Written By: Longjam Dineshwori | Updated : February 17, 2023 5:36 PM IST
Ligaments are fibrous connective tissue that connect the bones together and keep them stable. The cruciate ligaments (anterior cruciate ligament and posterior cruciate ligament) control the front and back motion of the knee. Sprain or tear of the anterior cruciate ligament is one of the most common knee injuries, especially among athletes. Anterior cruciate ligament (ACL) injuries are commonly seen among athletes who are in high demand sports like soccer, football, and basketball. Surgery may be required depending on the severity of ACL injury and the patient's activity level to regain full function of the knee.
Athletes who incur an anterior cruciate ligament (ACL) injury frequently choose ACL reconstruction (ACLR) with the intention of returning to sports at their pre-injury level. But what many people didn't know is that rehabilitation is key to successful ACL reconstruction and return to play, says Dr Rajani Singh, Physiotherapist, Nexus Day Surgery.
"The percentage of athletes who successfully return to pre-injury levels of sport is low and discouraging, whilst the rate of second ACL injury in athletes under the age of 20 has been reported to be as high as 40 per cent after returning to activity (RTS). Although fresh RTS insights have been released in recent years, the lack of validity of RTS criteria following ACLR remains," he tells TheHealthSite.
Also, many individuals are unaware of the severity of an ACL damage. Dr Singh asserts, "It affects more than only the bodily, as the psychological is also affected. Returning to sport after an injury is a multifaceted process that necessitates a biopsychosocial approach. ACL damage will necessitate a lengthy rehabilitation process (9 months or more)."
According to Dr Singh, ACL rehabilitation may be broken into five stages:
The Physiotherapist notes that ACL rehabilitation does not cease when the athlete returns to play, but rather continues until the patient achieves peak performance. In recent decades, there has been a greater emphasis on adequately preparing athletes for the rigours of their sport.
He adds, "A strong Return-to-Sports (RTS) plan should contain a performance-based recovery approach that takes the athlete through a progression of on-field rehabilitation, safe return to team training, safe return to competitive match play, and safe return to performance."
Dr Singh answers:
There is no standard conservative approach for ACL rehabilitation, although there is universal agreement that the period for return to sport should be extended to enable proper recovery. Concomitant injuries, objective physical examination data, functional return-to-sport testing, psychological preparation, activity-specific demands, and evaluation of biological tissue healing should all be factored into the return-to-sport decision.
Considerations of biological variables of tissue healing have a role in deciding the timing for return to sport using a conservative rehabilitation strategy. Many experts advocate returning to full exercise after 9 to 12 months since the transplant tissue undergoes necrosis, revascularization, and remodelling.
