For many individuals, their ACL-injured knee will never feel as it did before the injury. More than five years after ACL rupture, knee pain, symptoms, recreational limitations, and impaired quality of life are common. Additionally, an alarming number of individuals with ACL rupture will develop symptomatic knee osteoarthritis during young- or middle-adulthood. Many individuals do not return to sport and adopt a physically inactive lifestyle, and fear of re-injury is likely to be a contributing factor in this decision. Of further concern is the high rate of re-injury, which is associated with worse long-term outcome.

Collectively, these factors can have a detrimental impact on the quality of life of individuals who were highly active before sustaining an ACL rupture and often rely on their ability to be active for a fulfilling and satisfying quality of life.

However, understanding how to successfully manage this injury is a fundamental part of determining a successful return to sport.  Once you have the surgery, the graft is put back in place BUT in order for the graft to be healthy and strong, it needs a set of specific loads to be placed upon it in order to bring it back to its full functional ability.

To do this is not easy.  Those who know me and have had treatment with me will know that I rarely stress the importance of certain specific routines/exercise programmes.  Whilst there is some need for them, it very much depends where you are on the performance continuum. I like to have a holistic approach that suits the need of the individual so am much more open to more ‘generic’ programmes as opposed to the specifics (again, outcome dependent).

The ACL programme though is a different ball game.  There are non-negotiable elements within my rehabilitation programmes and ones which are essential to meet before you are deemed fit to return to play.  Throughout my career I have worked with a number of athletes from professional standard to semi-professional and club standard athletes.  My non-negotiable element has always been task/performance based criteria that people need to have met before they can progress safely onto the next stage of their rehabilitation programme, with the aim of getting the athlete back to their previous level of sport.

 

There are non-negotiable elements within my rehabilitation programmes and ones which are essential to meet before you are deemed fit to return to play.

 

So how do I get athletes back to being game ready/performance ready?  Its simple, we use measureable tasks which both myself and you as the athlete can see progress within.  Some of the examples of what I look for before early stage progression may be as follows;

 

1. 20 straight leg raises without knee lag on constructed leg.
2. Single leg bridges within 85% of un-operated leg.
3. Single leg squat to 90 degree whilst 10cm from edge of the chair – has to be within 85% of maximum reps from un-operated leg.

 

The examples here are a small selection of just some of the battery of tests I use to deem safe and clear guidelines for return to certain tasks.  This links in with the title of this post of ‘are we assessing or guessing’?  My philosophy is that there is no room for guessing.  We use hard facts to show you and prove to you that you are ready to return (or not as may be the case in some instances).  The underlying principle is that the data never lies and you cannot cheat science.  You are either ready or you are not.  There are no if’s, but’s or maybe’s.

I will not lie.  The process is HARD.  And it is time consuming.  But with the correct application and regular contact periods to evaluate where you are at, I am confident that the programme we run here at Bodylogics will be well equipped to have you back to your best in the quickest time possible, whilst returning you a better athlete that before your injury.

If you want to find out anymore on our ACL programme and how we may be able to help you then please feel free to reach out to us to discuss and we can arrange a conversation to help you get back to what you love doing most.