6 Items to prepare before ACL surgery - Prep Performance Center in Chicago

6 Items to get before ACL Surgery

Preparing for ACL surgery can seem intimidating, if not overwhelming.  Here are a few suggestions on items you should have to help your recovery go smoothly!  Some of the following may be provided by the hospital, but it is a good idea to check with your medical team before ACL surgery to ensure you have access.


Ice and cold packs can help reduce inflammation and pain following surgery, so it’s a good idea to have some available wherever you will be recovering.  Cold therapy machines are commonly rented for use after surgery. This unit functions by continuously running cold water through a cuff you secure around your knee and some options even provide intermittent compression to your knee to further reduce swelling and pain! Consider keeping 10-15 mini water bottles in your freezer to use with the cold therapy machine.

Loose Clothing

You may be surprised by how difficult it is to pull on a pair of pants or shorts without being able to bend your knee very much or stand on one leg. Make sure to have enough loose, comfortable clothing so that changing does not become a daily struggle.

Shower equipment

Getting into and out of the shower will require some maneuvering early in your recovery, and items like a shower stool and bath mat can help you bathe more safely. Take a look at the set-up of your shower beforehand to decide what you’ll need. Does the tub have a lip? Is it slippery or angled? You can also place a chair just outside of the tub so that you can get undressed while sitting and transfer from the chair into the tub.  Other bathroom items to consider include a removable shower head, grab bars and a toilet seat riser.

Trash Bags

You will be instructed to keep your incisions dry during the early phase of recovery to promote healing.  Make sure you have trash bags big enough to cover your knee while you bathe. You can purchase a more expensive leg cover from retailers, but many individuals prefer to use a standard trash bag.


Stocking up on small snacks such as apple sauce or pudding are important so that you do not take your pain medication on an empty stomach.  Consider choosing some food items that are high in natural fiber (i.e. pears, avocado, oat bran) to prevent constipation due to the medication.  You should be getting around 25-30 g of fiber per day to help you have regular, quality bowel movements, but few individuals actually get enough.


Although not an item, identifying your support team and their schedules is important before ACL surgery.  You may need to rely on others to cook, help you change, and help you bathe. You should identify people you trust whose schedules allow them to help out. This could mean a few people, especially in the first few weeks, helping out at different times so that you do not attempt a task that is unsafe before you know your limits. You should also ensure that whoever is helping you bathe is physically fit enough to help transfer to the tub and back up without losing balance. 

Another thing to consider before ACL surgery is how you want your recovery space to be set up. Consider removing carpets or objects that you could trip on and having a set place to keep your medication and a snack. If you live in a place with multiple bathrooms, you should think about which will be easiest to use with an assistive device (i.e. crutches or walker) and has the best shower and toilet set up. With the proper preparation, you will be able to focus on your recovery. See related article from NHS website on preparations before surgery.

Yes for sure you will be thinking a lot before ACL surgery, such as these: What to buy before ACL surgery? What to eat before ACL surgery? Nervous before ACL surgery? Should I wear a brace before ACL surgery? How to prepare the house for ACL surgery? Questions to ask before ACL surgery? How to sleep with ACL injury before surgery? Can I ride a bike before ACL surgery? All these you have in mind, you can be relieved by consulting to our physical therapist and book an appointment. Tap the button below.


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Why does my knee crack after my ACL surgery - Prep Performance Center

Why does my knee crack after my ACL surgery?

First and foremost, you are not alone! Hearing a crack or pop in the knee after your surgery is a very common experience among those who have gone through an ACL reconstruction. There are a few reasons this may be happening that are completely normal. Following surgery, there is typically some scar tissue that develops within the joint and surrounding structures. When you first start moving the knee around, this scar tissue will start to break up causing an audible crack or pop – this is okay!

Oftentimes after surgery, the affected structures will experience swelling. This is a normal part of the healing process. When there is swelling in the knee joint, this can cause the knee cap to track differently along the thigh bone when bending and straightening the knee. When the knee cap gets off its normal track, this can cause an audible crack or pop. Again, this is not something to be overly concerned about as once the swelling is resolved, this motion should return to normal. In addition to ice and elevation, safe and gentle range of motion at the knee can help to decrease post operative swelling. An example of a simple range of motion exercise to increase knee flexion is heel slides along the floor while sitting with legs stretched out in front of you. Other examples include low intensity stretching for the hamstrings and calf muscles. All range of motion and stretching should follow the prescribed guidelines of immediate post operative care set by the surgeon in order to protect the healing ACL graft. Specific instructions on these exercises are linked below!

