Athletic Performance Training

Rarely do I miss an opportunity to apply techniques from work to things I enjoy doing in my free time. Often that thing is cycling, the greatest sport in the world. But when autumn comes around and the streets turn cold and dark, I prefer the iron of the weight room over the carbon of the road. A technical sport like Olympic weightlifting is of course best mastered with the guidance of an experienced coach. To the less fortunate or ambitious, video analysis may help hone skills and track progress. Various apps offer basic video tools, but I’ve yet to find one that provides the data I am truly interested in: ground reaction forces (GRFs), forces applied to the barbell, accurate kinematics, and mechanical power output. That is why I developed my own weightlifting video analyzer. The demo below is the result of several techniques from work combined: AI & computer vision (Raidyn), state-input estimation & multibody dynamics (KU Leuven Mecha(tro)nic System Dynamics (LMSD)), and biomechanical impact modelling (Classified Cycling). At the core is a flexible multibody model of the barbell that feeds into a combined state-input-parameter estimator to infer the forces applied to the bar. With accurate barbell forces, GRFs can be estimated  with higher precision than methods based solely on accelerations derived from video. In addition, the model unlocks a virtually unlimited supply of synthetic training data for the AI model, ensuring robust segmentation of barbell motion and deformation. Initially I cast myself as the hero of the demo, but I soon realized that a video starring the Pogačar of weightlifting would make for a more spectacular analysis. Enter Bulgarian Karlos Nasar, 20 years of age at this year’s European Championships in Moldova, lifting a record-breaking 229 kg overhead. Running my analyzer on Nasar’s low-resolution YouTube video allowed me to test its performance on a subject it hadn’t seen before in training, with frame rate and resolution far below what I use in my own sessions – and yet the algorithms didn’t miss a beat. Sure, it helps that weightlifting consists of only two precisely defined movement patterns, but I was still pleasantly surprised. The demo below is just the start. Belgium’s cold season still has a way to go and I’ve got plenty of ideas to improve and expand the algorithms. Next up: joint and muscle force estimation. 

Integrated brain training is a real game-changer for ACL rehab. 🤔 In sports, athletes perform in dynamic, unpredictable settings, making split-second decisions while executing complex movements. That's a far cry from the controlled environment of typical rehab sessions. 💡 Rehab focuses on task-oriented exercises and internal feedback, but it might be missing the mark. From recent research it even seems that classic rehabilitation induces as much, if not more, of the neuroplasticity than the injury itself, increasing the risk of re-injury (Grooms, in press).   🏋️♀️ There’s a need for an implicit and dual-task approach in ACL rehab, starting from the early stages. The video highlights the integration of this approach into ACL rehab.   🔴 SL squat right leg; Pass left; Count -1.  🟢 Step-up right leg; Pass left; Count +1.  🟣 SL RDL right leg; Count -2.  🔵 SL squat left; Header.  🟡 Step-up left leg; Header; Count +2.  🩵 SL RDL left leg.   1️⃣ Neuromuscular deficits and muscle weakness occur at different central nervous system levels (Cortical, subcortical and spinal level) in ACL patients (Tayfur 2020, Bodkin 2019). These deficits in central activation are linked to poor recuperation of quadriceps activation and strength (Criss 2023). These neural deficits not only prevent effective strengthening, but also contribute to secondary injury risk (Capin 2016). Impaired strength and central nervous system excitability persist for months to years after ACL surgery, suggesting the need for integrated brain training during the early stages of ACL rehab (Kuenze 2015). Traditional concentric exercises cannot overcome the inhibited cortical drive to the muscle and therefore fails to adequately activate muscles and restore neuromuscular control (Lepley 2015).     2️⃣ There's a link between how our brains work and the risk of ACL injuries. Brain activity related to visual, proprioceptive and attentional integration are crucial factors in rehab and prevention of ACL injury (Grooms 2022). Interestingly, athletes with high-risk landing biomechanics following ACL rehab exhibit a brain activation pattern shifted toward increased visual-proprioceptive and spatial processing to organize movement. However, this heightened reliance on attentional and sensory processing for movement coordination might compromise their ability to effectively maintain neuromuscular control in high-pressure sports situations involving opponents or the ball (common scenarios for ACL injuries) (Villa 2020) The current task-oriented rehab methods might actually reinforce these less effective brain activation patterns rather than fixing them. It is paramount to design rehab programs that challenge both the body and the brain, simulating the unpredictable situations athletes face during games. By integrating tasks that require perception, quick decision-making and neuromuscular control, we are able to retrain the brain and reduce the risk of injuries (Chaaban 2023, Grooms 2017). #acl

