In this episode, Director of Rehabilitation at OL Reign, Dr. Nicole Surdyka, talks about on-field rehab after ACL injury. Nicole is currently the Director of Rehabilitation at OL Reign, one of the founding clubs of the National Women’s Soccer League, NWSL, which is one of the best professional women’s soccer leagues in the world. Today, Nicole shares her 5-phase on-field rehab strategy, and the decision-making process in return-to-play and return-to-performance. What are the criteria that Nicole looks at to determine progress to the next phase of rehab? She tells us about delaying return to sport to reduce second-injury risk, the return to sport continuum and how to define it, and the use of the StARRT framework for the return-to-sport decision-making. Nicole gives some valuable advice to her younger self, she tells us about integrating rehab with team activities, and communicating with athletes and coaches, all on today’s episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways Nicole implements on-field rehab in 5 phases. Phase 1: Simple, pre-planned, linear movements. The focus is on quality of movement and cleaning up movement technique before moving on. Typically includes walking marches, walking lunges, side shuffles, and jogging. Nicole starts this at 70-75 quad strength limb symmetry index. Phase 2: Pre-planned direction-changing movements. Typically includes accelerations, decelerations, sprinting, and change direction. Phase 3: Adding reactive tasks without a soccer ball. Direction-changing with an element of reacting to an external event. Nicole starts this with at least 80% quad strength limb symmetry index. Phase 4: Soccer-specific movements. The reactions are done in context – with a soccer ball. Phase 5: This phase should look like a modified training session. Delaying return to sport: each month that you delay that, there’s a 51% reduction in second-injury risk, up until the 9-month mark. Return-to-participation: When athletes are participating in their sport in a modified way – participation with certain limitations on activities. Return-to-sport: When there is no longer any medical reason to limit an athlete’s participation – “cleared to play”. Return-to-performance: There are no restrictions and athletes are training to become better at their sport. “Be patient. Every experience is valuable, and you can relate any experience to what you eventually end up doing.”   Suggested Keywords On-field Rehabilitation, StARRT, Injuries, ACL, Sport, Performance, Physiotherapy, PT, Therapy, Wellness, Health, Injury-Prevention, Recovery,   Recommended reading: Consensus statement on return to sport: https://pubmed.ncbi.nlm.nih.gov/27226389/ On-field rehabilitation Part 1: https://pubmed.ncbi.nlm.nih.gov/31291553/ On-field rehabilitation Part 2: https://pubmed.ncbi.nlm.nih.gov/31291556/   More about Dr. Surdyka:  Nicole is currently the Director of Rehabilitation at OL Reign, one of the founding clubs of the National Women’s Soccer League, NWSL, which is one of the best professional women’s soccer leagues in the world. Nicole is a physical therapist and strength and conditioning coach. She played Division 1 college soccer at St. John’s University and then went to Emory University where she got her Doctor of Physical Therapy Degree. Throughout college and PT school, Nicole coached youth soccer and worked as a personal trainer. After PT, school Nicole worked in various outpatient orthopaedic and sports medicine clinics before starting her own practice in 2018 where she worked with youth to professional athletes. Nicole specializes in on-field rehab for soccer players to help bridge the gap between rehab and sport performance. She is passionate about the return to sport process and how we can make better decisions for athletes returning to sport after an injury. Nicole has a website where she writes blog posts on rehab for soccer players, has eBooks available on specific injuries, teaches continuing education cou