Returning to Sport following ACL injury or surgery
Most Anterior Cruciate Ligament (ACL) injuries occur during contact and pivoting sports such as football, soccer and netball. Often one of the first questions we get asked by an athlete after getting the news they have injured their ACL is, “when can I go back to sport?” This can be a bit of a complicated answer, as it is not going to be the same for every sport, or every athlete.
Historically, ACL rehab progression has been a one size fits all approach, based around timeframes guided by surgeons (eg. return to running at 3 months, return to sport at 9-12 months) without enough functional testing to determine if the athlete is ready for demands of their chosen sport.
In the last several years, there has been a shift towards the use of comprehensive functional testing to help guide the progression of rehab and make decisions when it is suitable to return an athlete to their chosen sport.
Here at The Physio Space, we are big believers in the need for comprehensive return to sport testing. We follow the recommendations of the Melbourne ACL Rehabilitation Guide 2.0 developed by physiotherapist Mick Hughes and Dr. Randal Cooper. It incorporates a number of specific physical tests relating to the demands of running, jumping and pivoting sports. Some of the tests include,
single hop
triple hop
cross over hop
lateral hop,
plus several others.
Additionally, we regularly assess strength using hand held dynamometry, the gold standard, providing us with specific numerical data to determine if any strength deficits remain towards the late stages of rehab, rather than just comparing you to our own strength. This helps to identify any deficits that still need to be addressed prior to returning to play, irregardless of their post-operative timeframe. Being pain free with activity simply isn’t enough criteria to safely return an athlete to sport. The statistics speak for themselves:
Return to sport at less than 9 months post op = 39% chance of re-injury
For every 1 month delay of return to sport after 9 months, there is a 51% reduction in the chance of re-injury
Approximately 1 in 3 younger patients (<20 years old) have a second ACL injury.
Younger patients are 15 x more likely to injure in the first year of return to sport and 6 x more likely in the second year of return to sport.
If you are recovering from an ACL injury or surgical repair and would thourough physiotherapist input to help guide your rehabilitation, and determine if you are ready to return to training and sport, book in with one of our sports physiotherapists. We can complete a full assessment including functional and return to sport testing. If any areas of concern are identified, our physiotherapists can develop a treatment program to target these areas and help you reach your goals safely.