Young Athletes who return to sport before 9 months

hi Keith can you see this ? Jill

Yes Jill I can see it!

I must admit this was my favorite article so far to read, thank you Keith

I was shocked to read the stats that 1 in every 4 patient under the age of 25 who return to high risk sport will sustain a second ACL injury of some type. To me this is astoundingly high percentage and blows my mind to think this is accurate. I have a new perspective on all my ACL patients moving forward after reading this article. The other item that made me go Hmmm was the fact that achieving symmetrical muscle function or quadriceps strength was NOT associated with new ACL injuries in young athletes. I have been practicing PT for 30 years and from the start it was all about building up the VMO by E-Stim and strengthening exercises until you get the same results as the non surgical quadriceps before they can return to play as well as calendar time of 9 months to one full year(old school)

I worked for a group of orthopedic surgeons at Oklahoma Center for Athletes in the early 90"s and we had the old Cybex machine that all ACL patients had to be tested on the Cybex and results must be at least 90% equal to the non injury leg. Think about the torgue on the knee testing on the Ctbex machine and relying on this report only to send the athletes back to play. Now a days we avoid LAQ and the Cybex machine. LOL

Thanks Keith for a great up to date read! It was awesome!

This study helps to justify us as PTs on educating patients that just because pain is gone and some parameters have improved, it doesn't mean you are ready for return to play. 'Im sure we all have those patients that want to be done with PT as soon as pain is gone not only in post op cases, but with the common LBP, ankle sprain, etc. When it comes to ACL specifically, I think a big part of rehab that doesn't get a ton of notoriety is the neuromuscular re-ed type activities that you expose patient to for return to sport once the strength parameters are met. Sports can be highly unpredictable and I think the "extra" time spent continuing to strengthen the patient and expose patient to graded sports activities allows for the better prognosis. I have also seen an interesting study showing that a fairly large percentage of athletes that return to high level sport post ACL end up with the contra-lateral ACL torn within the first 4 to 6 months after return to play. This was primarily thought to be due to all time and focus spent on initial ACL limb and minimal focus spent on "strong" limb during rehab process. Something to think about and justify when treating these post op patients and getting other side involved in process for best outcomes.

This study helps to justify us as PTs on educating patients that just because pain is gone and some parameters have improved, it doesn't mean you are ready for return to play. 'Im sure we all have those patients that want to be done with PT as soon as pain is gone not only in post op cases, but with the common LBP, ankle sprain, etc. When it comes to ACL specifically, I think a big part of rehab that doesn't get a ton of notoriety is the neuromuscular re-ed type activities that you expose patient to for return to sport once the strength parameters are met. Sports can be highly unpredictable and I think the "extra" time spent continuing to strengthen the patient and expose patient to graded sports activities allows for the better prognosis. I have also seen an interesting study showing that a fairly large percentage of athletes that return to high level sport post ACL end up with the contra-lateral ACL torn within the first 4 to 6 months after return to play. This was primarily thought to be due to all time and focus spent on initial ACL limb and minimal focus spent on "strong" limb during rehab process. Something to think about and justify when treating these post op patients and getting other side involved in process for best outcomes.