Reducing Re-Injury Rates After ACL Tears

An anterior cruciate ligament (ACL) tear with subsequent reconstructive surgery and extensive rehabilitation is hard enough to go through once, so how can you reduce the risk of both re-injury and/or injuring the other leg?

  • Early focus in physical therapy on range of motion, quad activation
  • By the time you return to sport your knee flexion (bending) should be within 5 degrees of the unaffected side and extension (straightening) should be within 1 degree of the unaffected side.
  • Working on BOTH limbs equally will help to reduce risk of injury of the unaffected side
  • Re-injury rates can be upwards of 9% and injury to the unaffected side is as high as 20%, thus working on strength, balance and muscle control on both sides is imperative.
  • Ensure objective measurements are being taken (by your physical therapist)
  • It is important to track your range of motion, your quad girth and muscle strength to ensure you are hitting all goals prior to return to sport.
  • In the later phases of physical therapy, your “limb symmetry” should be measured. This is best done by looking at various single leg hops and comparing the distances hopped from unaffected to affected side. Research currently notes you should be at 90%, however more and more we are not satisfied unless nearly 100%
  • Limb symmetry testing
  • Test your confidence
  • A strong predictor of an individual returning to sport following ACL reconstruction surgery in their confidence.
  • Here is the Anterior Cruciate Ligament – Return to Sport After Injury scale that is a good predictor of confidence – ACL-RSI

The process from time of tear to return to sport takes 9-12 months. This includes countless hours spent in physical therapy and working on home exercises, not to mention the cost of both surgery and rehab. Ensuring you are in a positive PT environment from the start, committing to your home program, and specific testing to ensure you are ready to return to sport are all essential parts to returning to your desired activity with reduced risk of re-injury.