The Alpine Physio

The Alpine Physio ✅ Injury education
✅ Ideas for rehabilitation and exercises
✅ Simple solutions for pain management
✅ Current research on a sports injury rehabilitation

The 9–12 months after an ACL injury are some of the longest of your athletic life. Here’s how to get through them. Nobod...
04/06/2026

The 9–12 months after an ACL injury are some of the longest of your athletic life. Here’s how to get through them.

Nobody warns you about the mental side of ACL rehab.
You expect surgery to hurt. You expect to work hard. What you don’t expect is the grief — losing your sport, your routine, your identity, your season — sometimes two.
I see it every week in clinic. The athletes who come back strongest aren’t necessarily the ones with the best surgeons or the strongest quads. They’re the ones who trained their minds as hard as their knees.
These are the 8 strategies I work through with every ACL athlete I see in the Sea-to-Sky.

1️⃣ THE 3 R’s — RECOGNISE. REALISE. REBUILD.
Being on the shelf is a grief experience. Don’t fight that.
Recognise what’s happened. Realise what it means for your season. Then — and only then — rebuild, purposefully, through rehab.
You can’t skip the first two and expect the third to stick. The athletes who try to bypass the emotional process end up stuck six months later wondering why they’re not progressing.

2️⃣ OWN YOUR REHAB
Show up like an athlete, not a patient.
You’re not being fixed. You’re rebuilding. Ask questions. Track your numbers. Tell your physio when something feels off. Push back on plans that feel arbitrary.
The athletes who recover best treat rehab like a training block — because that’s what it is. You wouldn’t show up to a strength program and let someone else hold your numbers. Don’t do it in rehab either.

3️⃣ VISUALISE THE COMEBACK
Your mind-body connection is a tool. Use it.
Visualise your knee bending without fear. Visualise dropping into your first run. Visualise that first turn back on snow — what it sounds like, what it feels like under your edges, the way your body moves through it.
Elite athletes use imagery before every competition. There’s no reason you can’t use it during rehab. Five minutes a day, eyes closed, full sensory detail. It builds the neural pathways before your knee is ready for the real thing.

4️⃣ SET GOALS YOU CAN HIT
Big milestones motivate. Small wins sustain. Both matter.
The big ones — Week 2–6: full knee extension. Week 12: 10 × single-leg squat to a small box. Month 9–12: passing ret

Most ACL rehab covers the basics. Here are 5 things I see missed most often. 1️⃣ QUAD EXTENSIONSFor years patients have ...
14/05/2026

Most ACL rehab covers the basics. Here are 5 things I see missed most often.

1️⃣ QUAD EXTENSIONS
For years patients have been told that using a quad extension machine — or any other “open kinetic chain” exercise — is terrible for your graft.
“It will stretch it and make the graft loose.”
Science has proven this wrong, time and time again. You actually generate 2–3× more force on your ACL just by walking than you do during a quad extension (Englander et al. 2020).
There’s also no difference in graft laxity between patients who completed open-chain vs closed-chain exercises after ACL surgery (Perriman et al. 2018).
Start quad extensions early, progress slowly, and gradually work into full range — under the guidance of your rehab professional.

2️⃣ PLYOMETRICS
“Why do I need to practice jumping? I’m not a jumping athlete.”
Plyos are so much more than just jumping. They teach the body how to take off and land safely, improve reactive ability, and generate power and explosiveness.
As we get more dynamic and explosive, the force the knee absorbs from the ground increases. To prepare for the demands of mountain sports, I like to train for “impact” — the ability of the body to accept increased force, use it effectively, and protect structures sensitive to injury.

3️⃣ RANGE OF MOTION
Restore the knee’s range of motion, make it as flexible as it was before — pretty simple, right?
Wrong. The majority of patients I see with ongoing knee issues have some range restriction.
Achieving full knee extension is essential for walking, running, and pivoting sports — and should be a major early rehab goal. Missing it leads to compensations through the lower limb, pelvis, and back.
Knee flexion deficits are also really common, especially after ACLR + meniscus repair. Avoiding end-range flexion during rehab is a sure way for an active person to injure their knee in the future.
Think about how often you need end-range flexion — crouching into a crawl space, deep compression on skis, a big step-up on a hike. If you don’t train it, you’re not prepared for it.

True story 😂
07/05/2026

True story 😂

Your ACL isn’t one structure. It’s two. ✌🏾 The anteromedial (AM) and posterolateral (PL) bundles do different jobs at di...
05/05/2026

Your ACL isn’t one structure. It’s two. ✌🏾

The anteromedial (AM) and posterolateral (PL) bundles do different jobs at different knee angles.

AM = the main brake against your shin sliding forward.
PL = tightest near a straight knee. Shorter fibres, more strain, more vulnerable.

Most ACL tears happen when the knee is near straight and twisting. Edge catches. Awkward landings. Knee caving on a cut. The PL takes the hit first.

Surgery is where it gets less neat.

A graft isn’t your native ACL. Most reconstructions aim for functional stability — not a perfect anatomical replacement. Single-bundle (SB) uses one graft to replace both bundles. Double-bundle (DB) uses one graft per bundle.

DB sounds more anatomical. On testing it sometimes shows tighter knee laxity. But few studies find patients actually feel or function any differently.

And either way — around 1 in 5 graft ACLs re-rupture within five years (varies by study, age, and sport).

Which is why rehab can’t be one-dimensional.

Good rehab is control at every angle — especially the vulnerable ones near full extension where the PL takes the biggest hit.

Mid-rehab and want a return-to-sport plan that actually matches the biology? DM me.

📌 Save this for your rehab notes.

References:
Amis AA (2012). Knee Surg Sports Traumatol Arthrosc 20:613–620.