Similar to joint swelling, a weak quadriceps muscle can cause the knee cap to track differently and may result in a crack or pop. Following an ACL reconstruction, it is normal to experience quadriceps weakness. Regaining quadriceps strength is something your physical therapist will begin working on with you early in your rehab.  Much like swelling, once quadriceps strength returns the knee cap will track normally again. A safe quadriceps strengthening exercise to do following surgery is isometric quadriceps setting. This exercise will help to wake up the quadriceps muscle that has likely lost some strength since surgery. Again, all exercises should follow the guidelines set by the surgeon in order to protect the healing ACL graft. Specific instructions on these exercises are linked below!

While hearing a crack or pop is completely normal following surgery, make sure to tell your physical therapist and orthopedic surgeon at your next appointment. For more information about the goals of early post operative care, you can explore the Prep Performance Center specialized online ACL rehab program here!

Range of Motion and Stretching Exercises:

Heel Slides 

Hamstring Stretch 

Calf Stretch 

Quadriceps Strengthening Exercise:

Isometric Quad Setting 


On the other hand, contact your physical therapist or book an appointment today if you feel any of these symptoms.

– Why does my knee crack after my ACL surgery?

– Knee cracking years after ACL surgery.

– Knee popping 1 year after 1 ACL surgery.

– Will my knee ever be the same after ACL surgery?

– Knee popping 2 months after ACL surgery.

– Pain knee popping after ACL surgery.

– Knee popping 5 months after ACL surgery.

– Knee popping after ACL and meniscus surgery.

– Why is my knee popping with every step?


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Off Season Training Program for Youth Softball Players

Off Season Training Program for Youth Softball Players

Youth Softball Players | Off season training is just as important as in-season training. Training in the offseason allows a foundation to improve upon during your sports season. 

For a lot of overhead Youth Softball Players are plagued with injury when returning to the sport, they are deconditioned and attempt to return to the level of athleticism they had at the end of their season. It is important in the offseason to work on both strengthening and stretching in order to operate at an optimal level when returning. See related article by Sports Feel Good Stories wherein they also share about Softball Training Program.

Name of Exercise: Prone I, Y, T Lift

Target Muscle Group: Rotator Cuff/Shoulder stabilizers


– Lying face down on either a mat on the floor or a bed with room around you to extend your arms without interruption. Brace your core muscles. 

– For I: With your palm facing inward slowly lift one arm off the floor forming a letter “I” stopping before you feel your back lifting more. Focus on getting your lift through your shoulders and not your low back. Hold for 5-10s. 

– For Y: From the same starting position having your palm facing inward lift the same arm forming the letter “Y”. Again focus on getting a lift from shoulders and not your low back. Hold for 5-10s.

– For T: From the same starting position but this time with your thumbs up, lift your arm forming the letter “T”.  Hold for 5-10s

– Repeat each position 10 times then switch to the opposite arm.

– For additional strength, you may add weight to your hand.


– Make sure that the movement is coming from your shoulder and not your back. 

– Keep your neck neutral not lifting your head with your shoulder

Reasons to use the exercise:

This exercise targets stabilizing muscles of your shoulder. These may be small movements and small muscles you are targeting but they are important to strengthen in order to prevent injury. 

Name of Exercise: Overhead Shoulder press (Youth Softball Players)

Target Muscle Group: Shoulder, Chest and upper back.


– Chose dumbbells that is appropriate weight for you

– Sit in an upright chair bring both dumbbells to shoulder height and palms facing forward 

– Press the dumbbells up overhead straightening out your arms

– Slowly lower dumbness back to their starting position


– Be careful not to have forward rounded shoulders

Reasons to use the exercise:

This exercise much like the last will target the shoulder muscles in order to increase both power and stability when doing movements such as throwing, and hitting. 

