Mick Hughes: Sports & Exercise Physiotherapist

24/04/2026

Not every DVT waits for surgery.

Not every DVT presents as a dramatic red, hot and swollen calf.

And not every sore calf is “just tight.”

A recent ACL injury (or other significant lower limb injury) that requires a period of reduced ROM and weight bearing should keep you on high alert for DVT

New blog now live on The ACL Hub.

The ACL Hub ink in bio.

24/04/2026

Don’t let the knee distract you.

The most important red flag in acute ACL rehab is not always at the knee.

Lately, I’ve seen multiple confirmed DVTs in patients with recent lower limb injuries, immobilisation, and reduced weight-bearing ; often with subtle calf symptoms, and not dramatic textbook "red, hot & swollen" ones.

That’s what my latest blog on The ACL Hub is about.

Link to The ACL Hub in bio.

Tag a physio who should read this.

23/04/2026

Just dropped a new ACL Hub interview with Laura Opstedal ( and .physio ) : sports PT, clinic owner, and 25 years deep in the ACL trenches.

It’s one of those chats that feels like a warm cup of coffee and a professional kick up the bum (in the best way).

A few things we covered:

* Quad tendon grafts: why they can be a little unpredictable… and how Laura “respects the first 12 weeks” so the donor site doesn’t go rogue

* Patellar tendon myths: why anterior knee pain isn’t a life sentence and how the old fear of open-chain knee extensions shaped that narrative

* BFR: when it’s genuinely useful early vs when it’s just noise

* Return-to-sport testing: what she measures, what she watches in real training, and why the knee’s behaviour still tells the truth

If you’re a clinician, athlete, coach, or just an ACL nerd like me.. you’ll get a lot out of this one.

🎥 Watch the full interview for free on The ACL Hub (link in bio).

22/04/2026

Cryotherapy after ACL reconstruction: overrated… or underappreciated?

The evidence is not perfect, but there’s a pretty good case that cooling the knee can help reduce pain and make early rehab more tolerable.

And when paired with exercise, it may also help the quadriceps perform better in those all-important early stages.

That’s the focus of my latest ACL Hub blog - The ACL Hub link in bio btw

Are you on team PEACE + LOVE or PRICE? or depends on the patient?

Let me know in the comments below with a ☮️ or 🧊 or 🤷‍♂️ - no right answer and no judgements here

rehabscience evidencebasedpractice

16/04/2026

Sometimes the most important part of ACL rehab is the bit no one really posts about.

Not the surgery day. Not the first straight leg raise. Not the dramatic comeback clip.

Just the steady middle.

The part where the knee is improving, but still needs respect.

The part where strength is being rebuilt quietly. The part where swelling is still hanging around a bit, stairs are still a little awkward, and the physio’s job is mostly to stop everyone from getting too excited too soon.

This week’s blog is about exactly that.

A 4-week case update, some reflections on programming, and a reminder that boring rehab still does a lot of the heavy lifting.

You can read the full piece now on The ACL Hub - link in bio.

And if you got something from this, I’d love you to share it with someone else in the ACL world.

For those of you in clinic: what is one conversation you find yourself having all the time at this stage?

15/04/2026

I think we say “exercise is good for mental health” so often… that sometimes we forget to ask what that actually means.

This week on Exercise Matters, Randall and I unpack the evidence around exercise and depression; what types of exercise seem to help, how much may matter, and why this conversation is bigger than just “go for a walk and you’ll be fine.”

For me, this one felt personal.

Exercise has helped me a lot through some tough periods; particularly resistance training.

There was something about lifting weights that gave my mind a break when it needed one most. It didn’t solve everything, and I’d never pretend it does, but it has absolutely been part of what’s helped me.

So this episode is a mix of research, real-life reflection, and a reminder that movement can be a powerful support for people doing it tough.

The full episode of Exercise Matters is out now - have a listen and let me know what you think.

And just out of curiosity: are you more likely to clear your head with a walk or with weights? Let me know 👇

13/04/2026

Calling an exercise “functional” does not magically make it effective.

Keep it simple stupid.

New blog up on The ACL Hub. Link in bio.

