Episode 191 | Focus on What Matters: The MIT Approach in ACL Rehab

What is up everyone? Welcome back to the ACL Athlete Podcast. We’re diving into this MIT concept for ACL rehab. What MIT stands for, the most important thing – M.I.T. (most important thing). It’s a concept and framework I’ve learned in productivity and in business, especially with trying to manage my own time. It’s easy to get through a day and feel like you have accomplished literally nothing. There’ve been so many days like that. And so having these different ways to managing time and priorities is super important just as human beings, but especially trying to create my own time and manage my own time. This is really helpful. That’s where this MIT concept comes in. You pick one thing or goal to complete every day. My most important thing for the day or my MIT. Something I try to tackle first thing in the morning.

For example, this podcast was my MIT for this morning. It was my most important thing and so I am tackling this podcast recording yet, so that is my MIT. This reminds me of a quote I really like. I’m a big UGA fan born in Georgia, went to university of undergrad. I co-share with strength and conditioning, so very near and dear to my heart. I heard Kirby Smart, the head coach for UGA, reference this quote, and this was when we were chasing a national championship. And he says, “Keep the main thing, the main thing.” I loved it. Then I looked it up and it actually comes from Stephen Covey’s “Seven Habits of Highly Effective People.” And he says, “The main thing is to keep the main thing, the main thing.” So that is something that seems so simple, but emphasizing the importance of prioritizing and focus on achieving goals.

This concept encourages people to identify and be able to dedicate their attention to, specifically primary objectives without being too sidetracked or having distractions or the secondary tasks. ACL rehab is faced with all kinds of noise and ways to get distracted or sidetracked. I feel like procrastination kind of sets itself in, we don’t really want to work on certain things just like we do with just work or school or whatever that might be. Same thing with ACL rehab, especially if there’s some pain to work with, or it’s just not our favorite thing to do. We’re not choosing to be here. We just happen to have this injury and it’s in the way of us getting back to something we love to do and want to do. So there’s all this noise and ways to get distracted. I have enjoyed using this concept with my athletes whether that’s a phase we’re in the week or even a session theme, for example, the MIT could be used. 

For example, the phase that we’re in. Our MIT is quad strength, basically all of ACL rehab, as you guys know, quad strength, quad strength, quad strength. But let’s say for example, we are in this phase where it is such a huge focus for quad strength. I’ve got this athlete right now where they have been playing this game of catching up on quad strength. They were elsewhere. They had had these battles of cyclops lesion and all these other things coming up. And quad strength has been their limiting factor or their bottleneck. Our phase has been so focused on this because of where they are in this process. 

Another example is the week. Maybe this particular week for a different athlete is let’s get the swelling down. That is our MIT for this week. I don’t care about anything else. Sure, we’re going to do some other rehab stuff, but maybe our main focus because it’s the main bottleneck is getting our swelling down. Session—maybe your MIT for a session is achieving terminal knee extension. You’ve been after this thing. Instead of trying to focus on being able to do some hamstring work or knee flexion, or maybe you’re doing some squatting, whatever that might be, you’re still after terminal knee extension. And you are three months out. Maybe for a particular session, you’re like my MIT is, let me get this terminal knee extension. It might be for sessions and sessions after that, but at least you have something to really focus and hone in on. 

It allows us to get very focused on that one thing. If we can move the needle on this one thing, everything else will fall more in line. It is usually that bottleneck so that’s what this MIT can be focused on in this process as well. That rate limiting factor, as I had mentioned. It also allows us to reduce the noise since we can be working on 10,000 different things and exercises and movements and goals. These athletes who come to us from somewhere else and they’re like, yeah, I’ve been doing 30 to 40 exercises in a session. We’ve had people who have literally said they’re doing two to three hours worth of work in a session and they might even be post-op ACL and they’re doing thirty exercises. What is happening? This is madness. How about we cut this down and only do five to 10 and let’s make sure every single one of these is so freaking effective because the likelihood of 30 to 40 exercises, you probably haven’t tons of redundancy and not putting much intent behind any of those. What if we can reduce this and reorganize this and make it 25% to 50% of the time you’re actually spending. What if you can make this 30 minutes an hour, even 10 minutes to be able to move the needle on certain things. For example, maybe it is that knee extension that we’re working on and then we build that up over time. 

