Revolutionizing Athletic Training: A Comprehensive Approach

We have forged key partnerships with Physical Therapists and Athletic Trainers across prestigious platforms such as Medical Schools, College Sports, and professional leagues like the WNBA and NBA. Our primary aim with these collaborations is to create practicum learning experiences that enhance the skills of University Athletic Trainers, equipping them with the knowledge necessary for effective return-to-play protocols for college athletes. This involves a deep dive into Functional Fundamental Movements essential for recovery and performance enhancement.

A unique aspect of our approach in basketball is the seamless transition of shooting skills from amateur levels directly to professional without degradation in quality. The primary challenge, however, arises from the professionalization of youth sports, where children are subjected to rigorous schedules akin to professional leagues. Often, it is only after an injury that athletes pause to evaluate and correct their techniques—a critical intervention point we focus on.

Through our initiatives, we have conducted extensive interviews with over 60 athletes, including insights from four experts like Dr. Kelsey Brown and Dr. Allyssa Zallie, Sports Therapist Orlando Perez and Dr. Riley Nielson. These interactions have allowed us to move our theoretical knowledge from speculation to practical application, validating our methods across decades of established training protocols, biomechanics, and the identification of dysfunctional movement patterns.

Our most recent research has identified a crucial link between physical rehabilitation, skill development, and mental health recovery. Notable collaborations include our work with the University of Utah’s Athletic Training Department to support Daneesha Provo’s recovery from an ACL tear, and with Ortho-Carolina to develop a ten-month return-to-play protocol after a meniscus tear in a top rookie from the Indiana Fever.

One of our landmark achievements was with Tamika Catchings, a WNBA player who, after overcoming Plantar Fasciitis with our help at St. Vincent Performance Center, went on to win a WNBA Championship and was named the Championship Series MVP.

FINISHING SCHOOL

The Pro's Development Lab’s Integrated Skill and Mental Rehab (ISMR) Initiative represents a progressive and holistic approach to athletic rehabilitation and training, specifically designed as a finishing school for professionals in sports medicine and training. This innovative program focuses on the intricate interplay of physical therapy, skill training, and mental conditioning, all unified under the umbrella of the Finishing School for Integrating Skill and Mental Rehab (ISMR) Initiative.

The Vision and Collaborative Impact of ISMR

Vision: The ISMR initiative is committed to redefining sports rehabilitation by focusing on a comprehensive approach that nurtures the body, mind, and specific athletic skills simultaneously. This vision encompasses not just the recovery from injury but a complete restoration and enhancement of the athlete's physical abilities, psychological resilience, and technical skills specific to their sport.

Holistic Approach: Understanding that recovery and skill development are multifaceted, the ISMR program incorporates physical rehab, skill refinement, and mental health support into a seamless model. This approach ensures that athletes not only return to their sport physically healed but also mentally prepared and technically better than before.

Collaborative Efforts and Expertise

Professional Collaboration: The ISMR initiative thrives on a rich collaborative network that includes surgeons, medical practitioners, physical therapists, athletic trainers, psychologists, sports coaches, professional athletes, collegiate programs, and research institutions. Each contributor brings a specialized perspective that enriches the program, ensuring cutting-edge practices and a robust support system for the athletes.

Multi-disciplinary Team: The team behind ISMR is composed of experts from diverse backgrounds in sports medicine, psychology, coaching, and neurology. This team collaborates to drive innovation within the program, researching and applying new techniques and therapies that set new standards in athletic care and training.

Core Components of the ISMR Program

Physical Therapy:
- Tailored therapy sessions designed to address the unique physical needs of each athlete, facilitating effective recovery and strengthening.
Skill Training:
- Customized training regimens that focus on maintaining and enhancing sport-specific skills during the recovery process, ensuring athletes remain sharp and proficient in their sport.
Mental Conditioning:
- Psychological support and strategies are crucial, especially following injury. ISMR provides athletes with the tools to handle the mental challenges associated with their recovery and preparation for return to play.