Name of Exercise: Doorway Stretch

Target Muscle Group: Chest and shoulder


– Standing in the doorway place your entire shoulder and arm against the wall in a 90/90 position

– Slowly turn away from the wall while also pushing forward through the door. 


– Avoid extending your back. You should not feel the stretch in your back, it should be in your chest. 

Reasons to use the exercise:

This will increase mobility and motion in your shoulder. Many people rest in a forward shoulder posture, this can be due to school or working on a computer all day. This puts your chest muscle in a shortened position that is not optimal for those muscles to work. 

Name of Exercise: Squat Jump (Youth Softball Players)

Target Muscle Group: Glutes, quadriceps and hamstrings


– Start in a squat position with your butt down and back, your weight should be through your heels.

– Keeping your core tight, explode up from the ground using your arms for momentum. Your legs should straighten out and your arms should be at your side.

– When landing, make sure you are landing soft on the ground


– Make sure that your knees stay outward, they may feel pressure inward but make sure to drive them outward. 

Reasons to use the exercise:

This is an explosive movement much like you will have when running from base to base. This will work to target those muscles in a way that is similar and functional to you in a game situation. 

For more information about exercises to do during the off season, ask your physical therapist about our PREP Performance Center comprehensive strength and conditioning program specifically designed for an overhead athlete.


Contact us today!

Are you ready to perform at your optimal level? Contact Doctor of Physical Therapy, Mary Kate Casey at our Chicago, IL clinic today! Through our movement analysis, we can assess jumping and landing mechanics and help you improve performance and reduce your risk of injury. Give PREP Performance Center a call at 773-609-1847 for more information on our movement analysis program!

Book an Appointment Today

Rest and Recovery Integration into Off-Season Training for Gymnasts

Rest and Recovery Integration into Off-Season Training for Gymnasts (Level 7-9)

Recovery is crucial after an intense and exhausting competition season. Look no further for a few tips that will help you approach your summer off-season training in a safe and effective way. Even though complete rest is difficult for an elite-level gymnast, rest and recovery for at least one month in the off season will allow you to compete with less soreness, and a new fire and strength to attain new skills. Rest can include active rest of completing injury prevention programs and identifying muscle imbalances within the body to improve prior to the competition season. 

Following the rest period, a slow progression into summer is essential. Starting with basics, pits, drills, strength, and anatomical adaptation will allow you to ensure the proper technique is learned. This should include low intensity with high repetitions of skills to increase the body’s endurance and neural adaptation to new movement patterns.

Finally, reflection of the season as an athlete and with your coaches is crucial to improving performance. Valuable feedback will not only help with motor learning and goal setting but also begin to guide your mindfulness techniques for visualization when preparing for the next level.

Sharing here an ebook from gymbc.org regarding Strength and Conditioning for Gymnasts.

Look no further for a gymnast-specific conditioning routine to help you exceed your potential and reduce injury occurrence. Conditioning Routines are different then individualized Rehabilitation Programs, as they are focused on performance once the athlete has quality movement mechanics. If you believe you have pain or an injury, contact your PREP physical therapist in order to identify muscle imbalances or asymmetries prior to initiation of the exercises below. A physical therapist can evaluate you and initiate injury prevention and rehab program for you to complete as a part of your active rest and recovery. Integrating the previously mentioned recommendations with the following exercises before your routines, as well as focusing on proper nutrition, meditation, and hydration, your next season will be off to the right start!

Cardio: 3-4 days a week for a total of 30-45 min/day. Start your workout with cardio to get your muscles warmed up. 

EXERCISE 1: Block/Mat jumps along diagonal of floor 

Targeted muscles/importance:

– a cardiovascular system for stamina through routines, and general lower extremity strength with core stabilization

How to: 

– Set up mats/blocks about 5 feet apart 

– Jump on top of or over each, rebounding in between

– Can use a variety of patterns and/or progress to single leg


– Make sure your core stays tight and you do not let your upper body loosely flop forward and backward

– Rebound lightly through your toes, not pounding down on your heels

– Allow your knees to bend slightly and absorb the impact of the jump

EXERCISE 2: Killer Sprints (Rest and Recovery)

Targeted muscles:

– total body with quick twitch muscle focus throughout the legs

How to: 

– Set up 3 cones on the long edge of the floor or runway 

– Follow the sequence below to complete 1 set

– Begin at the start 

– Start, first, start/end. 