Irrgang JJ, Tashman S, Patterson CG, Musahl V, West R, Oostdyk A, Galvin B, Poploski K, Fu FH. Anatomic single- vs. double-bundle ACL reconstruction: a randomized clinical trial — Part 1: clinical outcomes.


AT OR BEFORE 9 MONTHS POST OP? READ THIS ⬇️ Grindem et al. (2016) followed young, active athletes after ACL reconstructi...
30/04/2026

AT OR BEFORE 9 MONTHS POST OP? READ THIS ⬇️

Grindem et al. (2016) followed young, active athletes after ACL reconstruction and found each extra month they waited before returning to sport cut their re-injury rate by roughly 51%, up to 9 months. After that, more time didn’t reduce risk further.

Two things worth knowing. It’s a per-month drop, so the gains compound the longer you stay committed through the early months. And time alone isn’t a free pass — athletes in the study also had to meet return-to-sport (RTS) criteria: strength, hop testing, movement quality, psychological readiness. Time + passing your testing criteria = the safest combo.

If you’re 6 months out and feeling great, that’s the right feeling. But the research says adding at least three more months of structured rehab is still earning you a meaningful drop in re-injury odds.

Mid-rehab and wondering where you sit? DM me — happy to help map the next stage.

Your surgeon picks the graft. Your biology runs the timeline. Your rehab decides the outcome.Most ACL info online focuse...
28/04/2026

Your surgeon picks the graft. Your biology runs the timeline. Your rehab decides the outcome.

Most ACL info online focuses on which graft is “best.” But the truth is messier — and more interesting. 🧠

Swipe through for:
→ Options for ACL graft (BPTB, QT, HS, allograft, synthetic, BEAR)
→ Why your own tissue tends to win for return-to-sport
→ The 4 healing phases your new ACL has to grind through
→ The window where your graft is weakest (approx weeks 4–12) and why load management here is non-negotiable

Six months post-op doesn’t mean ready. Biology doesn’t read a calendar. 🗓️

If you’re navigating ACL recovery in Whistler or Squamish, let’s build a rehab that matches what’s actually happening inside your knee.

Save this for your ACL recovery journey + send it to your ACL recovery buddy ✅

Olympics #2 🇨🇦 Still processing this one. It’s taken me a while to sit down and post — the come-down after four years o...
21/04/2026

Olympics #2 🇨🇦

Still processing this one. It’s taken me a while to sit down and post — the come-down after four years of build-up was real.

Our crew gave everything to get here. There were tough stretches along the way — injuries, results that didn’t go our way — but the effort never slipped. We rolled into the Games prepared, dialled, and tight as a team.

Massive thanks to every athlete and staff member who made this one to remember. One of the busiest chapters of my life. Also one of the best — getting to live and breathe our sport on the world stage, watching these athletes get their shot to show what they can do.

Grateful to have been a small part of the ride. 🫶🏂

Men’s Big Air going down at 10.30PST // 1.30ET TODAY feat. .bouchard Let’s Go! 🍁📸
05/02/2026

Men’s Big Air going down at 10.30PST // 1.30ET TODAY feat. .bouchard Let’s Go! 🍁

📸

Successful ACL rehab is a ‘5-pillar building’ — and most people try to move into the penthouse (sport) before the founda...
02/02/2026

Successful ACL rehab is a ‘5-pillar building’ — and most people try to move into the penthouse (sport) before the foundation is done. 🏔️🏗️

Here’s the evidence-based pathway I want every ACL athlete to hit before “sending it” for the season:

Pillar 1 — Restorative phase
✅ swelling under control • ✅ effective quad activation ✅ full knee extension

Pillar 2 — Strength + neuromuscular control
Build the engine: balance/proprioception + major muscle strength + core control

Pillar 3 — Running / agility / landings
Plyos → power (strength + speed) → cutting/pivoting → reaction drills (earned, not rushed)

Pillar 4 — Intro to chaos
Sport-specific + game/competition-style drills + smart load/volume scaling

Pillar 5 — Return to sport
Baseline testing + monitoring + ACL prevention work + load management

If you rush the early pillars, your body just borrows movement from somewhere else — compensations show up fast.

And if you skip the later pillars, sport becomes the “test”… and the cost can be setbacks, increased reinjury risk, and a longer road back.

SAVE this for later, and SEND it to a teammate who’s “feeling good” wayyyyy too early 😅


Physios are an under-utilized resource in B.C.’s healthcare system — and one simple update could make care faster + smoo...
25/01/2026

Physios are an under-utilized resource in B.C.’s healthcare system — and one simple update could make care faster + smoother for you 👇

Right now, if we suspect something like a fracture, significant joint injury, or need imaging to confirm what’s going on… you often have to:
➡️ book in with you family doctor (often impossible)
➡️ wait for the imaging requisition (and follow up multiple times to check it’s been received)
➡️ wait again for the scan (sometimes > 3 months wait)
➡️ then finally address your issue

This infographic from the PABC highlights the case for trained B.C. physiotherapists being authorized to order diagnostic imaging (X-ray, ultrasound, MRI, CT) as part of a team-based model of care.

✅ What the evidence supports:
• Better access + shorter wait times
• Lower system costs (less bouncing around)
• Better patient outcomes (earlier answers → earlier right treatment)
• PTs order imaging responsibly + in line with best practice

What it means for patients (aka you):
Less runaround. Less delay. More clarity. Faster return to work/sport/life.

If you’ve ever felt stuck in limbo waiting for imaging, this is why scope modernization matters.

👉 Want to support this? CONTACT your MLA (QR codes on the poster) and SHARE this post so more people understand what’s at stake.

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