As a runner, there is nothing more frustrating than being sidelined with an injury. Unfortunately, stress fractures are a common injury among runners, and they can be particularly frustrating to deal with because the treatment typically involves rest and limited activity. However, physical therapy can be a game-changer when it comes to healing from a stress fracture.

First, let’s talk about why rest alone may not be the best approach. While it’s true that rest is essential to allow the bone to heal, too much rest can actually be detrimental to the healing process. That’s because bone mineral density (BMD) can decrease during periods of inactivity. BMD is the measure of the amount of minerals, such as calcium and phosphorus, in a certain amount of bone tissue. When there is not enough stress placed on the bone, osteoclasts (cells that break down bone tissue) can become more active than osteoblasts (cells that build new bone tissue), leading to a decrease in BMD.

This is where physical therapy comes in. Physical therapists are experts in designing exercise programs that promote healing and prevent further injury. With a stress fracture, the goal of physical therapy is to gradually introduce stress to the bone in a controlled way to stimulate osteoblasts and prevent a decrease in BMD. This can be achieved through exercises such as weight-bearing activities and resistance training, which can be tailored to each individual based on their specific injury and level of fitness.

One technique that has gained popularity in recent years is blood flow restriction (BFR) training. BFR involves using a cuff or wrap to partially occlude blood flow to the limb during exercise. This technique has been shown to increase muscle strength and size, but it may also have benefits for bone health. Research has shown that BFR can stimulate the release of growth hormone, which is essential for bone growth and maintenance. Additionally, BFR can lead to an increase in vascular endothelial growth factor (VEGF), which promotes the growth of new blood vessels and bone tissue.

In summary, physical therapy can be an effective way to speed up the healing process for runners with stress fractures. By gradually introducing stress to the bone through controlled exercise, physical therapists can promote bone health and prevent a decrease in BMD. Techniques such as BFR may also have additional benefits for bone health. If you’re a runner in The Midlands who is dealing with a stress fracture, consider reaching out to Vertex for expert physical therapy care. Our team of skilled therapists can design a personalized program to help you heal and get back to doing what you love.

If you’ve recently had ACL reconstruction surgery, your knee is now going through several phases of healing—and one of the most critical (but least talked about) is the revascularization phase.

At Vertex PT Specialists, we help patients across Columbia, Cayce, and Irmo, SC safely navigate this crucial stage so they can get back to sport, training, or everyday life without setbacks.

What Is the Revascularization Phase?

After ACL reconstruction, your surgeon typically uses a graft—often a patellar tendon, hamstring tendon, or quadriceps tendon—to replace the damaged ligament. That graft is initially avascular, meaning it doesn’t have its own blood supply.

Over the next several weeks, your body begins a process called revascularization, in which new blood vessels form within the graft. This helps deliver oxygen, nutrients, and immune cells to the healing tissue, and sets the foundation for long-term graft integration.

Timeline: When Does Revascularization Happen?

  • Starts: Around week 4 post-op
  • Peaks: Between weeks 6–12
  • Clinical significance: This is the time when the graft is biologically weakest, even if you feel stronger

This is one of the most dangerous times to do too much too soon.

⚠️ Why You Shouldn’t Rush ACL Rehab During This Phase

Even if the swelling has gone down and your range of motion is improving, the graft is still structurally vulnerable. This is when a misstep—like trying to jog early, jump, or pivot—can lead to a re-tear or failed reconstruction.

Our Columbia-based ACL physical therapists often tell patients:

“This is when you feel good—but the graft isn’t ready yet.”

✅ What You Should Focus On Instead

During this phase of ACL rehab, your physical therapist will progress you through targeted exercises that promote healing without overstressing the graft. These may include:

  • Active and assisted range of motion to maintain mobility
  • Early quadriceps and hamstring activation, including isometrics and light band work
  • Swelling and inflammation control to support tissue healing
  • Progressive weight-bearing as tolerated, focusing on quality of movement
  • Foundational glute, trunk, and hip stability exercises to prepare for loading phases

As your knee tolerates more, your therapist will begin layering in low-load strength work and neuromuscular control drills that build toward return-to-sport milestones. The goal during revascularization is steady, structured progression—not stagnation or aggressive timelines.

Clinical Insight from Vertex PT

At Vertex PT Specialists, we see a high volume of ACL reconstructions, especially among athletes, tactical professionals, and active adults in the Midlands region of South Carolina. Our experience has shown that:

  • Skipping ahead during the revascularization phase increases the risk of graft failure
  • Adherence to evidence-based protocols yields faster return-to-sport timelines and lower reinjury rates

Every rehab plan is individualized, based on graft type, sport demands, and tissue healing.

