How To Have a Speedy But Safe Recovery After ACL Surgery

Who would have thought that hopping on one leg could be so helpful? During our younger years, playing hopscotch was just fun. But thanks to this study, we now know the importance of single-leg hopping when preparing athletes to return to their sport. This activity is especially important after surgery for an anterior cruciate ligament (ACL) tear.

The researchers (a combined group of physical therapists, athletic trainers, and sports medicine physicians) tested two groups of athletes. One group had completed rehab after ACL surgery. The second group played the same sports and were matched by age and sex (male versus female) but were healthy and without knee injuries.

Surgical techniques for ACL reconstruction have steadily improved over the years. So have rehab efforts on the part of physical therapists. The goal, of course, is to return the athlete to full performance as quickly as possible but safely (i.e., without reinjury).

That's not as easy as it sounds. Often there are significant pressures placed on athletes from coaches, parents, teammates, and even themselves. The result may be the injured athlete gets back into the game too soon with less than optimal results and with an increased risk of another injury.

Can this be prevented? Yes, by ensuring the athlete has the power, strength, and agility needed for those vertical jumps, quick turns, and sudden changes in direction on the court or field. What's the secret? Hopping on one leg.

After testing athletes with nine different tests, they found that three of those tests were sensitive enough to really measure differences from one leg to the other. The tests were the single hop, crossover hop, and triple hop.

Athletes who can complete these three activities during the final phases of rehab are ready to safely return-to-play. They must be able to do so with a performance on the injured leg that is at a level at least 90 per cent of the uninvolved leg.

What makes these tests so special or different? The key is the unilateral hopping (on one leg). Most training activities on the field are two-legged (broad jump, vertical jump, shuttle run).

When athletes are tested on two-legged activities, problems are masked. It turns out that being able to hop on one leg with speed and stability is a much more sensitive and accurate way to detect significant impairments.

The bottom-line is that rehab should not be so rushed that athletes recovering from ACL reconstruction are at risk for a second injury. Efforts should be made to equalize performance from side-to-side as a way to prevent future problems (including injury of the uninvolved knee).

Predicting when an athlete is ready for unrestricted, full activity following ACL reconstruction is no easy task. But the results of this study just gave us another reliable tool for ensuring a speedy but safe recovery. No sense going through all those weeks and months of rehab to blow it the first time back out on the court or field.

Reference: 

Deydre S. Teyhen, PT, PhD. Return to Sport: When Should an Athlete Return to Sport After an ACL Surgery? In Journal of Orthopaedic & Sports Physical Therapy. June 2011. Vol. 41. No. 6. Pp. 388.

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