🦵 ACL Post-Op Rehabilitation Roadmap From Surgery → Strength → Safe Return to Sport Postoperative rehab after ACL reconstruction isn’t just about healing — it’s about restoring strength, confidence, and performance while minimizing reinjury risk. Recovery typically takes 9–12 months and follows a phased, criterion-based progression, not just time alone.👇 🔹 Phase 1: Early Protection (Weeks 0–6) 🎯 Goals: ✅ Reduce pain & swelling ✅ Restore knee ROM ✅ Rebuild quadriceps strength 📌 Targets: • Quad strength ≥ 60% LSI • NMES to improve activation • Gradual Open Kinetic Chain (after surgeon clearance) 💡 Focus: Control inflammation + wake up the quad 🔹 Phase 2: Intermediate (Weeks 7–9) (Enter only if early goals achieved) 🎯 Criteria to start: • ROM 0°–115° • Effusion ≤ 1+ • Normal gait 📌 Goals: • Full symmetrical ROM • Quad strength ≥ 70% LSI • Balance & neuromuscular training • Begin aerobic conditioning 💡 Focus: Stability + movement quality 🔹 Phase 3: Late Strength (Weeks 10–16) 🎯 Progressions: • Start running • Landing mechanics training • Gym-based strengthening 📌 Targets: • Quad strength ≥ 80% LSI 💡 Focus: Strength + controlled impact 🔹 Phase 4: Transitional (Months 4–6) 🎯 Introduce: • Jumping • Sprinting • Deceleration • Agility drills 📌 Targets: • Strength + hop tests ≥ 85% LSI 💡 Focus: Power + sport movement prep 🔹 Phase 5: Return to Sport (Months 6–12) 🎯 Sport-specific conditioning & drills 📌 Clearance criteria: ✅ No pain or swelling ✅ Quad + hop tests ≥ 90% LSI ✅ Psychological readiness (confidence & low fear) 💡 Focus: Performance + safety 📃 Key Takeaway 🚫 Don’t rush timelines ✔️ Follow criteria-based milestones Because: Strength + symmetry + confidence = lower reinjury risk

Your Peloton is great for your heart. It's doing nothing for your bones. Professional cyclists lose bone density during training. A systematic review on cycling and swimming confirmed it: zero positive effect on bone mineral density. Zero. You could be the fittest person in the room and have the weakest skeleton. Bone only responds to mechanical load. On a bike or in a pool, there's almost none going through your frame. Your heart gets stronger. Your bones get nothing. I spent years in consulting sitting twelve hours a day. Back-to-back meetings in windowless rooms. I trained on top of that and thought I was covered. I wasn't. Nobody told me that sitting all day signals to your bones they don't need to stay strong. Day after day, year after year, they adapt. Just not in the direction you want. What the research says works: Heavy compound lifts, twice a week, 30 minutes. • Squats • Deadlifts • Overhead press Five sets of five at 85%+ of your max. The LIFTMOR trial put postmenopausal women with low bone mass on this exact protocol. They gained roughly 4% in lumbar spine density. Adherence above 90%. No fractures. If it was safe for that population, your excuses are thin. Add 10 jumps, three times a week. Two minutes total. Do them between calls. Nobody needs to know. 60 minutes a week. Less time than a strategy meeting that could've been an email. After 30, you lose 0.5-1% of bone mass per year. By 50, you could be down 10-20% and feel completely fine. The official screening recommendation for men? Wait until 70. Or until something breaks. When was the last time a doctor mentioned your bone density? I wrote about all of this in Sunday's Upward ARC newsletter. 20 peer-reviewed sources. The full protocol, the screening blind spots, and what changes after 30. Subscribe here www.andreheeg.com Stay healthy, Andre Heeg, MD, PhD