– Start, first, start, second, start/end

– Start, first, start, second, start, third, start/end

– Try and perform each set as quickly as possible 

Strength: should be done at least 2 days/week, with progression to 3 as appropriate. 

EXERCISE 3: Seated straight leg raise over small cones 

Targeted muscles:

– iliopsoas, rectus femoris, vasti, and lower abdominals 

How to: 

– sit in a straddle position with cones in a half moon shape in front of you at mid-shin length 

– 4 cones on each side

– Lift one leg over the cone furthest away from the midline, keeping your trunk upright

– Perform all 4 lifts on one side from outside to inside, then inside to outside before switching to the other leg 


– Be sure to not use your hands or momentum to lift your leg, use the strength of your hip flexors 

– Keep your lower abs activated 

– Lower your leg back down slowly, rather than just flopping it to the ground

EXERCISE 4: Bilateral Shoulder External Rotation

Targeted muscles:

– Infraspinatus, teres minor, posterior deltoid, middle trap, and rhomboids

How to: 

– Stand with your back against the wall with light weights in both hands (can also use a resistance band)

– Start with hands together and elbows band to 90 degrees by your side

– Open up your hands away from the midline of your body keeping your elbows tucked tight to your side

– Slowly return to the middle


– Keep your shoulders relaxed and head in a neutral position, not shrugging them and activating your traps 

– Keep a slight squeeze between your shoulder blades the entire time and do not let your shoulders roll forward off the wall

– Keep your heels, bottom, back, and shoulders against the wall

Endurance: Important to work on our endurance muscles that are “on” all the time for stability during most skills to make sure they do not fatigue out by the end of your routine.

EXERCISE 5: Back extension holds 

Targeted muscles:

– Paraspinals/erector spinae, scapular stabilizers, and glute max

How to: 

– Hang your upper body off the end of a mat or vault table, hinging at the hips and having a partner sit on or hold your legs down

– Place your hands behind your head and lift up so your chest is above the mat 

– Squeeze your shoulder blades together and down


– Keep your gaze looking a few feet in front of you, being sure not to bring your neck into extension with your back 

EXERCISE 6: Plank hold 

Targeted muscles:

– Rectus abdominals, obliques, transverse abdominals, hamstrings, scapular stabilizers

How to: 

– Start on your stomach with elbows directly below your shoulders bent at 90 degrees

– Push off with your toes and elbows so your stomach and knees come off the ground.


– Keep back flat and straight through your shoulders, hips, knees, and toes. 

– Keep a slight squeeze in your glutes and between your shoulder blades for improved stabilization

– Do not allow your head to hang between your arms

Flexibility: 25-30 minutes before practice. Flexibility is extremely important as a competitive gymnast, but it is important to implement safely into your training routine, and then focus on strengthening those muscle in their new range of motion for stabilization. 

EXERCISE 7: Bridge Splits (Rest and Recovery)

Targeted muscles:

– iliopsoas, rectus femoris, and hamstrings 

How to: 

– Set up two blocks ~ 1 foot high parallel to each other 

– far enough away that your lower legs are on each side

– Hold your splits in a double elevated position for 2×30 seconds each side


– Be sure to keep your back knee turned under facing the mat and hips/trunk square

– Make sure to maintain an upright trunk and good posture throughout the exercise

– Do not have anyone push down on you to gain more range in this position

EXERCISE 8: Circle wall screens (Rest and Recovery)

Targeted muscles:

– rotator cuff and scapular stabilizers

How to: 

– Kneel in a 4-point position with your right shoulder near a wall

– Keep head and trunk neutral, and circle your R arm forward all the way around slowly staying parallel to the wall 


– Rotating the trunk or head to circle your arm around 

-Circling your arm side to side rather than in one place all the way around

– Keep your arm close to the wall and in line with your body 


Contact us today!

Are you ready to perform at your optimal level with rest and recovery integration? Contact Doctor of Physical Therapy, Mary Kate Casey at our Chicago, IL clinic today! Through our movement analysis, we can assess jumping and landing mechanics and help you improve performance and reduce your risk of injury. Give PREP Performance Center a call at 773-609-1847 for more information on our movement analysis program!

