What is an ACL? The anterior cruciate ligament or commonly known as the ACL is a ligament located in the anterior (front) position of the knee joint. Its main purpose is to connect the femur to the tibia and help in the stabalization of the knee joint. The ACL can be torn in both a contact and non-contact fashion through a multitude of different mechanisms. Commonly we see these in changes of direction, decelerations, and contact through tackles. 70% are non-contact in nature and 30% are contact in nature (McNair, et al). Females are affected 4-6x more than male athletes with ACL injuries (Hewett, et al). The rehabilitation process is a long one, with many different milestones and processes in order to safely return to sport. ACL rehabilitations need to be multi-diciplinary with communication occuring between the surgeon, phsyiotherapist, and in later stages the S&C coach.
"no two acl rehabs are similar in nature, different ligaments coupled with different surgical procedures and grafts create a unique rehab/reconditioning plan for each athlete"
The literature, through the work of Matt Jordan is showing that assymetries can exist upwards of 24 months post surgery (Jordan, et al). From a rehab model, we want our athletes to be within 90% of limb symmetry between the left and right (Grindem, et al). The longer the athlete waits to return to sport past 8 months, also reduces the chances of a re-tear or a new tear of the "healthy limb." It is a multi-factorial injury which is why we belive in working as part of a multi-diciplinary team. It's through a solid line of communication between the surgeon, physiotherapist, and S&C coach that we can target the individual needs of that athlete. It is also important that ACL injury return to sport is not based on a chronological timeline, such as 9 months. It needs to be criteria based on meeting certain goals and targets from a physical, psychological, and physiological perspective. It can be the most one the most difficult times in your sporting career so having a good team on your side to help in every aspect of your journey, makes a huge difference.