Helping athletes get back in the game

Terese Chmielewski, P.T., Ph.D.

Pointing to the images on her computer screen, Terese Chmielewski, P.T., Ph.D., identifies a problem with the football player’s movement. As he performs vertical jumps and single leg jumps, it’s clear the player is putting too much force on his right leg.

The athlete has an old knee injury and this lingering movement problem could set him up for further injury, Chmielewski explains.

“We will give this information to his athletic trainers and strength coaches so they can work on this issue before the season starts,” said Chmielewski, an assistant professor in the department of physical therapy.

Chmielewski is a team member of the Biomechanics and Motion Analysis Lab at the UF & Shands Orthopedics and Sports Medicine Institute, where sophisticated infrared cameras capture images of athletes in motion and plates in the floor measure the force their bodies exert on the ground. The information is fed into a computer program that produces 3-D images of the athletes. Chmielewski analyzes the images and looks for residual movement problems from previous injuries or movements that could predispose athletes to injury. She then works with Susan Tillman, a Shands Rehabilitation physical therapist at the institute, to determine if deficits in joint motion, muscle flexibility or muscle strength might be contributing to the movement problem. The program has been so successful at identifying potential for injury that a steady stream of UF teams visit the lab for testing — football, volleyball, women’s soccer, women’s basketball and gymnastics, to name a few.

With grant funding from National Football League Charities, Chmielewski is investigating the effectiveness of two rehabilitation programs for athletes recovering from knee surgery to repair a torn anterior cruciate ligament, or ACL, a season-ending injury for most athletes. Chmielewski manages a clinical database at Shands for patients with ACL reconstruction to develop evidence-based return-to-play guidelines.

“Athletes may go back to playing sports after an ACL injury, but they may not play at the same level as they were before the injury,” said Chmielewski, whose own ACL injury shortened her athletic participation.

Chmielewski also leads an NIH study on a rehabilitation protocol for people who have had surgery to repair a meniscus tear by comparing a standard course of rehabilitation with one that focuses on strengthening the thigh muscles. To evaluate the treatment’s effectiveness, she uses functional measures as well as magnetic resonance imaging and biomarkers in blood and urine samples that indicate knee cartilage status. Tears in the meniscus, a disc that cushions the knee joint, are common in athletes and non-athletes alike and are often linked to the development of osteoarthritis.

“We want to help athletes get back to the highest level of performance as possible,” Chmielewski said. “Sports are a big part of these athletes’ identities and their quality of life is reduced if they can’t play.”