If you are not clear as to what weight you should lift, how many reps/sets you should do, for various goals, read this! 1. Strength Goal: Maximize how much you can lift in a single effort (raw strength). Typical for: Athletes, powerlifters, or anyone wanting to get functionally stronger. Guidelines: Reps: 3-6 per set Sets: 3-5 Load: 80-90% of your 1RM (heavy weights) Rest between sets: 2-4 minutes Focus: Low reps, high intensity, perfect form Example: Heavy squats, deadlifts, bench press 2. Hypertrophy (Muscle Growth) Goal: Build lean muscle size and volume. Typical for: Those looking to tone, shape, or add muscle mass. Guidelines: Reps: 6-12 per set Sets: 3-5 Load: 65–80% of your 1RM (moderate to heavy) Rest between sets: 60-90 seconds Focus: Time under tension, controlled tempo, and muscle engagement Example: Dumbbell presses, lunges, rows, leg press 3. Endurance Goal: Improve muscular stamina - the ability to sustain effort over time. Typical for: Runners, cyclists, beginners, or people looking for functional fitness. Guidelines: Reps: 12-20+ per set Sets: 2-4 Load: 40-60% of your 1RM (light to moderate) Rest between sets: 30-60 seconds Focus: Controlled movement and consistency Example: Bodyweight squats, push-ups, resistance bands, light kettlebells 4. Power Goal: Develop explosive force (strength + speed). Typical for: Athletes, advanced lifters, or those training for performance. Guidelines: Reps: 1-5 Sets: 3-5 Load: 70-90% of your 1RM (but moved fast) Rest between sets: 2-3 minutes Focus: Quick, explosive lifts with full control Example: Jump squats, power cleans, medicine ball throws 5. General Fitness & Longevity Goal: Build strength, maintain muscle, improve posture, and support daily function. Typical for: Most people seeking balanced, sustainable fitness. Guidelines: Reps: 8-15 per set Sets: 2-4 Load: Moderate weight - challenging but safe Rest between sets: 60-90 seconds Focus: Full-body training, mobility, and injury prevention Example: Compound lifts, functional movements, core and balance work 🧠 Basic Rules of Thumb *** Form comes before load. Never compromise technique to lift heavier. *** Progressive overload - gradually increase weight, reps, or intensity over time to keep improving. *** Muscle needs challenge + recovery. Muscles grow and adapt after training - sleep and nutrition matter. *** Mix goals periodically. Cycle between strength, hypertrophy, and endurance phases for complete fitness. *** Listen to your body. Fatigue, pain, or poor recovery mean you need rest or adjustment. 🌿 In summary: Train heavy and low reps for strength. Train moderate and medium reps for muscle growth. Train light and high reps for endurance. Choose based on your goal - then let consistency do the rest. #resistancetraining #clarity #goals #healthcoach #ganeskuduva If you truly want to learn about health and fitness, follow me.

