Jul 13, 2017
Don’t Set A Date For Getting Back In The Game
Return-To-Play Advice For Athletes After ACL Surgery
“When am I ready to return to sport after ACL surgery?” — is the question patients often ask after undergoing anterior cruciate ligament repair or reconstructive surgery — the answer? — it’s a little more complicated than you might think.
Recovering from ACL surgery is no walk in the park, and it is likely to entail months of rehabilitation to gain back your motion and strength and be ready for competitive sport.
It is of the utmost importance to ensure you’ve made a full recovery before getting back on the playing field, as no one wants to put themselves at a higher risk of reinjury. Rushing back to sport after surgery can lead to further knee injuries and even graft rupture. Not only does a premature rebound upset the physical recovery, but there are also a number of psychological implications of an injury which can affect an athlete’s ability to return to play.
There is, nonetheless, scores of evidence to suggest those who undergo a surgical procedure to repair or reconstruct an anterior cruciate ligament are extremely likely to get back in the game. A recent study has shown 82% of patients had returned to some kind of sports participation following reconstructive surgery.1 Here’s a helpful video outlining all you need to know about ACL tears and injuries.
There’s no set timeline for your recovery
“...don’t be in competition with your physical self when it comes to your rehabilitation.”
It’s not a race, so don’t be in competition with your physical self when it comes to your rehabilitation. Remember, there is no blanket time frame when it comes to making a full recovery — your orthopaedic surgeon or physiotherapist will have your best interests at heart, and thus, will appropriately advise you based on your individual circumstances.
There are both a number of risks and benefits associated with an athlete’s return to sport; and so a patient-to-patient review is crucial to full restoration of knee strength and mobility, as well as preventing further injury or damage to your cartilage, meniscus, tendons or other knee ligaments. Postoperative outcomes often depend on adhering to range-of-motion (ROM) exercise and strengthening programs, which have shown accelerated positive results for patients.2
You’ve got to keep your head in the game too
“Feeling mentally prepared to bounce back is just as important as making a physical recovery…”
Studies have shown psychological factors, including the fear of reinjury, play a significant role in the return-to-play rate among athletes. Despite having physically recovered, you may not feel psychologically ready for sport. Feeling mentally prepared to bounce back is just as important as making a physical recovery, and so your rehabilitation could take longer than you might expect. It’s okay if you’re not quite there yet — lowered levels of confidence after an ACL injury or tear is one of the biggest hurdles an athlete can overcome throughout their rehabilitation.
If you’ve recently suffered a sporting injury, it’s important to seek motivational help over the course of your recovery. For example, a rehabilitation professional can assist you in becoming actively involved in managing both your injury and behavioural changes by addressing the psychological aspects relevant to your recovery.3
Think long-term about your therapy goals
“Remember, it’s better to wait it out than to expect another surgery.”
Consider what you wish to achieve long-term rather than any short-term goals you may have for you and/or your sporting team. A complete recovery takes time, and is always better than the experience of short-lived glory — like a single win for the season.
Your orthopaedic surgeon will be the best person to decide whether you’re ready to hit the playing field again. This decision will be based on the time it takes for your graft to come along, your range-of-motion, and your psychological readiness to participate. Most orthopaedic evidence suggests athletes should wait a minimum of 9 months rehabilitation before resuming pre-injury sporting activity.1,4 Remember, it’s better to wait it out than to expect another surgery.
Push yourself — but not beyond your physical limits
“...support your joints by strictly adhering to your recommended physiotherapy regime to give yourself the best chance of a full recovery.”
It’s important to work towards your athletic goals, but you also need to allow your body the time it needs to repair itself. Pushing too hard too fast is a dangerous feat which can often lead to an interference with the maturing ACL graft. Failing to address the progression of your physical recovery can affect your joint stability and mobility, strength, balance and endurance — this, in turn, leads to poor athletic performance along with additional surgical action.
So support your joints by strictly adhering to your recommended physiotherapy regime to give yourself the best chance of a full recovery. For best outcomes, ask your physiotherapist about exercises which produce low or unstrained ligament values to avoid graft endangerment.5 And, as the saying goes, “see the light at the end of the tunnel.”
Implement these injury prevention techniques once you’ve made a full recovery
Recent studies have shown ACL injuries can be reduced by up to 70% with the implementation of a specific warm up program.6 So here’s a helpful infographic which demonstrates how you can minimise and protect yourself from a future ACL injury.
Based on the Gold Coast, Dr Jason Tsung specialises in surgery to amend ACL injuries.
Dr Jason Tsung does not endorse any treatments, procedures or products referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon.
1. Ardern, C.L., Webster, K.E., Taylor, N.F. and Feller, J.A., 2011. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med, 45(7), pp. 596-606.
2. Shelbourne, K.D. and Nitz, P., 1990. Accelerated rehabilitation after anterior cruciate ligament reconstruction. The American journal of sports medicine, 18(3), pp. 292-299.
3. Ardern, C.L., Taylor, N.F., Feller, J.A., Whitehead, T.S. and Webster, K.E., 2013. Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. The American journal of sports medicine, 41(7), pp. 1549-1558.
4. Grindem, H., Snyder-Mackler, L., Moksnes, H., Engebretsen, L. and Risberg, M.A., 2016. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. Br J Sports Med, 50(13), pp. 804-808.
5. Beynnon, B.D., Fleming, B.C., Johnson, R.J., Nichols, C.E., Renström, P.A. and Pope, M.H., 1995. Anterior cruciate ligament strain behavior during rehabilitation exercises in vivo. The American Journal of Sports Medicine, 23(1), pp. 24-34
6. Gilchrist, J., Mandelbaum, B.R., Melancon, H., Ryan, G.W., Silvers, H.J., Griffin, L.Y., Watanabe, D.S., Dick, R.W. and Dvorak, J., 2008. A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. The American journal of sports medicine, 36(8), pp. 1476-1483.
Aug 2, 2017
Many people suspect arthritis, but avoid sharing their concerns with their doctor and accepting their pain as a circumstance…
Jul 13, 2017
Recovering from ACL surgery is no walk in the park, and it is likely to entail months of rehabilitation to gain back your motion…
Jul 3, 2017
Swelling, chronic pain, and tenderness can make it really difficult to find the motivation to get moving; but did you know you…