Book an Appointment Today

home office set up mobile app - Prep Performance Center (3)

Set Up For Success: At Home Office Set Up, Exercises and Survival Tips

Home Office Set Up. Good morning everyone! Happy Tuesday… I hope you are ready and prepared to start working from home for the next few weeks. As a physical therapist and business owner, I am often caught in the middle of my workday going against all of the advice I give my patients. We all should practice what we preach, but when you have a few hours to work from home, who wouldn’t want to do it on the couch?

During this uncertainty, we want to help you make the most of your time and have a few tips as you start working from home … your body will thank me later. Not only should you make these changes now, but think about them when you return to the office. While you are still working a full workday, you should have an extra 15 min per day to dedicate to yourself and your health. Think about how you no longer have that long commute on the train or the sluggish drive-in on the highway. Try a few of our stretches and exercises (with home office set-up) and we will have you ready for your Spring activities without skipping a beat!

Also sharing herewith an article from healthline.com as they are giving us insights about 30 exercises that we should try.

***We are going to use household items that most people have at home and we hope you will think about making these changes as you work from home and once you get back in the office. 

Set a schedule and try to stick to it

While this would be a great time to catch up on some Zzzs, it is also important that you stick to a schedule and keep yourself motivated. With so much uncertainty, we all need to do our part to complete everyday work tasks and show our employers that this work from home situation that we all hope for is possible. Sticking to a schedule will also help us stay on task and mentally prepared to get back into the office. 

Give yourself the breaks you deserve (At home or in the office)

Your employers may be shaking their heads at this, but as a Doctor of Physical Therapy and business owner, I believe it is very important to give yourself breaks throughout the day to reset your body and mind. Exercise has been shown to increase employee productivity! Throughout your workday at home, grab a cup of coffee, check-in on a friend, or check out some of our 15 min workouts to give yourself the break your mind and body deserve. 

Get a workout in a home office set-up

Research shows that if you exercise before, after or during your workday, employees often show increased productivity and job satisfaction. It might seem like a dream come true to be able to work from home, but without having outlets like the gym, a kickball league, or a child’s little league game, we could go stir crazy. Try our at-home workouts to give yourself the best chance of making it through the next few weeks. If anything, do it for the people around you: your roommate, boyfriend, wife, or children. They will thank you later!  Purchase our 4-week At Home Prevention & Performance Plan and gain access to our Custom Online App. 


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Work early and start your home-cooked meal early 

This is the time to take care of yourself and eat properly. Think twice before reaching for that frozen pizza. Despite what everyone may think, the grocery stores are still open and while they may have limited availability, there are opportunities to buy fresh ingredients to make delicious home-cooked meals. As your exercise regimen is most likely curbed at this time, try to make the right choice in food selection. Think about making 2-3 more servings than usual and save for your lunch the following day. 

Give yourself some stretch time

The third time’s a charm … we have said it before: give yourself some time to stretch during your workday. Tight muscles lead to muscle inhibition and overtime that can lead to general wear and tear on your body and poor posture. These stationary positions often lead to neck and back pain in the working professional and can often be prevented by 10-15 min per day of stretching. We like to think of this as UNDO to what you DO. If you are sitting in a chair with your head and shoulders forward, you need to UNDO that posture by stretching out the front of your body and giving your body a reset!

Don’t sit on the couch during your workday

Third time’s a charm … AGAIN. DON’T SIT ON THE COUCH. Enough Said.

I know you have been sitting at a desk every day for the last +3 years … and your desk set up works. That doesn’t mean it is correct. Most people have a desk chair and a computer in their home. But do you sit in that chair correctly? Is your keyboard at the right height? Is your neck in a good resting position? Again, as a business owner, I often find myself (as does my husband) with my neck crooked down at my phone and my laptop in my lap while sitting on the couch. For the next 3 weeks, try to stay away from working on your couch or your bed. This will only land you in my office, and while I love helping people, I enjoy educating people to prevent injury and implement the right things from the start. So check out our video to help you set up the correct at home desk. 