This is something that is really important to help reduce the noise and make sure we’re not working on so many different things at the same time. And this brings up another quote I like to use, “The man who chases two rabbits catches neither,” this is by Confucius. And this is basically just the adage of, if you are after two rabbits, you’re not going to get both of them because they’re going to be running in different directions and you’re not going to be able to capture them. If we are focused on one rabbit then, “Hey, we can follow that rabbit and we can be able to catch that rabbit.” But the thing is, when we’re after too many goals, it starts to get really diluted in our plan and the way that we’re navigating our movements and our exercises. We need to try and find the signal within the noise. How do you find that? Through evidence-based testing. That is what’s going to create this honesty around where the athlete is. And then we’re going to make sure we’re targeting goals that are not only long-term but short-term. And then therefore, we have a starting point and then we have this next point we’re working with, what we would say from A to B and the long-term goal is Z. We just need to focus on this next step and then we’re going to create a plan around that. Prioritizing the MIT as numero uno. And that way as you move forward, and if things get overwhelmed or maybe you have limited time and need to work on one thing, is the MIT. You can finish that day, that session, even that week, for example, and all you did was the MIT every day, then you can be happy and feeling successful in that. And that’s the 1% better we’re looking for in this ACL rehab process, that next break we need to lay down for the foundation. You feel clarity in what your plan and programming is targeted. 

This is something that we do find a lot, especially with just the overwhelming nature of ACL rehab. As I had mentioned, it feels like this part-time other job that you are doing, especially early, because you are doing a lot of range of motion work. You’re working on this thing repeatedly, and this limiting your life a lot more. You want to put more work into it. And then as you go, hopefully, it’s turning into this performance, strength and conditioning type program. That way it’s looking more like you’re going to the gym and rehabbing and training stuff versus this constant daily grind which does start to slow up, but it is a long process.  We’re playing a long game here. This is something that’s really important to consider with so many variables in ACL rehab. 

One of the things too is, especially for our younger athletes, we like to make sure that they know what it is that they are focusing on because it’s easier for distractions and for things to come into place. And then therefore maybe there’s not as much intense effort behind everything. Because even if they’re coming to the clinic two to three times a week, for example, there’s so much time outside of that. And so therefore there needs to be a lot of intention behind knowing what are we chasing and what are our goals. And that’s where the plan comes into play, is what we’re after with these milestones and criteria, having these goals set up, but most importantly, making sure that we do have an MIT and these priorities that these athletes know. 

Try it for yourself. A lot of times you’ll find you’re wasting a lot of time chasing a bunch of different rabbits and catching none of these. Instead, you have an MIT, ensure some secondary goals with that. And your one rabbit, you’re chasing is the MIT. That’s the thing, the most important thing that we are after. This can help really streamline things while you’re going through ACL rehab because we just want to make sure we don’t get confused with trying to tackle 10 different goals. We want to make sure we have, especially our top three, but then pick that number one. If you say, if I can accomplish this number one, this will move the needle forward. This will help with the bottleneck of this process. A lot of times the athletes are like, well, maybe it’s this extension, maybe is this pain that I’m dealing with in the front of my knee, maybe it’s quad strength. Sometimes it’s a combination but usually, we can tease out what it is that specific bottleneck and that MIT that we can focus on. Then that way you can keep rolling in your ACL rehab. 

I hope that this is something that you can put into place, and think about your rehab now and think about what is your MIT and what are you focused on in this phase and this week, for example, maybe in a particular session. This is something that we try to communicate to our athletes and something I want to use more and more with our athletes because it just helps to really simplify things and eliminate some of the noise that can be with ACL rehab. I know you all feel me on this because it does feel like a lot, many times. This is something that I hope can be helpful to you.

If you have any questions or if you need any assist, you know where to find us. There’s information in the show notes. We are always here to help respond to any questions that you may have. Otherwise, I will catch you guys next week. This is your host Ravi Patel, signing off.