The study by Grindem, et al (2016) stated.

Our results suggest that time to return is associated with reinjury, and the effect is larger in the early months after surgery. Of note, all patients who returned to sport before 5 months suffered a knee reinjury. Beyond 9 months after surgery, we did not find a statistically significant decreased risk by month later return. Still, 19.4 % of these patients also suffered knee reinjuries. Time alone is therefore not sufficient for determining readiness for level I sports participation.

With Instagram and other social media platforms all showing quite unique and exciting task-based exercises for the ACL, it is vital to understand where you are on the continuum and also understand the process in which the ACL heals as well as the forces that will go through the knee when doing particular tasks.   For example, how many of you knew that performing a leg press (at any weight I will add) has 0% strain on the ACL graft whereas walking up stairs can produce as much as 4x the amount of force in comparison.  And how many of you here would think that walking upstairs is perfectly safe and the leg press machine a disaster waiting to happen?  The data proves it is quite the opposite.  Whilst I am not intending to produce fear here, the point is that what may seem like innocuous and simple challenges are in fact surrounded by a whole level of complexity when it comes to rehabilitation.  You are in fact safer performing a highly loaded leg press in the early stages compared to walking upstairs.

ACL Specialists North London

Whilst building strength and robustness in the knee is important, without it we wouldn’t be stable enough to support our body weight, the rehabilitation of an ACL goes way beyond that of developing only strength.  Proprioception is a term/word that many of us may not be familiar with, but your ligaments play a vital role in this skill/quality of the body.  Proprioception is the bodies’ ability to control itself in space without having to consciously think.  You can imagine it this way.  Your ACL ligament ha thousands of nerve endings in which are there to help you understand how much to bend your knee when running, how much to bend your knee when landing from a jump, etc….. how much laxity to allow when changing direction, etc…. which are all designed to protect you.  After an ACL rupture, these nerve endings are damaged and need time to heal and time to be ‘re-taught’ what their job/role is.  I constantly see patients who describe episodes of ‘giving way’ and this is often due to a neurological pathway from the brain to the knee not being strongly established or ‘rehabilitated’ well enough.

Finally, the testing aspect of your rehabilitation.  Return to sport and progression from phase to phase should be clear and concise and use hard sets of data to determine whether you are ready or not.  I always say, ‘if you are not assessing then you are guessing’.  To say that something ‘feels stronger’ is not good enough.  Also, what are we measuring against?  If you can perform 10 squats at 40kg weight, is this good or bad?  We must use data to assess against subjects of a similar ability/characteristics and therefore each and every person’s clinical data and programme will be highly unique and individual.  The same programme cannot be given to our elite sports person as it can be to our 70-year-old recreational athlete who injured their knee in a car accident.

Here at Bodylogics, we pride ourselves on using the most up to date research and data to drive and influence our decision making.  We are forever changing our approach to suit the individual and working with their wider team in many instances to get the athlete back to their best in the shortest BUT safest time frame possible.  We follow strict protocols and work alongside some of the leading surgeons in this field.  Your rehabilitation at Bodylogics is guaranteed to be one of the best around and you can be sure that you are in the safest hands possible.

If you want to find out more then look at our standard ACL protocol leaflet to get an idea of what to expect on your journey but also appreciate that there can never be a one size fits all and that your programme will be highly individualised to your needs and goals.