Dr. Mike Staropoli, 1200 Post Rd E, Westport, CT (2026)

01/06/2026

A lot of ACL plans are built around two checkpoints:

✅ get strong
✅ jump progressions
…and maybe reconditioning

The problem is what’s hiding in between.

Deceleration is where the forces are highest and the time to deal with them is the smallest. That’s also where most athletes have the least dedicated work:

• plenty of squats and jumps
• plenty of cone drills and “change of direction”
• almost no focused time on braking

So the athlete gets cleared, starts cutting, and feels:
• off-balance when they slow down
• rushed into turns
• unsure of their knee when speed and angle change

That isn’t just confidence.
That’s a braking system that hasn’t been trained enough.

If you’re in the middle of ACL rehab, ask yourself:

“Am I actually training how I stop…
or just how I move once I’ve already stopped?”

🧩 Save this for your mid-stage ACL phase or send it to someone chasing cutting before their brakes are ready.

12/29/2025

Deceleration isn’t “just stopping.”

It’s massive force (5.9x BW) in very little time, and your hip, knee, ankle, and trunk all have to organize fast to handle it.

If you’re rehabbing an injury or coaching change of direction, this is the braking system, the rhythm, patterns and coordination you’re really training.

12/22/2025

We talk about talent, work ethic, and mindset. But in sport, availability is its own skill.

Many athletes in pain managing a flare-up are usually doing a lot—  just without a plan for how stress and recovery stack across the week, a month, a year.

Hard days on top of hard days. “Off” days that aren’t actually off. Our system, neuromuscular, tendons and joints never get a real chance to adapt.

The goal isn’t less work. It’s better organized work.

Learn to plan high, medium, and low days.
 Space out the heavy tendon loads.
 Protect quality while you chase quantity.

That’s how you stay available — and stay progressing.

12/17/2025

Front of knee pain after ACL – patellar or quad tendon – is almost never random.
 It’s usually a sign that the load and recovery aren’t organized well, not that your knee is “broken” or that one exercise ruined everything.

Tendons don’t hate work. They hate poorly timed work.

Heavy jumping, elastic knee-dominant work all have a cost.
 If those big doses stack on top of each other without enough recovery, the tendon stops adapting and just starts complaining.

Most tendons need ~48–72 hours to recover from a heavy hit of load before you hammer them again – and that assumes they had the capacity for that dose to begin with.

That’s where pacing comes in:
* plan your high-load days and space them
* use lighter or different patterns on the days in between
* let irritated tissue calm and adapt instead of layering stress on stress

You don’t protect your knee by avoiding work altogether.
 You protect it by organizing the work and progressing intentionally.

🧩 Dealing with this right now?
 Save this and adjust your next week of training instead of guessing.

12/16/2025

Mid-stage ACL isn’t a holding phase. It’s where you stop just rehabbing the knee and start preparing the athlete.

We are moving past early ROM, introduction to movement and loading and rehab starts looking much more like training.

Mid-stage should have a clear purpose:

1️⃣ Build load capacity – progress volume & intensity of movement, not just add random exercises.
 2️⃣ Dial in landing mechanics – control force consistently before adding more variables to consider, aka chaos.
 3️⃣ Own deceleration before cutting – stopping well is the skill that earns effective change of direction.
 4️⃣ Add controlled chaos – controlled reaction, ball/skill work, timing changes in an environment you can safely and successfully adapt.
 5️⃣ Condition without losing mechanics – repeatable efforts, not random exhaustion. We want to really focus on progressing quality — quality sprinting and change of direction, quality running and skill work, not just getting tired for the sake of a hard conditioning session. Build high quality efforts.
 6️⃣ Keep what you’ve built – gym work and tendon capacity don’t become optional. As players start focusing on the sport, they can forget about the foundational strength that helped get them there. Keep feeding it.

When this phase is planned well, late-stage return to play is smoother, safer, and more successful.

12/10/2025

If returning after ACL feels harder than you expected, you’re not doing anything wrong.

Most people were never taught that getting back on the field and performing well are different phases of return to sport.

Understanding the difference between Return to Sport → Return to Play → Return to Performance is a simple framework that helps you stay consistent, confident, and progressing instead of frustrated.

💪 Return to Sport:
 You’re participating again — individual work, modified sessions, positional drills, controlled conditioning. It’s exposure without full demand.

⚽️ Return to Play:
 You’re back in team training and maybe earning minutes, but not yet performing at your true level. This is the transition phase.

🏆 Return to Performance:
 You’re competing at — or above — your pre-injury standard. Skill, decision-making, conditioning, and confidence have all returned.

