ACL Knee Rehabilitation and Return to Sports

Single leg strength & stability are a really important part of ACL rehabilitation, especially if you want to return to sports that require you to run or kick/pivot on 1 leg. While bilateral movements (done on 2 legs such as squats) are great, they allow for one side to compensate for the other and you may not realize the weak link until you separate them out. In addition, working on lateral (side to side) stability during rehab will help athletes prepare for quick changes in direction and explosive speed. Our client @wushubella is performing an exercise on the pilates reformer that addresses BOTH of these concepts. She’s putting nearly ALL of her body weight through the right leg while sliding the left leg out against some resistance provided by the springs of the machine. She needs to have really good control and stability of each leg since her primary sport is wushu, a form of martial arts characterized by high speed kicks and jumping through the air (think Jet Li movies).

So how do you determine whether an athlete is ready to return to sport after ACL rehabilitation? Some of the functional tests we look at include:

  • Functional Jump Test: Jump with both legs. Develops not only confidence in patient that they can jump off both legs with propulsive force, but also tests whether patient can control eccentric deceleration landing using knees.
  • Functional Hop Test: Hop forward with one foot, landing on the same foot from which one took off. Helps determine whether an athlete is prepared for stop-and-start movements, as well as cutting maneuvers.
  • Lower Extremity Functional Test (LEFT): Designed to progressively stress patient; incorporate acceleration/deceleration maneuvers; perform multiple stresses to the lower extremity; simulate movement patterns often found in reactive sports; induce fatigue factor. Identifies potential injuries in athletes, as well as residual deficits following ACL reconstruction.
  • Sport-Specific/Position-Specific Testing: Using our client as an example, putting her in positions to simulate her jumps and landing, kicking and pivoting.