Returning from ACL surgery: Please don’t listen to the present sports news articles circulating.
According to today’s sports news Bernard Brogan is aiming to return to play for the Dublin footballers by August 2018, 6 months post ACL surgery. In November 2017 Zlatan Ibrahimovic 7 months post ACL surgery tried returning to play for Manchester United. Zlatan returned for 105 minutes in total before subsequently suffering an injury relapse and is yet to return playing in 2018.
I am not saying it is not possible to return post 6 months ACL surgery, but each individual situation needs to be analysed. These are athletes coming to the end of their successful playing careers that are willing to take the risk of re-injury to achieve winning one last All-Ireland or a soccer Premiership title.
Yes, I can understand their situation but as a chartered physiotherapist I would not advise this, we are evidence-based practitioners. We look at what is fact versus what is fiction.
FACT: Athletes that return to sports (RTS) after 9 months and have equal quadriceps strength left and right have 84% lower risk of reinjury (Grindem et al., 2016).
FACT: The reinjury rate was significantly reduced by 51% for each month RTS was delayed until 9 months after surgery (Grindem et al., 2016).
FACT: Hamstring to quadriceps strength ratio deficits were associated with an increased risk of an ACL graft rupture (Kyritsis et al., 2016).
FACT: Athletes who did not achieve the 6 discharge criteria to return to play versus who did had a 4 times greater risk of re-injury (Kyritsis et al., 2016).
FACT: Young athletes return to sports at a high rate (91%) after ACL reconstruction. Unfortunately, the prevalence of a second ACL injury is high at 32%. Within this population, an earlier return to sport is predictive of a second ACL injury (Dekker et al., 2017).
Advise to the athlete would be to seek out a chartered physiotherapist with experience in ACL injuries.
When returning to sport take your time, achieve the makers/goals set out prior to returning to play.
If you are a younger athlete < 18 years of age, time and achieving all discharge criteria are most important.
Work hard, Take your time and take advantage of this time to make yourself a better athlete for the future.
Damien Mc Mahon (MISCP)
Dekker, T., Godin, J., Dale, K., Garrett, W., Taylor, D. and Riboh, J. (2017). Return to Sport After Pediatric Anterior Cruciate Ligament Reconstruction and Its Effect on Subsequent Anterior Cruciate Ligament Injury. The Journal of Bone and Joint Surgery, 99(11), pp.897-904.
Grindem, H., Snyder-Mackler, L., Moksnes, H., Engebretsen, L. and Risberg, M. (2016). Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. British Journal of Sports Medicine, 50(13), pp.804-808.
Kyritsis, P., Bahr, R., Landreau, P., Miladi, R. and Witvrouw, E. (2016). Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. British Journal of Sports Medicine, 50(15), pp.946-951.< Back to All Blog Items