Outcomes and Benefits

Comprehensive Recovery: By treating the athlete holistically, ISMR ensures a thorough recovery process that addresses physical, mental, and skill-related challenges.
Reduced Risk of Re-injury: A well-rounded recovery and training program decreases the likelihood of future injuries by strengthening the body and mind together.
Confidence Building: Athletes graduate from ISMR feeling mentally resilient and physically robust, ready to tackle the demands of their sport with renewed vigor and enhanced skills.

Conclusion: The Future of Sports Rehabilitation

ISMR, as part of The Pro's Development Lab, represents the future of sports rehabilitation. By integrating skill and mental rehab with traditional physical therapy, ISMR provides a pioneering and comprehensive model that promises not only to heal but also to enhance the capabilities of athletes across all sports. This initiative invites all stakeholders in the field of athletic training and rehabilitation to join in advancing this transformative approach.

PLAYER NAME YEAR LEAGUE LOCATION INJURY TIME-FRAME

Tamika Catchings 2007 WNBA Indianapolis, IN Achilles Tendon Phase 10

Tamika Catchings 2008 WNBA Indianapolis, IN Plantar Fascitis Phase 10

Michelle Taylor 2009 HS Tampa, FL ACL Phase 10

Joey Graham 2012 NBA Tampa, FL Wrist Phase 7

Lauren Wall 2014 HS Tampa, FL ACL Phase 10

Grace Kim 2014 Korean Tampa, FL Achilles Tendon Phase 10

Zaria McBride 2015 Winthrop Rock Hill, SC Achilles Tendon Phase 10

Miquala Santoro 2015 Winthrop Rock Hill, SC Hip Phase 10

Xavion Lockwood 2016 HS Tampa, FL Wrist Phase 8

Tiffany Mitchell 2017 WNBA Charlotte, NC Torn Meniscus Phase 10

Lex Reynolds 2018 HS Rock Hill, SC Hand/Wrist Phase 10

Daneesha Provo 2019 U-Utah Salt Lake City ACL Phase 10

Kitija Laksa 2019 USF Tampa, FL ACL Phase 10

INTEGRATED SKILL REHAB

Integrated Skill and Mental Rehab (ISR)/Fusion Rehab ©

Revolutionizing Athletic Rehabilitation: A Holistic Approach to Performance and Well-being

Integrated Skill and Mental Rehab (ISR)/Fusion Rehab © is an innovative venture where sports science, physical therapy, and mental conditioning converge to redefine athlete rehabilitation. Our collaboration with esteemed Physical Therapists and Athletic Trainers from prestigious medical schools, colleges, universities, and professional sports leagues, including the WNBA, NBA, and MLB, has established a new benchmark in post-injury athlete care.

Unique Approach to Rehab: The ISR Fusion

Our core philosophy is rooted in understanding the intricate relationship between an athlete's physical prowess and mental fortitude. We've created a systematic program, co-existing with post-op physical therapy, ensuring that clinical rehabilitation isn't just about recovery, but also about enhancing performance and preventing future injuries. Our method focuses on Functional Fundamental Movements (FFM), designed to address the lack of skill transition from amateur to professional levels in sports, especially in basketball shooting.

Mental Rehab: Shaping the Mindset

At ISR, we recognize that physical recovery is only one aspect of an athlete's return to peak performance. Our mental rehab component addresses the psychological trauma often associated with injuries. Through knowledge-based sessions, we foster a positive mental environment, focusing on attributes like emotional intelligence, personality traits, fear of failure, and critical thinking, helping athletes create new neural pathways and reinforce a competitive mindset.

Skill Rehab: Neuroplasticity and Beyond

Our skill rehab taps into the principles of neuroplasticity, homunculus remapping, and neural smudging, ensuring a comprehensive reprogramming of motor skills. This approach is particularly crucial during the rest period and early rehab stages, where the risk of neural smudging is highest due to reduced physical activity. By engaging the athlete's brain in the learning process, we minimize smudging, promoting faster and more effective skill recovery.

Expanding Horizons: The Pro's Development League and National Partnerships

Looking ahead to 2025, ISR is set to become a national brand through our Pro’s Development League (D-League). This initiative extends our methodology, supporting athletes from their eighth-grade year through college and professional careers in sports or other fields. We're not just about basketball; our programs span across various sports, embodying our philosophy of Servant Coaching, Injury Prevention, and Integrated Skill Rehab.

