over time. However, we do have some questions from the audience that we might want to address before we end this session. One question would be, do, and this would be to all of our speakers, how do you or do you assess the quality of movement to determine readiness to return to sport? Yeah, so I think from a GPS standpoint that's really nice. It's hard to do, you know, for a high school athlete or somebody that doesn't have that technology. So I think, you know, the functional movement screen is a pretty good test for that. It's multi-body positions. It's, you know, picking up a marble off the floor. It's kind of like Y balance plus. So we use a lot of that in our physical therapy clinics to try to figure out their movement patterns. Any other comments? We have another question regarding consulting psychologists for our athletes who are injured. Do any of you consult, regularly consult psychologists for return to sport? I work pretty closely with some of our psychologists and we have some mental skills coaches that are really helpful. It's a benefit of being in a big institution, but in the community, you know, finding a local psychologist that you can use because a lot of these kids really struggle with that anxiety about going back to sport in addition to maybe having a difficult recovery. One of the things that I think you really have to think about is if there's a mismatch between their physical performance and their score on psychological readiness. Melissa showed one of these papers. We have some that show that if you have people who score really high on the ACLRSI and they have poor risk appraisal, they think I'm not going to get re-injured and they're scoring themselves really high early and go back to sport, they're the highest risk for re-injury. But then there's the opposite where you have somebody who's fully recovered by every test we can do and has poor risk appraisal and poor psychological readiness in other directions. Those would be the people. But the middle part is you got to make sure they're well rehabbed. So if they're not well rehabbed, that is often the reason why they score themselves poorly. Their knee doesn't feel well. It's swollen. It doesn't move right. They're weak. They don't feel like, you know, so that, the solution for that is not a psychologist. It's getting them fully rehabbed and I'm embarrassed sometimes about my profession at what, how people are clear for sport at really low measurements of readiness. Do that first. Yeah, great. Thank you. And last question, several of you mentioned open chain exercises and certainly that's been controversial and historically we've delayed those. What are your, what's your feeling on when to start open chain exercises and rehab? Okay, I'm going to start that, say this, that's an old wives tale. There's the same strain closed chain as open chain and when you walk, it's about four times that strain. So you let them walk. We start them with full and I can say, let me just say this, the new OKU we wrote has that in there. The new residence curriculum, which means all the new residents are going to get the real science, do open chain exercise. There's nothing to be afraid of and it's the best way to get good results. So, I mean there's really no controversy when you look at the science. It's just nonsense. Yeah, no, I know, I agree and I think that you know kind of dispelling those, you know, and basing our, you know, our rehab on science and return to sport is extremely important. And with that, I'd like to thank our speakers today and congratulate them on excellent talks and this will conclude our session today.

movement assessment

GPS technology

functional movement screens

psychological readiness

open chain exercises