If you chose to have anterior cruciate ligament reconstruction (ACLR) surgery, you want to return to a sport or activity with cutting and pivoting. Nearly all ACLR patients share this objective, according to MOON Knee Group research.
And if you’re reading here, you want to know how the research findings can help you get back to your activity:
These MOON Knee Group research findings can help you reduce your retear risk and improve your on-field performance. Here’s what we know followed by recommendations in the next section:
What is universally clear: all athletes do NOT get back either their preinjury activity level or to a specific sport following ACL reconstruction.
What follows is how you can improve your chances your return-to-play capabilities.
Combining MOON Knee research results with clinical experience, here are seven keys to a safe return to sport after ACL reconstruction. While it is a short list, it goes from immediately following your injury to your decision to return to practice and then play:
Even without contact, you can put enough force on your ACLs to tear them. You can reduce your tear or retear risk by training to land and change direction with lower force. See the complete landing and deceleration discussion with images and video at How to Decelerate and Land to Prevent ACL Injuries.
Best practice on when to safely return to play is evolving. Which criteria are best is hotly debated. And no set of tests has been validated through research (see Best Practices below).
So how can you make your decision? Work with your sports professional team of physicians, physical therapists and athletic trainers. Get evaluated and listen to their recommendations, even if it means delaying your return.
It is reasonable to expect that you can return to your sport or activity. It is also reasonable to expect a lower level of performance. But everyone is different.
Guidance that you are ready to return to play is a recommendation, not a guarantee.
A 2017 study co-authored by MOON Knee Group contributor Dr. Eric McCarty, chief of sports medicine and head team physician at the Sports Medicine and Performance Center at Colorado University in Boulder, came to this conclusion:
Although there are many recent publications indicating criteria for return to sport following ACL reconstruction, there is no predictive validity of any of the studies at the present time . Therefore, based on the present literature and clinical experiences of the authors, we recommend the following:
A battery of varying tests examining different psychometric properties (state of mind influences return to play success)
A battery of tests based on the measurement of impairment in addition to the examination of strength and power
Specific quantitative and qualitative criteria for assessment of performance and function
Examination via proactive and reactive activity to simulate a real-case sports activity scenario
A fatigue factor in the terminal phases of clinic testing (fatigue is a risk factor for ACL tears and retears)
Psychological testing to evaluate for potential kinesiophobia (fear of movement)
The further you progress in your return-to-sport program, the less ACL research can tell you about your specific choices.
Why? Because everyone is different. People with reconstructed ACLs:
These differences make it challenging to apply one set of return-to-play guidelines to everyone. You could beat the averages and successfully return to your sport in less than nine months. You could struggle to return in two years—or at all.
The further you get from surgery and the first three rehab phases, the more these differences matter. Which is why effective return-to-sport programs are tailored to each individual.