The sports rehabilitation of the ACL athlete requires a fundamental platform of planning, programming, and activity progressions from day one until the time of discharge and return to play (RTP). Conditions such as noxious stimuli (pain, edema, etc.), arthrogenic inhibition of the quadriceps, kinesiophobia, neurocognitive deficits, limitations in range of motion (ROM) and movement, hindered overall function, etc., are concerning. These consequential conditions must be addressed through an appropriate and supervised means of patient care to allow for physical activity progressions from low load/low velocity to high load/high velocity concluding in an optimal RTP. This demonstrated physical ability is essential as successful participation in competitive athletics most often engages high loads (physical stressors) performed at high velocities. A sports rehabilitation platform that has been successfully incorporated and documented over many years is the rehabilitation modified version of Hall of Fame Strength and Conditioning Coach Al Vermeil’s Hierarchy of Athletic Development. Vermeil’s hierarchy was initially established and utilized for the performance enhancement training of athletes. The basic version of the hierarchy (Figure 1A) has continued to evolve (Figure 1B) and has also been adapted for the sports rehabilitation professional (Figure 1C). This rehabilitation modified model has also continued to evolve with the significant efforts and contributions of my friend and professional peer Robert Shapiro to become the rehabilitation platform that is employed for patient care today (Figure 2). It is very important to note that during the ACL rehabilitation process when planning and programming the enhancement of specific components and physical qualities throughout the hierarchy, there must be a corresponding relationship (timing) with the biological soft tissue healing continuum (Figure 3). This relationship is essential to ensure a safe and appropriate transition throughout the athlete’s ACL (hierarchy) rehabilitation as well as not to disrupt the soft tissue integrity and ACL post-operative biological healing process. This coordinated effort of is also essential to avoid undesirable soft tissue biological consequences and/or post-operative injury. For several reasons (genetics, concomitant knee/ACL injury, type of surgical intervention, etc.) ACL athletes, like the general population, have varied rates of biological healing, however, biological healing does transpire at predictable time intervals (Figure 4). The soft tissue healing continuum as related to the appropriate corresponding programming for the inclusion of specific physical qualities in the rehabilitation model is presented in Figure 5. For efficient and effective anticipated ACL outcomes appropriate inclusion of the various stages of the hierarchy should transpire with the corresponding suitable stages of the biological soft tissue healing process.

Do you prescribe glute med exercises? 🙋♂️ This study analyzed how different hip exercises target individual gluteal muscles for performance, injury prevention, and rehabilitation. Here’s what stood out: 💡 Key Findings: 🏋️♂️ Loaded split squat, single-leg RDL, and single-leg hip thrust = 🥇 top exercises for gluteus maximus. 🤸♂️ Bodyweight side plank and single-leg RDL = 🔑 for gluteus medius and minimus. ⚙️ Adding external resistance (12RM) boosts muscle forces across all exercises by 28–150N! 🎯 What makes these exercises effective? 📈 Peak muscle forces align with maximum fiber length, making muscle lengthening a major factor in generating tension. 🧘 Low fiber velocity during these exercises = optimal control and tension generation. 💪 Practical Takeaways: 🥇 For maximum strength: Use tier 1 exercises (split squat, RDL, hip thrust) to target gluteus maximus. 🏠 For no-equipment training: Try side planks for glute medius and minimus. ⚖️ For all-around glute activation: Single-leg RDLs hit all three gluteal muscles effectively! 🔍 Why this matters: 🔧 Whether you’re optimizing for athletic performance, addressing hip/knee pain, or building muscle strength, these findings can guide smarter exercise choices. #physio #sportsmedicine #sportsphysio #rehabilitation #performance #basketball #football #soccer #vestibular

💥 Your patient’s non-injured knee #Hamstring is compensating before you even take your first #ACL post-op step ! A cool study published in the International Journal of Sports Physical Therapy (#IJSPT) reveals that ACL reconstruction triggers an immediate, systemic nervous system rewrite—affecting both legs within just 15 days of surgery. Here is what the data shows about early-stage recovery in Muscle Activation, studied with #KMyo by KINVENT : #QuadricepsShutdown: Voluntary activation of the vastus medialis (VM) collapsed by 55.2% , and the vastus lateralis (VL) dropped by 47.5% compared to healthy controls. #TheStiffeningStrategy: To protect the joint, the brain rapidly spikes hamstring co-activation by up to 67.8% , creating a protective but movement-limiting "flexor facilitation" pattern. #ContralateralEcho: This isn't just a local knee issue. The healthy, non-operated limb also demonstrated significantly higher hamstring co-activation compared to healthy controls. 🧠 The Clinical Takeaway #ArthrogenicMuscleInhibition (AMI) is a centrally mediated motor reorganization, not a localized injury. If we don’t actively target this neural shutdown within the first 2–3 weeks, a temporary protective reflex can hardwire into a chronic, dysfunctional motor pattern. To optimize outcomes, we must look beyond the surgical knee and address bilateral neural drive from day one. Kudos to Roberto Ricupito, Marco Bravi, Fabio Santacaterina, the one and only Florian FORELLI and the research team for quantifying this critical early window. 👉 Physios & Strength Coaches: Knowing the healthy limb is altering its neural drive this early, how does this change your day-one assessment and rehab progression? (Link in the comment section) #SportsMedicine #ACLRehabilitation #PhysicalTherapy #SportsScience #SportsPhysicalTherapy #Orthopedics #Neuroplasticity #sEMG Michael Jeanfavre PT, DPT, FAAOMPT, SCS, OCS, CSCS jerome piquet Cedric Cassou Erwann Le Corre Blanchard Sylvain Alexandre GERMAIN Hugo DEL RABAL

