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163. ACL treatment options and cross-bracing with Clare Walsh

Release Date: 04/17/2024

163. ACL treatment options and cross-bracing with Clare Walsh

Physio Edge podcast

ACL injuries result in significant time away from sport and distress for patients. The variety of management options, from surgical intervention to non-surgical management and rehabilitation protocols, often makes us uncertain when educating and helping patients choose the most appropriate care for their needs and goals. Recently, a pioneering non-operative ACL injury management pathway called the “Cross bracing protocol” has been pioneered and developed by Dr Tom Cross and Tom’s father (the late Orthopaedic surgeon) Dr Merv Cross. This protocol offers a promising alternative for...

162. Three top tips for treating runners with a meniscal injury. Physio Edge Track record: Running repairs podcast with Tom Goom

Physio Edge podcast

How can you treat patients who experience knee pain and swelling during and after running? If you suspect their symptoms are caused by a meniscal injury, how can you rehab and return these patients to running without surgery? In this Physio Edge: Running repairs podcast with Tom Goom, you’ll explore meniscal injuries in runners, recent research on runners with meniscal tears, and how to provide effective non-surgical management. You’ll discover: Initial steps for managing pain and swelling in affected runners. Techniques to restore and maintain range of movement. Strategies for rebuilding...

161. Overcoming persistent shoulder pain in tennis players with Jo Gibson

Physio Edge podcast

Jo Gibson (Upper Limb Rehabilitation Specialist Physio) discusses the keys to successfully treat persistent anterior shoulder pain in two tennis players who had not recovered despite previous extensive rehab. In this podcast Jo explores what to include in your rehab of sportspeople who place large demands on their shoulders, elements commonly overlooked in shoulder rehab and how to address patients’ psychosocial factors, fears and beliefs to successfully treat persistent shoulder pain. The handout for this podcast consists of a transcript and research articles referenced in this...

160. ACL injuries with Zoe Russell

Physio Edge podcast

Join David Pope (APA Titled Musculoskeletal and Sports & Exercise Physio) and Zoe Russell (Specialist Sports Physiotherapist, FACP; APA Titled Musculoskeletal Physio) in the Physio Edge podcast as they explore how to assess, treat, and manage patients suffering from ACL injuries or suspected ACL injuries. You'll discover how to assess a patient with a suspected ACL injury, and criteria you can use to identify whether a patient may be suited to non-surgical management or is likely to require surgery. You'll also understand when immediate or delayed surgery is the best option, and how to...

159. Rotator cuff tear arthropathy & subscapularis tears. Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

Rotator cuff tear arthropathy (RCTA) is a pattern of glenohumeral joint degenerative changes following rotator cuff tears, causing shoulder pain and stiffness. Subscapularis tears can also be involved in RCTA, or a significant cause of shoulder pain and disability. How can you identify RCTA and subscap tears in your shoulder pain patients? How can they be treated, and do these patients respond well to non-surgical management? Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio). The handout for this podcast consists of a transcript and research articles...

158. Hip dysplasia treatment. Physio Edge Track record: Running repairs podcast with Tom Goom

Physio Edge podcast

How can you successfully treat hip pain and instability associated with your patients’ hip dysplasia? Find out the eight critical steps to excellent results with hip dysplasia in this podcast, which is part 3 in this three-part podcast series with Tom Goom (Running Physio). Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at Free video series: Achilles Tendinopathy from start to finish line! with Tom Goom In this free Masterclass "Achilles tendinopathy: Assessment & rehab from start to finish line" presented by Tom Goom and...

157. Case study: Frozen shoulder or misdiagnosis? Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

When a patient presents with a potential frozen shoulder, what other differential diagnoses must be considered? Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio), exploring the case study of a patient diagnosed with “frozen shoulder” with symptoms that don’t quite match a typical frozen shoulder. What’s the diagnosis of this patient’s stiff shoulder? You’ll also discover whether an X-ray or imaging is required when a patient presents with a stiff or frozen shoulder. The handout for this podcast is the transcript associated with this...

156. 3 types of hip dysplasia and how to identify them. Physio Edge Track record: Running repairs podcast with Tom Goom

Physio Edge podcast

Hip dysplasia is a commonly missed cause of hip and groin pain. In this podcast, which is part 2 in the 3 part series with Tom Goom (Running Physio), you’ll discover three types of hip dysplasia that will cause different symptoms and need different treatment (based on Wilkins et al. 2017), how to identify each type, and common exercises and a treatment approach that may be stirring up your patients hip and groin pain. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at Tricky tendons - Your free video guide to tendinopathy...