When you understand the phases, everything makes more sense — the confidence dips, the soreness, the timing, the fatigue, the mental load.

You’re not behind.
 You’re adapting — to training loads, match speed, recovery demands, and the process of rebuilding toward your new level.

🧩 Save this for your RTP plan.

12/08/2025

Injuries are complex and although we continue to learn more every day, we should start by controlling what we can actually do today.

12/05/2025

📈Progressing mid grade MCL injury throughout the week.

Our GOALs this week as we progress through the loading and provide some different options and solutions:

1. Increase unilateral strength and motor control
2. Stress the medial knee in a tolerable way
3. Improve gross force production
4. Get moving laterally

All tissue responds to stress — with appropriate recovery times, they continue reorganize stronger against load.

Muscle may adapt by increasing size or speed of firing, joints will improve ranges of control, bones will adapt to tolerate greater stress in directions they are exposed to and ligament will reorganize stronger — that includes the MCL.

And ultimately, our entire system adapts to improve coordination and application.

These are common objectives in our rehab.

is continuing to smash it and getting back to running and intro to change of direction is a huge W!

12/02/2025

Many athletes assume that when pain shows up, the safest thing to do is shut everything down.
 But for many injuries, full rest actually makes the return harder — not easier.

The goal isn’t to remove the athlete from training.
 The goal is to adjust the dose, the demands, and the environment so the system can keep adapting while the irritated tissue settles.

With this basketball player, the pain wasn’t random:
 there was a clear spike in workload and a few movement limitations that limited him.
 So instead of stopping, we reshaped his training:

• smaller doses of what irritated the back • maintained shooting and practice with adjusted volume • monitored response to load • addressed the specific limitations in the gym • kept conditioning, rhythm, and coordination on the menu

He stayed active and in the game.
 And his return stayed smooth — because we modified intelligently rather than disappearing from training.

Pain doesn’t mean “stop.” Pain means pay attention — and adjust the version of training your body is ready for.

🧩 Save this for the next time you’re managing pain or helping an athlete stay availables.

12/01/2025

Many injuries don’t require shutting everything down — they require better management.

Most athletes lose far more from doing nothing than from training with smart adjustments.
 Load, movement, conditioning, confidence… all decline faster than people realize.

The goal isn’t to avoid stress — it’s to find the level of training your body can currently tolerate and build from there.

Modify → don’t stop. Train around the injury. Understand pain behavior. Communicate early and often.

If you can stay active, you stay prepared.
 And staying ready is always easier than getting ready again.

🧩 Save this for the next time you’re navigating an injury.

11/26/2025

MCL Sprain Load Intro Session

Here is the majority of a session for one of our pro players recovering from a grade 2 isolated MCL injury.

We have two primary goals in the load intro phase:

1. Introduce load to key movement strategies and tissue
2. Build other essential outputs to prepare for the next progression.

With some normal quad weakness and sensitivity to frontal plane movement, it has allowed us to load linear movement, introduce early lateral movement strategies, address pre-run coordination and stiffness as well as build aerobic power.

We have found mid-grade MCL injuries in the first handful of weeks being more sensitive in mid range knee flexion positions, as well. Although this might seem limiting, we find plenty of areas we can continue to build capacity and tolerance until the knee is comfortable taking stress here.

A prime example is our ankle and calf dribbles. These are a pre-run activity we have found success in as expanding amplitude of higher hip/knee flexion and HS load is currently sensitive. There is no need to stop the pattern all together. Once the tissue adapts, we move into the new range. In the meantime, we prepare the person with the previous step.

Athlete:

11/25/2025

A lot of athletes wait to start rehab because they think they need things to “calm down” first.
 But what usually needs calming isn’t the injury — it’s the uncertainty.

Early rehab isn’t about doing more. It is about having a strategic plan.
 It’s about managing the things you don’t see in those first few weeks:
 ▫️ Loss of ROM
🔹 Loss of strength 🔻Movement limitations 🔸Changes in how and how much you load
▪️Confidence in return 🔹Conditioning dropping
🔻Managing pain
🔸Education on the process

Starting rehab soon after an injury helps improve the timeline for return to sport by decreasing how much of a drop off in output and working on the other qualities needed to train and play.
 It means guiding your system while the tissue heals.

Thats the difference.

When creating an effective plan, using all your time wisely is the difference to create an efficient return to play.

Dr. Mike Staropoli

01/06/2026

12/29/2025

12/22/2025

12/17/2025

12/16/2025

12/10/2025

12/08/2025

12/05/2025

12/02/2025

12/01/2025

11/26/2025

11/25/2025

Address

Website

Alerts

Contact The Practice

Shortcuts

Share