The Anterior Cruciate Ligament (ACL) is considered a vital sensory organ, not merely a passive structural stabilizer. It acts as a proprioceptive sensor, packed with mechanoreceptors that send real-time feedback to the central nervous system regarding joint position, tension, and movement speed. Key Aspects of the ACL as a Sensory Organ: Proprioception and Coordination: The ACL contains Ruffini endings, Pacinian corpuscles, and Golgi-like endings that detect ligament stretching. This information allows the brain to understand knee position and coordinate muscle activity to protect the joint. Ligamento-muscular Protective Reflex: The sensory information from the ACL initiates rapid muscular contractions (especially the hamstrings) to prevent excessive knee loading. Neuroplastic Changes: An ACL rupture disrupts this sensory loop, causing profound changes in the central nervous system, sometimes described as a "brain injury" rather than just a mechanical tear. Impact of Injury: When the ACL is injured, this "sensory input" is lost, leading to poor postural control and reduced muscular reflexes. Rehabilitation Focus: Because it functions as a sensory organ, rehabilitation following injury is not just about strengthening the knee, but rebuilding the neuro-sensory connection (proprioceptive training) between the knee and the brain.

Top Physiotherapy Tips for ACL Repair ✅ 1. Restore full extension early • Extension is more important than flexion in the first 2 weeks. • Prevents gait deviation & cyclops lesion. ✅ 2. Quads activation is the priority • SLR without lag • NMES + quad sets • Avoid letting the knee “hang in flexion”. ✅ 3. Early WBAT (if ACL alone) • Encourages normal gait and reduces swelling. • Closed kinetic chain exercises are preferred early. ✅ 4. Control swelling aggressively • Ice, compression, elevation, lymphatic drainage. • Effusion slows quadriceps recovery. ✅ 5. Focus on neuromuscular control • Balance board, perturbation training. • Helps prevent re-injury. ✅ 6. Avoid open-chain knee extension 0–30° early • High strain on the ACL graft. • Safe range: 90–45° early on. ✅ 7. Don’t rush pivoting and cutting • Even with good strength, graft maturation takes 9–12 months. ⸻ 🔹 Top Physiotherapy Tips for ACL + Meniscus Repair 🔒 1. Protect the meniscus first • WB restricted: TTWB (0–2 w) → PWB (2–4 w) → WBAT (4–6 w) • Flexion limited to 0–90° for first 4–6 weeks. 🔒 2. Avoid deep squats & loaded flexion • No squats > 90° for 3 months. • Avoid pivoting, twisting, or kneeling early. 💡 3. Brace locked in extension during walking • Reduces shear on the meniscus sutures. 💡 4. Start quadriceps strengthening in safe ranges • SLR, quad sets, NMES • CKC delayed until week 4–6. 💡 5. Gait training progresses slowly • Normal gait only after weight-bearing restrictions end. 💡 6. Expect delayed running & sport • Running: 12–16 weeks • Return to pivot sports: 6–9 months ⸻ 🔹 Combined Clinical Pearls ⭐ The meniscus repair dictates the early rehab — not the ACL. ⭐ Never allow knee flexion under load early after meniscus repair. ⭐ Effusion = stop progression. ⭐ Quadriceps strength symmetry is the best predictor of safe return to sport. ⭐ Lateral meniscus repairs need more caution than medial.