Quad Inhibition and Muscle Atrophy can really slow down the recovery process. However, Jackie Kleihege and Jena-Claire Auten know it is essential for healing. Finding the balance between helpful and hurtful is kind of an art form.

Looking at the timeline is essential so we can see the progress of where we have come.

We do not have all the data yet from the quad tendon ACL

We have 10 years of data on it

In the acute phase, it looks about the same.

If we can interrupt the inhibition early then we have better outcomes

It is really hard to study the brain when we are studying the knee

Decrease swelling

Decrease local inflammatory response

ICE???

We still want the natural healing process to continue through that phase.

And then for that to quietly fade out.

JK: I have probably underutilized it most of my career.

      I needed to give something more and then added NMES and made a difference.

PRE-OP therapy is critical

There is not a magic wand protocol

Pre-Op nutrition is super important as well.

Latency is key – I want those first 7 days like they are falling downhill, then I dial it back.

Often day 1 postop patients do not look bad, but then days 2-3 are worse.

JA: Genetics plays a role in the inflammation process.

Consistency is key, similar to Instagram and Facebook, they keep putting the ads in front of you and then you end up buying it…

Continue to use the same methods so the patients know what is coming and can buy in

OPEN KINETIC CHAIN – the type of graft makes a difference as well

I need to be able to read the signs and customize the options for them.

The goal is quad communication

Biofeedback can help give visual and auditory feedback.

It is really as good as they say.

The uses keep growing.

Femur fractures were one of the biggest changes on paper.

Jena Claire Auten – JenaClaire.Auten@memorialhermann.org

Jackie Kleihege –  jacquelyn.kleihege@memorialhermann.org

Jeremy Jackson

Shawn Ready – shawnreadyatc@gmail.com

Ray Olivo – rayolivo1@gmail.com

Dr. Mark Knoblauch – maknobla@Central.UH.EDU

Dr. Layci Harrison – lharris5@Central.UH.EDU

Bob Marley – Bob.Marley@uth.tmc.edu

Dr. Josh Yellen – jbyellen@central.uh.edu

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs

PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

Donate and get some swag (like Patreon but for the school)

DragonflyMax – one-stop EMR

HOIST – no matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.