ACL Physical Therapy in Columbia, SC

If you’re looking for ACL rehabilitation near Columbia, SC, you’re in the right place.

At Vertex PT, we help patients through every stage of the ACL recovery process—including the often-overlooked revascularization phase. With clinic locations in Cayce, Irmo, and Downtown Columbia, we’re trusted by orthopedic surgeons, coaches, and athletes alike.

Ready to Start Rehab or Reassess Your Current Plan?

Whether you’re 4 days or 4 weeks post-op, we’ll build a program that meets you where you are.

Contact Us Today

Reference

Sawyer GA, Anderson BC, Christiansen BA. The Revascularization Phase of Tendon and Ligament Healing and its Relationship with Fibrosis. Curr Rheumatol Rep. 2021 Feb 10;23(3):16. doi: 10.1007/s11926-021-00972-y.

When is it? Saturday April 15th

Where is it? Vertex PT Specialists in Cayce, SC (located across from Krispy Kreme)

Who is it for? Anyone looking to test their strength and endurance, PR their 5K, or just come out to run/walk and have a good time!

The Vertex Pump & Run is an event that measures overall fitness by testing both strength and endurance.

In the competition, participants bench press a percentage of their body weight. Each lift (up to a maximum of 30 reps) reduces their 5-kilometer run time by 30 seconds. There will be ten (10) age/gender divisions. Depending on age, men must bench press 60% to 100% of their weight, and women 40% to 70% of their weight.

Weigh-in and bench press begin at 7:00 a.m. The running portion of the 5K Pump & Run starts at 8:00 a.m. Participants can choose to register for the 5K run/walk only, which also starts at 8:00 a.m.

The 5K race will be timed by Strictly Running and is part of Columbia Running Club’s Tour de Columbia. The race will start and finish at Vertex PT.

Entry to the Pump & Run or the Vertex 5K includes a T-shirt that is guaranteed if you register before April 1st!

CLICK HERE TO REGISTER

 


Example:

  • A 45-year-old female who weighs in at 150 lbs will bench press 60% of her bodyweight for reps, which is 90 lbs.
  • She successfully bench presses 90 lbs for 15 reps.
  • She then runs a 5k and finishes in 24 minutes.
  • Her recorded time is therefore 16 minutes and 30 seconds, after reducing her 5k time by 7 minutes and 30 seconds due to her 15 successful bench press reps.

 

BENCH PRESS RULES

  • The lifter must lie on their back with their head, shoulders, and buttocks in contact with the bench surface. The lifter’s feet must be flat on the floor, and the shoes must not have an excessively thick sole that could elevate the heels. The lifter must position themselves correctly on the bench so that their eyes are directly under the bar.
  • The grip width of the barbell is not specified, but it must be evenly distributed on both sides of the lifter’s body. The lifter must grip the bar with both hands using a thumb-around grip. This grip must be maintained throughout the lift.
  • The lift begins when the barbell is lifted from the rack stands and lowered to the lifter’s chest. The lifter must lower the bar under control to touch their chest, and then immediately press the bar upward until their elbows are fully extended.
  • One repetition is counted when the lifter lifts the bar from their chest to the fully “locked out” position with the elbows extended. The lifter must hold the bar steady in this position before lowering the bar back down to their chest.
  • The lifter is allowed to rest at the top of the lift but not on the chest.
  • The lifter can perform a maximum of 30 unbroken reps before racking the bar. If the lifter fails to complete 30 reps, their final score will be the total number of reps completed.
  • A spotter will be present to ensure the lifter’s safety. The spotter must be ready to take the bar if the lifter cannot complete the rep or if the lifter requires assistance during the lift.
  • If the lifter racks the weight or requires the use of a spotter, the bench press or “pump” portion is complete, and the lifter’s last full rep will be counted towards their final score.

Course Map (Click this link to zoom in).

 

Race Day Schedule 

7:00 am – Packet pick up, Late Registration

7-7:30 am – Weigh in and Bench Press

8:00 am – 5K race begins for EVERYONE

10:00 am – Awards Ceremony

Packet Pick Up

Friday, April 14th – 8:00 a.m – 6:00 p.m

Saturday, April 15th – 7:00 a.m – 7:30 a.m

 

Registration Cost

5k Run – $40

Pump & Run – $45

Dr. Brandon Vaughn, Chief Executive Officer and Founder of Vertex, Physical Therapy joins us on today’s Footnotes. In this episode we get to hear his thoughts on running a business, doing business in a caring profession, and learning how things should be done from your experiences.

Watch and listen here.