We are excited about the prospect of a National Partnership and other like-minded organizations. Together, we can create a new norm in sports culture, blending medical, clinical, and skill-based rehabilitation to offer athletes a comprehensive, three-dimensional recovery experience.

Join us in this journey to transform athletic rehabilitation, where every setback is an opportunity for a stronger comeback.

COMPARING PROTOCOLS

ACL PATELLAR TENDON AUTOGRAFT RECONSTRUCTION PROTOCOL WITH INTEGRATED SKILL REHAB

EXAMPLE OF THE TWO WORKING TOGETHER

*Physician may modify time frames for the use of brace and crutches

The athlete will sleep in TROM brace locked in extension for the first week or as directed by PT/MD

Immediately post-op to week 4

WBAT with brace locked in extension and crutches *

Goals:

Protect graft (neovascularization, 8 weeks) and fixation (strength and stiffness/bone plug fixation graft in proximal tibia v. distal femur (gold standard), 6 weeks)

Decreased effects of immobilization

Control inflammation/swelling – 15 minutes of compression, ice and towel under ankle for extension, before tx and after tx

Patient education – Discuss importance of working on knee extension at home

Normalize gait on level surfaces (basketball court)

PT EXERCISES (APPROX. WEEK 1)

Patellar/scar mobilization

Passive extension of knee with rolled towel raising calf off of the table, AAROM extension

Heel slides

Quadricep isometrics (NMES)

SLR (to 45-60 degree for 6 seconds) until there is no extension lag

HS, gastroc/soleus stretch

Gastroc/soleus strengthening

Normalize gait on basketball court as TROM brace is unlocked with the ROM present

PHASE 1: OF INTEGREATED SKILL REHAB

Goals:

Program movement patterns

A Bosu ball will work core muscles

Mirrors and videos

Activities:

BACKSPIN/ LEVEL OF ARC/HAND-EYE COORDINATION

Make sure ball is appropriate size for player

Without the player sitting on Bosu ball

Program hands movement without the ball and make sure non-shooting hand stays up (MIRROR/VIDEO)

Create a quarter turn from the waist up to forehead or above eyes

Create the mindset that 21 times in a row equals a habit

With the player sitting on Bosu ball

Progress to using the ball – program backspin – fingers driving through the ball

Repeat the same movements

Three fingers in the center of the ball

Educate on the balance fingers

Non-shooting hand fingers

Arc Training

Using the court, educate the player on different levels of arc and then practice

Arc-Activities

Shoot to the hand, line drills, hit the backboard while sitting – program the “set point,’ straight lines, shooting touch, hands inside lines of the rim, timing, rhythm, and distance

Continuing Phase I (week 2)

Physician Visit

Suture removal – patient education on maintaining incision (10 days – 2 weeks)

Goals

Maintain full knee extension

If athlete demonstrates volitional quadriceps control with no knee extensor lag - d/c knee brace (possibly s/p 2 weeks)*

Control swelling

Achieve 100-120 degrees of knee flexion

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PT Exercises

Full passive extension, gravity assisted and active flexion working to 90-100 degrees of flexion, active-assisted extension, quadriceps isometrics and SLR

Stationary cycling for ROM if 100 degrees of flexion present, progress resistance as tolerated

Progress to normalizing gait on basketball court while dribbling basketball

Hamstring curls adding weight as tolerated (with patellar tendon autograft)

CKC quadricep strengthening (wall sit, step ups, mini squats (teach appropriate mechanics with full squat in mind), 90-30 degree leg press, quad isometrics at 60 and 90 degrees) *utilizing a basketball with mini squats, wall sits

Toe raises

Single leg balance (proprioception), *without/with basketball

PHASE 2: INTEGRATED SKILL REHAB

Goals

Check with PT/physician for protocol

Continued progressive 21’s

Rebuilding the shot mechanics with the ball

Balancing on one leg combined with sitting on Bosu ball

Activities…Shooting moving further from the ball

BACKSPIN/ LEVEL OF ARC/HAND-EYE COORDINATION

“STEPPER SERIES”

