STAGE ONE: STRENGTH

We use Isokinetic dynamometry for this – A machine which measures not just how strong you are, but how strong you are through a joint’s full range of motion. This lets us find weak spots in your range (if they exist) and then we can guide your team in how to make changes to fill in the gaps. Isokinetic dynamometry is the gold standard in single joint strength testing.

We have looked at our data in detail, compared it to existing published data, and taken the key variables you need to improve on, measure and change as part of rehabilitation.

We have published some of this data for other’s to benefit from too, and to check that others agree with our data set, but most of our data comparisons we have kept to benefit you directly.

From our research into ACL injuries, we know that these scores are important as those with smaller differences in peak quad strength between legs and those with high quad strength return to play at 9-months with less knee pain (ES 0.42, 0.45) (Franklyn-Miller et al., 2018), but we use this to test neck, shoulder, back, hip, knee and ankle strength dependent on your condition.

Isokinetic muscle strength and readiness to return to sport following anterior cruciate ligament reconstruction: is there an association? A systematic review and a protocol recommendation. Undheim MB, Cosgrave C, King E, Strike S, Marshall B, Falvey É, Franklyn-Miller A. Br J Sports Med. 2015 Oct;49(20):1305-10 in post operative ACL patients Countermovement Jump and Isokinetic Dynamometry as Measures of Rehabilitation Status After Anterior Cruciate Ligament Reconstruction. O’Malley E, Richter C, King E, Strike S, Moran K, Franklyn-Miller A, Moran R. J Athl Train. 2018 Jul;53(7):687-695

 

STAGE TWO: POWER

Imagine a dimmer switch on the wall, you can turn the lights on slowly or fast, you choose, and life is the same, you cannot just get strong when you rehabilitate, you need to adapt the speed of the muscle strength, and use more than one joint at the same time. We use force plates to assess rate of force development and over 1 million data points already collected to compare your progress. We can assess right versus left, and concentric versus eccentric, and test your neck, back, upper and lower body dependent on the condition.

We can identify gaps in your rehabilitation or encourage you to successfully progress to the next stage, with the knowledge that your progress is safe.

As with all our testing, we have published some of this data for other’s to benefit from too, and to check that others agree with our data set, but most of our data comparisons we have kept to benefit you directly.

We use the countermovement jump to understand how rapidly you are able to deceleration and accelerate your body and how much force you are able to produce while doing so. We are also able to measure the loads through each leg to understand if you are favouring one side over the other.

Our research has demonstrated that there are differences in deceleration and acceleration abilities between legs depending on the type of graft you have in your ACL surgery. Further, these asymmetries are different to those seen in maximum strength (Miles et al., 2017).

Back to Normal Symmetry? Biomechanical Variables Remain More Asymmetrical Than Normal During Jump and Change-of-Direction Testing 9 Months After Anterior Cruciate Ligament Reconstruction. King E, Richter C, Franklyn-Miller A, Wadey R, Moran R, Strike S. Am J Sports Med. 2019 Apr;47(5):1175-1185 Whole-body biomechanical differences between limbs exist 9 months after ACL reconstruction across jump/landing tasks. King E, Richter C, Franklyn-Miller A, Daniels K, Wadey R, Moran R, Strike S. Scand J Med Sci Sports. 2018 Dec;28(12):2567-2578

 

STAGE THREE: RUN

How you produce force and absorb it during running is important whether running is your sport, or part of what you do. We need to make sure that you can apply the strength and power changes you have made to running as you rehabilitate. We can assess joint angles and relationships such as pelvis rotation, ground contact time and running cadence. Making changes in how you maintain this can be continued with your rehab team whether at SSC or back with your own team. We will be giving you detailed factors and variables we identify to work on and analysis to work with.

We use the same motion capture technology used in Hollywood, and high end sport analysis, using reflective markers placed on your skin and multiple infrared cameras to record your movements and digitise your running. This lets us accurately compare variable’s that cannot be seen in detail with slow motion video and allow us to interpret these for your rehabilitation team compared to our data.

We benefit from comparing your data to patients who have returned to sport after injury and identifying how you apply the initial two levels of rehabilitation, most of our data comparisons we have kept to benefit you directly but we have published successful outcomes using our approach.

Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: a case series.Breen DT, Foster J, Falvey E, Franklyn-Miller A. Int J Sports Phys Ther. 2015 Feb;10(1):85-94

 

STAGE FOUR: AGILITY

Changing direction is one of the bodies most challenging tasks, We need to slow down, change direction, then accelerate, putting significant demands on the lower limb, torso and whole body.

This is difficult to assess but we have been collecting the largest database in Europe for the last 8 years with over 100,000 variables assessed per test in over 10,000 patients. We have recently begun an artificial intelligence project to identify the variable’s which expose risk of re-injury in a post-operative ACL patients and you can benefit directly from this data. We provide you with detailed risk analysis and variables to work on to improve both performance and risk reduction.

We have tracked changes in these variables in both patients with athletic groin pain and in the identification of performance changes and in rehabilitation reinjury risk. We have published widely our results but at this stage have kept many of the detailed analysis available to those undertaking SSC Lab testing and for feedback to their rehabilitation teams.

Biomechanical factors associated with time to complete a change of direction cutting maneuver.Marshall BM, Franklyn-Miller AD, King EA, Moran KA, Strike SC, Falvey ÉC. J Strength Cond Res. 2014 Oct;28(10):2845-51 Back to Normal Symmetry? Biomechanical Variables Remain More Asymmetrical Than Normal During Jump and Change-of-Direction Testing 9 Months After Anterior Cruciate Ligament Reconstruction.King E, Richter C, Franklyn-Miller A, Wadey R, Moran R, Strike S.Am J Sports Med. 2019 Apr;47(5):1175-1185 Principal Component Analysis of the Associations Between Kinetic Variables in Cutting and Jumping, and Cutting Performance Outcome. Welch N, Richter C, Moran K, Franklyn-Miller A. J Strength Cond Res. 2019 Biomechanical but not timed performance asymmetries persist between limbs 9 months after ACL reconstruction during planned and unplanned change of direction. King E, Richter C, Franklyn-Miller A, Daniels K, Wadey R, Jackson M, Moran R, Strike S.J Biomech. 2018 Nov 16;81:93-103. Clinical and biomechanical outcomes of rehabilitation targeting intersegmental control in athletic groin pain: prospective cohort of 205 patients. King E, Franklyn-Miller A, Richter C, O’Reilly E, Doolan M, Moran K, Strike S, Falvey É.Br J Sports Med. 2018 Aug;52(16):1054-1062.

 

STAGE FIVE: FIELD

We offer the world’s most comprehensive return to play testing system, bringing our data set to field based testing. Jumping, landing, cutting, running, braking, acceleration and sprinting are assessed in VU®. Not once but 5 times, comparing right and left sides continuously through a challenging field test using inertial sensors powered by XSens, and software developed by the VU® team at SSC.

This test is in development for use in clubs around the world as a measure of performance, recovery status and progression. It is challenging, and repeatability is critical, to demonstrate your readiness to return to the field, track or pitch. Wearing 8 inertial sensors in a body suit we track multiple variables simultaneously and provide an immediate score and detailed analysis for your team. Soon you will be able to pit your VU score against the world’s best , and will be available for your own club to measure your rehababiltion and performance.

VU® gives the same kinematics, joint angles and performance variables used throughout SSCLab and we have published the reliability, repeatability and validity of the test.

 

STAGE SIX: PERFORMANCE

Often after a period of time out of sport, the level of training managed during rehabilitation is not at the same aerobic level of normal training. You lose fitness, your diet changes and often you gain or lose weight as it is difficult to optimise during recovery, and worry about other factors that might jeopordise your recovery.

We offer as the final stage of SSCLab detailed assessment and interpretation using Cortex metabolic breath by breath gas analysis of your Vo2Max on rowing ergometer, Wattbike, your own bike or treadmill.

We also offer blood profiling of current nutritional and health status. This is a part of our HealthLab service and looks at HOMA-B, CRP, ESR, FBC, Fe2+, Vit D and B12 among other measures to identify areas of nutritional or health optimisation.

Finally, we can perform the gold standard body composition test of DEXA measurement of body fat to give clear targeting for training program design, the incorporation of HIIT or training adaptation.