Ten weeks to start throwing after UCL surgery sounds like a miracle timeline, until you’re the clinician staring at a stiff elbow, a deconditioned arm, and a protocol that assumes the athlete is further along than reality. We’re seeing more internal brace UCL repairs and fewer “classic” Tommy John reconstructions, and that shift is changing how baseball pitchers, gymnasts, and other overhead athletes move through rehab.

We talk through what’s actually different about the internal brace procedure, why surgeons became so optimistic early on, and why many athletes still aren’t truly ready to throw at week 10 even if they’re technically cleared. Readiness means more than ligament stability. We dig into the practical stuff that decides outcomes: restoring extension early without creating inflammation, building real strength and arm care habits, and using a plyometric progression before a return-to-throwing program. We also share what we’re watching for clinically, including ulnar nerve irritation from prolonged bracing, motion that never quite “settles,” and the unique posterior-medial elbow pain that can show up with deep flexion or forced extension.

Most importantly, we argue for criteria-based rehab over calendar-based rehab. If the athlete has time before the next season, use it to build capacity instead of chasing an artificial milestone. If you work in sports physical therapy, sports medicine, or baseball performance, this conversation will help you spot red flags early and guide internal brace athletes with more confidence.

Subscribe, share this with a coach or clinician who manages throwing programs, and leave a review if it helps. What’s the earliest return-to-throwing timeline you’ve seen that actually held up long term?

To see full show notes and more, head to: https://mikereinold.com/the-new-tommy-john-the-rise-of-the-internal-brace/

My new online course is here and $100 off this week: The ACL Rehab Masterclass: A Complete Guide to Criteria-Based Rehabilitation, Testing, and Return to Sport. I teamed up with Dan Pope and Kevin Coughlin from Champion to show you our complete system for ACL Rehab.

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We’ve all seen it: the acute ACL patient who drags their leg into the clinic, unable to squeeze their quad to save their life. We call it Arthrogenic Muscle Inhibition (AMI), and for years, we’ve treated it as a stubborn, long-term enemy. But a fascinating new study from the American Journal of Sports Medicine suggests we might be overcomplicating it.

Researchers analyzed 300 acute ACL patients and found that while AMI is incredibly common (affecting over half of patients), it’s also surprisingly fragile. In fact, they found that nearly 80% of cases could be fully reversed in a single session with simple exercises. In this episode, we dive into the 'Red Flags' that predict quad shutdown—including one common sleeping habit you need to ban immediately—and how to flip the switch back on for your patients.

To see full show notes and more, head to: https://mikereinold.com/risk-factors-of-arthrogenic-muscle-inhibition

My new online course is here and $100 off this week: The ACL Rehab Masterclass: A Complete Guide to Criteria-Based Rehabilitation, Testing, and Return to Sport. I teamed up with Dan Pope and Kevin Coughlin from Champion to show you our complete system for ACL Rehab.

Click here to learn more and save $100 this week

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We all have our favorite "go-to" exercises for patellar tendinopathy. For years, the single-leg decline squat has been the gold standard, often introduced early in rehabilitation to target the tendon. But what if I told you that this specific exercise actually places more load on the patellar tendon than running or double-leg jumping?

A massive new study just analyzed 35 common rehabilitation exercises—from step-ups to plyometrics—and ranked them based on actual biomechanical load. The results turn traditional progression models upside down and might explain why some of your patients flare up during "standard" rehab protocols. In this week's episode, we break down the 3 distinct tiers of tendon loading and give you a data-backed roadmap to build the perfect progression.

To see full show notes and more, head to: https://mikereinold.com/ranking-the-top-patellar-tendon-exercises-by-tendon-load/

My new online course is here and $100 off this week: The ACL Rehab Masterclass: A Complete Guide to Criteria-Based Rehabilitation, Testing, and Return to Sport. I teamed up with Dan Pope and Kevin Coughlin from Champion to show you our complete system for ACL Rehab.

Click here to learn more and save $100 this week

Support the show

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Want to learn more? Check out my blog, podcasts, and online courses
Follow me: Instagram | Twitter | Facebook | Youtube