Functional shot movements: “Stepper series” for two weeks. Combining standing for 15 shots, and sitting for 10 shots to rest the opposite leg

Stationary (no pressure to injured area)

Shot training/Programming

Train the left hand to shoot, this process is done in an effort to program the movements in the brain and then transfer the movement to the right hand

Still programming all movement above as in phase one, but in a different drill set

15 shots from 5 spots, honing in on what has been taught from phase one

POST-OPERATIVE WEEK 3

Goals

Full ROM

Strengthening

PT Exercises

Stationary bike

Quad isometrics

Continue partial squats, wall sits, step-ups (with/without basketball), Inclined leg press (70-0 degree range)

Frontal plane and sagittal plane cone drill walking speed

Toe raises

Hip SL clams with TheraBand

Monster walks with TheraBand

PHASE 3: INTEGRATED SKILL REHAB

Goals

Start introducing lower body movements (because knee brace is d/c and ROM is close to full)

Activities

Test shooting mechanics

21’s with no ball

110’s: included trying to repeat movement patterns, not just making shots. Progress to different shots: Catch and shoot, off the dribble, step-back series, two steps from the basket

Within these two -three weeks, the knee flexibility will increase a little more to the point where the player will feel comfortable with the movements, at a comfortable rhythm. That rhythm, the speed, based on a scale of 1-10 should be consistently around the 4 mark.

CRITERIA TO ADVANCE TO PHASE II OF PT (4-6 WEEKS POST-OPERATIVE)

Full extension/hyperextension

SLR without extensor lag

Minimal swelling/inflammation

Normal gait on level surfaces (basketball court)

Goals

Greater than or equal to 125 degrees of knee flexion

Continue to build strength

PT Exercises

Progress stationary bike

ROM/flexibility exercises as tolerated

Tilt board/balance board

Progress CKC strengthening to step ups at increased height, partial lunges, partial squats, leg press as tolerated

Dynamic Cone drills for balance/proprioception (sagittal plane and frontal plane)

Monster walks with TheraBand

INTEGRATED SKILL REHAB

At this point, we gage how well the physical therapy is going, which will usually mean a little more bending and a little faster movement – (5) speed. If that’s the case, the player is able to increase knee bend, which means the player’s shooting range will also increase, and we can add a few more pieces to the shooting mechanics. The goal is to rebuild the player’s mechanics, the thought process and the player’s knowledge so that they can defend the mechanics.

PT– 6-12 WEEK’S POST-OPERATIVE

Goals

135 degrees of flexion

Full extension

Continue strengthening

Level Treadmill (AlterG?)

PT Exercises

Progress strengthening - CKC strengthening to step ups at increased height, partial lunges, partial squats, leg press as tolerated

Restore normal gait w/stairclimbing (because of 135 degrees of knee flexion needed for descending stairs)

Hamstring strengthening (gentle if hamstring graft is used)

Tilt board/balance

Level treadmill

Outdoor biking on level ground

INTEGRATED SKILL REHAB

Repeat all previous movements

Start paying attention to makes and misses

Include all functional movements of prior phases and see if mechanics stay the same

Should be able to increase speed; movement and rhythm wise

Activities as tolerated

210’s catch and shoot – 18 feet from basket

310’s off the dribble (respectable pace) 16 feet shots

PT – 12-20 WEEKS POST-OPERATIVE

Goals

Continued strength

Introduce jogging and light running

Introduce agility drills

Determine need for ACL functional brace

PT Exercises

Continue strengthening exercises progressing as tolerated

Start jogging (front and backward) and light running program (progress to jogging with basketball)

Introduce cone agility exercises not for time (without and with basketball/medicine ball)

INTEGRATED SKILL REHAB – AS TOLERATED

410’s jab series jab and reload, jab and go, jab and cross…all into shots off the dribble

510’s includes all of the above movements; add a step back to each movement before the shot

Add the 3 series – This starts the process of the player slowly learning how to play defense. If the defense is 3 steps away from them when they catch the ball, they automatically shoot. Two steps away they automatically drive and shoot off the dribble, and if the defense is one step away, or quickly approaching, they attack the basket.

