitation and Return-to-Sport

Welcome to episode number 9 of The Residents of the Roundtable Podcast. Join Joey, Rayce, and Robert, as they discuss the topic of UCL rehabilitation and the article "Rehabilitation and Return-to-Play Criteria Following Ulnar Collateral Ligament Reconstruction." There is a lot of variability among various UCL reconstruction rehabilitation protocols. Protocols can range from 12 months up to 18 months. Regardless of the protocol, the foundation and principles of the protocol remain the same. We discuss implementation of the protocol and why delaying plyometrics to continue to focus on strength/hypertrophy a little longer might yield better results. Lastly, we cannot neglect that the individual to focus solely on the sight of repair. We can continue to work on thoracic rotation, hip rotation, contralateral upper limb strength, lower body strength to allow the individual to better maintain pertinent biomotor qualities to sport.  Let us know what you think! For more episodes, subscribe and tune in to our podcast. You can also follow Joey Scambia, Rayce Houser, and Robert Santana on Instagram. @joeyscambia.dpt @rayce.houser_dpt @santana_dpt Wilk K, Arrigo C, Dugas J, et al. (2017). Rehabilitation and Return-to-Play Criteria Following Ulnar Collateral Ligament Reconstruction. Operative Techniques in Sports Medicine.

Episode 8: Shoulder Stabilization Criteria Based Testing

Welcome to episode number 8 of The Residents of the Roundtable Podcast. Join Joey, Rayce, and Robert, as they discuss the topic of posterior shoulder instability and the article "Return to Sport After Shoulder Stabilization Procedures: A Criteria-Based Testing Continuum to Guide Rehabilitation and Inform Return-to-Play Decision Making." Many therapists and healthcare professionals will utilize time and a simple clinical examination to determine whether an individual is ready to return to sport. Athletes who do not undergo a criteria-based return to sport test battery had a 22% greater rate of recurrence compared to those who undergo and pass. Similar to ACL-R, although objective performance tests such as the CKCUEST and UQ-YBT may be within 90% symmetry, strength deficits in the rotator cuff/shoulder girdle may continue to persist; which highlights the value of true objective strength measurements with dynamometry. Moreover, testing criteria should best approximate the demands of the sport/activity the individual desires to get back to. An eclectic approach incorporating both open chain and closed chain tests will likely serve as the most useful versus putting all of our eggs in one basket. Remember, not only does the testing demands need to approximate sport, but also training as well. Let us know what you think! For more episodes, subscribe and tune in to our podcast. You can also follow Joey Scambia, Rayce Houser, and Robert Santana on Instagram. @joeyscambia.dpt @rayce.houser_dpt @santana_dpt Otley T, Balster S, Myers H, et al. (2022). Return to Sport After Shoulder Stabilization Procedures: A Criteria-Based Testing Continuum to Guide Rehabilitation and Inform Return-to-Play Decision Making. Arthroscopy, Sports Medicine, and Rehabilitation.

Episode 7: Phased Approach to Posterior Shoulder Instability

Welcome to episode number 7 of The Residents of the Roundtable Podcast. Join Joey, Rayce, and Robert, as they discuss the topic of posterior shoulder instability and the article "A Comprehensive Rehabilitation Program for Posterior Instability of the Shoulder." There are 3 main subcategories of posterior shoulder instability: traumatic, atraumatic, and repetitive microtrauma. Prognosis with conservative and non-conservative management will depend on the mechanism of injury along with other factors. A treatment framework can be used to guide exercise prescription for posterior shoulder instability. The entry point for each individual will be determined by their training age/history, subcategory classification, number of episodes of recurrence, and symptom severity/irritability. 1) Scapular Phase 2) Phase 1: 0 degrees of shoulder elevation 3) Phase 2: 0-45 degrees of shoulder elevation 4) Phase 3: 0-90 degrees of shoulder elevation 5) Phase 4: 0-180 degrees of shoulder elevation Let us know what you think! For more episodes, subscribe and tune in to our podcast. You can also follow Joey Scambia, Rayce Houser, and Robert Santana on Instagram. @joeyscambia.dpt @rayce.houser_dpt @santana_dpt Watson L, Balster S, Warby S, et al. (2017). A comprehensive rehabilitation program for posterior instability of the shoulder. Journal of Hand Therapy.

Episode 6: Arthrogenic Muscle Inhibition

Welcome to episode number 6 of The Residents of the Roundtable Podcast. Join Joey, Rayce, and Robert, as they discuss the topic of arthrogenic muscle inhibition (AMI) and the article "Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions." Typical physical therapy interventions to address AMI have included NMES and exercises such as quad sets to improve quadriceps activation. However, there are many underpinnings of AMI and traditional interventions have only addressed part of the problem. We discuss other interventions, modalities, and exercise strategies to resolve AMI to improve quadriceps activation. With the potential for AMI to last for many months following surgery, it is crucial to resolve AMI with a multimodal approach. Let us know what you think! For more episodes, subscribe and tune in to our podcast. You can also follow Joey Scambia, Rayce Houser, and Robert Santana on Instagram. @joeyscambia.dpt @rayce.houser_dpt @santana_dpt Sonnery-Cottet B, Saithna A, Quelard B, et al. (2019). Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions. British Journal of Sports Medicine.