155. Stingers, burners & shoulder instability in sport. Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

Stingers or burners are a burning or stinging pain, often with some paraesthesia and occasionally weakness, often occurring in impact sports such as rugby or American football. When your patients present with neck and arm symptoms, how can you differentiate a stinger or burner from a C/sp fracture, discogenic symptoms or nerve root compression, which all require very different treatment? How should you manage patients with one-off or repeated stingers or burners? Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio). The handout for this podcast consists of a...

154. Hip dysplasia key signs and symptoms. Physio Edge Track record: Running repairs podcast with Tom Goom

Physio Edge podcast

Hip dysplasia is a commonly missed cause of hip and groin pain, catching, clicking, locking or popping, resulting from lack of coverage of the femoral head by the acetabulum. How can you identify hip dysplasia in your hip or groin pain patients, and avoid misdiagnosing it as iliopsoas or adductor related groin pain? What signs and symptoms will your patients reveal in their subjective history that’ll help you identify this condition? Find out the key signs and symptoms of hip dysplasia in this podcast with Tom Goom (Running Physio). Improve running injury assessment & treatment now with...

More Episodes

Recently, a pioneering non-operative ACL injury management pathway called the “Cross bracing protocol” has been pioneered and developed by Dr Tom Cross and Tom’s father (the late Orthopaedic surgeon) Dr Merv Cross. This protocol offers a promising alternative for patients with ACL injuries who are suitable for non-surgical intervention, where the ACL injury may heal or repair itself.

Not all patients with an ACL injury are suitable for the Cross bracing protocol or non-surgical management, so how can you identify whether your patient is suitable, and which treatment options are best for each patient?

In this insightful podcast episode, we discuss the complex challenge of ACL injury management and Cross bracing with Clare Walsh (Specialist Sports & Exercise Physiotherapist, FACP).

Clare treats a lot of patients with ACL injuries with prehabilitation, post-op rehabilitation, or non-surgical management including Cross bracing. Clare works alongside Dr Tom Cross and other Sports Medicine Doctors, Orthopaedic surgeons (including the late Dr Merv Cross) and leading Sports Physiotherapists at Stadium Sports Physiotherapy and The Stadium Clinic.

Clare teaches on the Cross bracing course conducted in Australia for Physiotherapists and health professionals, and is a Senior Educator & Presenter here at Clinical Edge.

In this podcast we explore:

Cross bracing
- What it is and how it developed.
- What research has been performed to date, and what it shows about the chances of ACL healing with the Cross bracing protocol.
- Assessment tests & specific imaging that are used to assess patient suitability.
- Why patients might opt for Cross bracing rather than surgery.
- Who isn’t suitable for Cross bracing.
- Potential negative outcomes of Cross bracing.
- Which patients are more likely to be suitable and successful with Cross bracing - eg. injury type, age, level of sport, goals, psychosocial factors.
- Medical factors that impact suitability.
- Psychosocial factors that impact whether a patient can undergo the protocol.
- Which leg (right or left) is better suited to bracing and why.
- Which type of braces are commonly used.
- How soon the protocol needs to commence after injury to be successful.
- Which concomitant injuries can still heal in a brace and which need surgery e.g. meniscus injuries, bucket handle tears of the meniscus, MCL tears.
- How long patients remain in a brace.
- Exercises and activities that can and should be performed throughout Cross bracing.
- How patients can move or walk around throughout the Cross bracing period.
- How Cross bracing has changed and evolved.
- Whether the ACL is at increased risk of re-rupture following the protocol.
- Essential medical management during the protocol.
- Whether therapists can put a patient in a brace, or manage the protocol independently.
- What to you do if you think a patient may be suitable for Cross bracing.
- How to refer patients for Cross bracing
- Followup imaging at the end of the protocol.
- Functional assessment tests used at the end of the protocol.
- Return to training (RTT) and return to play (RTP) following the protocol.
Which patients require surgery instead of conservative management.
Early surgery vs delayed surgery.
Spontaneous ACL healing - what the research says.
How to use patient-centred decision-making to guide patients into the most suitable recovery pathway - surgery, bracing or non-surgical management.
Case studies and comparisons of patients that underwent either Cross bracing or ACL reconstruction.

This podcast is packed full of great information on this emerging ACL injury treatment. You’ll finish this podcast with a deeper understanding of ACL injury management and Cross bracing plus practical knowledge, solutions and insights you can apply into your practice.

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