09/04/2026

This one kept me humble.

A really sensible non-operative ACL plan turned into a surgical one after an instability episode in a social soccer game.

But the big lesson for me was that good rehab still leaves a footprint.

He went into surgery strong, prepared, and gave himself a really good early platform.

Sometimes the plan changes. The work still counts.

Ever had a knee humble you like this?

A Case That Challenged My Thinking on Non-Operative ACL Rehab

01/04/2026

A little clean-up post from me after this morning’s doughnut announcement

The joke, for anyone still unsure, was not just the career change.

It was also the idea that I possess even the faintest level of baking competence.

This was essentially a very public self-own.

I can help rehab an ACL. I can probably talk your ear off about quads. I cannot, however, be relied upon to produce a respectable baked good.

I always try to keep these April 1 posts light and harmless, because I never want the joke to come at the expense of trust.

So thanks to everyone who rolled with it and let me have one small annual moment of nonsense.

No hiatus. No doughnut shop. And no evidence whatsoever that I could decorate one without immediate disaster.

Before I retreat back to my usual posts tomorrow, I'd also like to formally complain that I spelt out APRIL FOOLS DAY with the first letter of each sentence and received, as far as I can tell, zero credit for it.

It would appear I massively overestimated the reading diligence of this community 🤣

31/03/2026

After a lot of thought, I’ve decided to take a 12-month hiatus from physiotherapy.
Putting this into words feels a little strange, because this profession has given me so much over the years.
Right now though, I feel pulled in a slightly different direction.
I've spent a long time helping people rehab injuries, but I think it might finally be time to explore another passion of mine.
Lately, that passion has involved a dangerous amount of baked goods.

For that reason, I’m excited to share that I’ll be opening my own doughnut shop.
Obviously this is a big change, but it’s one I’m strangely excited about.
Over the next few months, I’ll be pouring my energy into recipes, glaze consistency, and elite-level sprinkle selection.
Leaving clinic work, even temporarily, won’t be easy.
Still, it feels like the right time to follow my heart… and probably my stomach.

Don’t worry, I’m sure I’ll still end up talking about knees far more than any doughnut shop owner should.
And yes, there is every chance I name one of the flavours The Baker's Cyst.
Yours truly - and thanks always for your support, Mick.

*** If the penny hasn't already dropped, this is an April Fool's Day post. There are clues with the starting letter of each sentence - sorry, not sorry if I got you good!

29/03/2026

I started the ACL Hub nearly 12 months ago thinking it would be a nice little corner of the internet for people who wanted better ACL info.

And now we’re sitting at nearly 5,500 members.

So apparently there are thousands of people out there who also enjoy a good ACL deep dive. Weird, but wonderful.

Genuinely though, thank you.

The best part of the ACL Hub has been building a space where patients and health professionals can learn together, ask better questions, challenge ideas, and make sense of the latest ACL evidence in a way that feels practical and honest.

Between the ACL Hot Minute research breakdowns, ACL Rehab Room clinicial case studies & ACL expert/athlete interviews I hope you've enjoyed me trying to make ACL rehab make sense without making you fall asleep.

If you haven’t joined yet, come say hello - link in bio

Are you in The ACL Hub? Raise your hand in the comments 🙋‍♂️🙋‍♀️

29/03/2026

I started the ACL Hub nearly 12 months ago thinking it would be a nice little corner of the internet for people who wanted better ACL info.

And now we’re sitting at nearly 5,500 members.

So apparently there are thousands of people out there who also enjoy a good ACL deep dive. Weird, but wonderful.

Genuinely though, thank you.

The best part of the ACL Hub has been building a space where patients and health professionals can learn together, ask better questions, challenge ideas, and make sense of the latest ACL evidence in a way that feels practical and honest.

Between the ACL Hot Minute research breakdowns, ACL Rehab Room clinicial case studies & ACL expert/athlete interviews I hope you've enjoyed me trying to make ACL rehab make sense without making you fall asleep.

If you haven’t joined yet, come say hello.

The ACL Hub: https://open.substack.com/pub/mickhughesphysio?utm_source=share&utm_medium=android&r=5g0ytt