Returning to sport after an injury is a journey filled with anticipation, hope, and significant challenges. Whether you’re four to six months post-operation or just beginning to research ACL injuries and rehabilitation, understanding the intricacies of this process is crucial. This article aims to equip you with the knowledge and tools to navigate your return to sport safely and effectively, reducing your risk of re-injury and ensuring a successful comeback.
The Importance of Passing Basic Return to Sport Testing
Did you know that passing basic Return to Sport (RTS) testing measures can reduce your risk of re-injury by 84%? This statistic underscores the critical importance of meeting specific objective measures before resuming sports activities. It’s essential to be honest with yourself and ensure that your body is ready to handle the dynamic stresses of sport, from running and jumping to landing.
The Right Timeline for Recovery
If you are approaching the 4-6 month post-op mark, it’s time to assess your progress honestly. This period is not the end but the beginning of a crucial phase in your rehabilitation. Mentally, you might feel ready to return to your pre-injury level of activity, but physically, your body is likely not there yet. The next 5-7 months will be about building a strong foundation, focusing on your strengths, weaknesses, power, endurance, stability, and mobility.
The Long Game of ACL Recovery
ACL recovery is often perceived as daunting due to the length and intensity of the process. For many athletes, especially youth, the challenge lies in coping with the loss of their athletic identity during a critical developmental period. I can speak from personal experience—tearing my ACL at 18 and the subsequent journey back was both a physical and mental test. As a Doctor of Physical Therapy and an ACL survivor, I emphasize that mindset is paramount. Understanding your timeline, setting realistic goals, and preparing for potential setbacks are keys to success.
Key Statistics to Consider
Understanding the realities and statistics of ACL recovery can help set realistic expectations and guide your rehabilitation journey:
- 41% of surgeons report using strength and functional tests in RTS decision-making.
- 80% of ACL reconstruction (ACLR) patients return to some form of sport.
- 65% return to the same sporting level, but less than 55% return to a higher competitive level within 1-2 years post-ACLR.
- Delaying RTS by one month after nine months post-op can reduce re-injury rates by 51%.
- For every 1% increase in quadriceps strength, there is a 3% reduction in re-injury risk.
- Athletes who meet RTS criteria are 8 times less likely to suffer re-injury.
Essential Return to Sport Testing
Your physical therapist should use a comprehensive set of tests and measures to determine your readiness to return to play. These should include:
- Range of Motion: Knee and ankle flexibility.
- Strength: Hamstring and quadriceps strength, 1RM with single leg squat.
- Mechanics: Double leg and single leg squat mechanics, deceleration mechanics.
- Balance and Agility: Y Balance Test, lateral agility endurance assessment.
- Hops and Jumps: Single leg, triple, and cross over hop tests, box drop to vertical jump.
- Pain and Swelling: Pain level should be <2/10, with no swelling around the knee joint.
For a comprehensive checklist of RTS tests, download our detailed guide and discuss it with your physical therapist.
Advocating for Yourself
It’s crucial to have an open and honest conversation with your physical therapist about their RTS testing procedures. If they don’t have specific guidelines, advocate for yourself using the provided checklist. Remember, recovery is not a race, and arbitrary timelines should not dictate your return to sport. Passing the appropriate tests and measures is essential to minimizing the risk of re-injury.
Trust the Process
Recovery from an ACL injury is a marathon, not a sprint. Embrace the journey, trust the process, and ensure you are fully prepared before returning to sport. Slow and steady wins the race—plan for the long haul, and enjoy the ride.
By following these guidelines and working closely with your healthcare provider, you can increase your chances of a successful and safe return to sport.
