ProActive Physical Therapy: Leading the Way in Injury Prevention

ProActive Physical Therapy is building on the science and research of common sports injury patterns through a new and innovative program. ProActive Performance Project (P3) conducts screenings to identify athletes at risk and applies researched-based training to prevent future injuries.

Tucson, AZ, December 02, 2013 --( Olympic skier Lindsey Vonn recently experienced another anterior cruciate ligament (ACL) injury and will be receiving aggressive physical therapy. Statistics show that her odds were 1.74 times more likely to experience a second injury following her initial injury! Similarly, a recent study by the Orthopedic Journal of Sports Medicine(1) has shown a second incidence of injury to be 15 times greater within the first 12 months. The reason for this can be explained in motor control theory:

For a moment, think of the human body as a robot with a very, very powerful computer running software programs to control movements. When an injury happens the brain receives a signal. The signal is usually pain and swelling: the body’s natural chemical reaction to an injury. The brain begins to run a motor program that tells the muscles to protect the injured area. However, even when an injury heals, the brain can still have these protective mechanisms in place.

For example, if a person has shoulder pain, a program runs to tighten one of the deep chest muscles (pectoralis minor). When this muscle is in protection mode, it will pull the shoulder blade forward (scapular protraction). This changes the mechanics of the shoulder and can prolong the problem in those who keep using their shoulder.

After an ACL surgery, research studies show that the motor control programs are not back to normal until about 18 months. Even three years later(2), only 50% of people are back to full sporting activities.

As motor control experts, physical therapists evaluate the motor programs the brain is running and identifies “compensations” the body has made to protect an injury. When compensating for one problem, the brain will likely overload another part of the body, which if not corrected, can become a new problem.

Patterns are emerging from the ongoing research in this field. And from the research conducted, ProActive is developing screening tools that allows identification of possible patterns that can either prolong a healing injury or create a new injury.

Back to the ACL: 70% of ACL injuries are found to be non-contact!

“Non-contact” means that the injury was not caused by contact with another player or a hard fall to the ground. When playing sports, the body is using motor programs to control the body’s muscles (software programs controlling the robot). When running, stopping or suddenly changing directions, the brain’s automatic programs are coordinating muscles to perform at a high level. In a non-contact injury, the motor program loses control and an injury occurs.

These are some “motor programs” or strategies, that may increase the risk of an ACL injury:

Quadriceps dominant strategy

Ligament dominant strategies

Leg imbalance

Leg dominance

ProActive Physical Therapy is reviewing the science of these common patterns and applying its name to the situation...Proactive. With current research and ProActive’s own on-going research, the results are being applied to athletes of all ages in a new program called the ProActive Performance Project (P3).

The ProActive Performance Project (P3), a division of ProActive Physical Therapy, is a team of healthcare professionals creating and establishing relationship with athletes, families and teams to identify and decrease risk factors through detailed screening and training.

Other than the fact that Lindsey Vonn is an Olympic Skier, her story is not that unique (see Derrick Rose). Athletes at all levels push their bodies to the limits! Any time kids are pushing themselves to the limit, there is an increased chance of an injury. Preventing injuries is possible with the right kind of training; the kind that attempts to correct some of the motor control strategies that put kids at risk.

P3 has an opportunity to identify the kids who are using strategies that may predispose them to a non-contact injury. This includes the full spectrum of injuries that can happen with athletic activity from the common ankle sprain to the devastating ACL tear. With specific screening and previous injury history, P3 can identify risk patterns that can be improved.

P3 is teaming up with the Tucson Soccer Academy (TSA) (3) to screen their athletes to identify those at risk. If found, P3 will begin working with coaches and provide trainers with very specific exercises and education to target impairments and risk factors.

To learn more about preventing ACL injuries, visit

ProActive Physical Therapy
Craig Smith