We go from programming to practice speed – 50% of current level of function

Add practice shots; eliminates the term “quick shots” which is basically the case for lower shooting percentages on every level for the game of basketball; mainly because players never learn footwork off the dribble. No rushed shots, even if they are miss-reads, learn to use patience and get the shot off.
Progression: ADD anything that could happen in a game situation so the player can go through it at 8 speed and learn how movements are done correctly and learn patience.

PHYSICAL THERAPY CRITERIA TO RETURN TO SPORT (6 MONTHS)

Quadriceps strength at least 80% of contralateral leg

Hamstring strength at least 80% of contralateral leg

Full ROM

No swelling

Good stability Complete a running program

CRITERIA FOR RETURN TO PERFORMANCE:

Full and Half Court Activities

Free throw shooting
Triple attack/Triple threat
Have extra players to go (8)-speed defense
Drills that include passing off the dribble
Different ways to shoot against the clock
Mike Miller – 21 points in two minutes
Critical Thinking and Attribution Theory
Shooting test: 80% of shots in a straight line
Combo-moves, footwork, changing directions
Skill-specific conditioning drills
Play a game but go (9)-speed using the 3-Essentials

Integrated Skill and Mental Rehab: Return To Performance

At Integrated Skill and Mental Rehab (ISR), our "Return To Performance" program is designed to support athletes in making a seamless and efficient transition back to peak performance following an injury. Our unique approach combines the latest in physical therapy, sports psychology, and skill development to create a comprehensive rehabilitation strategy tailored to each athlete's specific needs.

Holistic Rehabilitation Approach Our approach recognizes that recovery from sports injuries is not just about physical healing but also about mental and skill-based recovery. We integrate three core components into our rehabilitation process:

Physical Rehab: Our team of physical therapists and athletic trainers work closely with athletes to restore strength, flexibility, and endurance. We use cutting-edge techniques and equipment to ensure the best physical outcomes.
Mental Rehab: Recognizing that injury can be a significant mental setback for athletes, our sports psychologists focus on rebuilding confidence, resilience, and focus. We employ cognitive-behavioral strategies to help athletes overcome fear of re-injury and mental blocks that often accompany their return to sport.
Skill Rehab: We don’t just want athletes to return to their sport; we want them to return better than before. Our skill rehab focuses on the technical aspects of sport-specific movements, ensuring that athletes not only regain their previous skill level but also enhance their performance through improved techniques and efficiency.

Tailored Rehab Programs Each athlete's journey through the "Return To Performance" program is unique. We start with a thorough assessment to understand the specific demands of their sport and the nature of their injury. This assessment includes:

Biomechanical analysis
Skill proficiency evaluations
Psychological readiness assessments

Based on this comprehensive evaluation, we develop a personalized rehab plan that addresses the athlete's physical, mental, and skill-related needs.

Phase-Based Rehabilitation Our rehabilitation process is divided into phases, each designed to build upon the previous one, ensuring a safe and effective return to sport:

Phase 1: Recovery and Reconditioning - Focuses on healing and gentle conditioning to regain mobility and reduce pain.
Phase 2: Strength and Coordination - As the athlete’s condition improves, we introduce strength training and coordination exercises to recondition the body for athletic demands.
Phase 3: Skill Reintegration - Sports-specific skills are reintroduced and refined, with an emphasis on technique and injury prevention strategies.
Phase 4: Performance Enhancement - The final phase focuses on optimizing performance, including speed, agility, and sport-specific tactical skills.

Support Beyond Rehabilitation At ISR, our commitment to athletes extends beyond physical recovery. We provide ongoing support and training options to prevent future injuries and enhance overall athletic performance. Our program includes:

Injury prevention workshops
Nutrition and lifestyle counseling
Continued mental coaching

Return To Performance isn’t just about getting back to the game; it’s about setting a new standard for the athlete’s future in sports. We ensure that when athletes step back into the game, they are not only recovered but also reinvigorated, resilient, and ready to perform at their best.