Proper At Home (Office) Desk Set Up

Try a few of these tips to keep you from back or neck pain while you work from home (office set-up):

– Put the laptop on a hard surface 

– Tilt the screen back so it is angled up towards your face

– Push your buttocks to the back of the chair 

– Feet flat and on the ground 

– Sit on your “sit” bones 

– Maintain the natural curve of your spine 

– Shoulder blades gently back and relaxed 

– Chin gently tucked and looking down at approx 10-15 degrees of neck flexion at your laptop

– Use a lumbar roll to maintain neutral spine alignment 

– Be safe and don’t forget to #PREPare!


Dr. Mary Kate Casey, PT, DPT 

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An Athlete’s Guide to Resting Up and Getting Back in the Game

An Athlete’s Guide to Resting Up and Getting Back in the Game

An Athlete’s Guide – At PREP Performance Center, we know how important an athlete’s sport is. It’s more than just a hobby – it’s a lifestyle that you’ve chosen to take on for yourself. While you may be eager to start training for your next tournament or competition as soon as one is complete, it is important to take time for proper rest and recovery. Letting your body rest is a crucial part of being an athlete – it allows for recovery from repetitive strain and actually helps in increasing your strength in the long run.

Without rest periods, your body becomes worn out and your risk of sustaining an injury increases. If you’re a committed athlete and you’re interested in learning more about sports physical therapy for proper rest and recovery, contact PREP Performance today!


6 Important Stretches for Avoiding Pain (Athlete’s Guide):

After a tireless weekend of physical activity at the tournament or competition you trained so hard for, your mind may immediately go to what your next training plan will look like. However, the period of time between completing a competition and beginning training once again is the ideal place to rest and recover. It is important to stretch your body after a physically demanding event, in order to avoid pain or injury. For athlete’s guide, here are some helpful stretches to incorporate include:

1. Kneeling hip flexor stretch. Kneel on a mat or soft surface. Make sure you’re positioned so your right knee is straight up and the bottom of your right foot is flat on the floor. Extend your left leg behind you so the top of your left foot is flat on the floor. Begin to shift your weight forward and stop when you begin to feel the stretch in your hip. Hold for 30-45 seconds, then switch legs.

2. Pigeon stretch. Begin on a mat or soft surface. Sit so your left leg is extended behind you, with the top of your left leg flat on the floor, and your right leg bent so the outside of your calf and thigh are flat on the floor. Your right foot should be almost touching your left hip. Slowly lean forward with your arms outstretched so your chest is resting on top of your bent right leg. Keep your head tucked toward the ground. Hold for 30-45 seconds, then relax and switch sides.

3. Calf stretch. Stand with your hands on your hips. Step forward with your right leg and bend your knee, keeping your left leg straight behind you. Place your left heel flat on the ground so you feel the stretch in your left calf muscle. Hold for 30-45 seconds, then switch legs.

4. Quad stretch. Stand with your legs hip-width apart. Relax your shoulders and flex your abdominal muscles. Use your right hand to pull your right leg toward your buttocks, so your knee is bent facing the floor. Hold your right foot in your hand for 30-45 seconds, then repeat on the left side.

5. Hamstring stretch. Begin by holding onto a stable object, such as a wall, chair,  or railing. Place your right foot on a slightly raised surface, such as a step or a curb, so your heel is touching the surface and your toes are facing upwards. Make sure your hips are straight. Slowly bend your left knee until you begin to feel the stretch in your right thigh. Hold for 30-45 seconds then repeat with the left leg.

6. Supine twist stretch. Begin by laying on a mat or soft surface, with your back flat on the ground and your right knee bent. Use your left arm to bring your bent right knee to the other side of your body, keeping your right arm outstretched flat on the ground. Rotate your hips slightly to the left in order to do this. Hold for 30-45 seconds then repeat with the left leg.

If you are a committed athlete and you’d like to focus more on your rest and recovery, contact our Chicago, IL physical therapy center today! If you are feeling pain, we can help you get started on a treatment plan for your specific needs that’ll get you back in the game as quickly as possible. At PREP Performance, our sports physical therapy programs are aimed at providing relief, improving your optimum performance, and getting you back to doing the sport you love!

Contact PREP Performance Center for more information.


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