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ACL Rehabilitation Progression: Where Are We Now?

  • ACL Rehab (T Sgroi and J Molony, section editors)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

With the increase of publications available to the rehabilitation specialist, there is a need to identify a progression to safely progress the patient through their post-operative ACL reconstruction rehabilitation program. Rehabilitation after ACL reconstruction should follow an evidence-based functional progression with graded increase in difficulty in activities.

Recent Findings

Clinicians should be discouraged not to use strict time frames and protocols when treating patients following ACL reconstruction. Rather, guidelines should be followed that allow the rehabilitation specialists to progress the patient as improvements in strength, edema, proprioception, pain, and range of motion are demonstrated. Prior to returning to sport, specific objective quantitative and qualitative criteria should be met. The time from surgery should not be the only consideration.

Summary

The rehabilitation specialist needs to take into account tissue healing, any concomitant procedures, patellofemoral joint forces, and the goals of the patient in crafting a structured rehabilitation program. Achieving symmetrical full knee extension, decreasing knee joint effusion, and quadriceps activation early in the rehabilitation process set the stage for a safe progression. Weight bearing is begun immediately following surgery to promote knee extension and hinder quadriceps inhibition. As the patient progresses through their rehabilitative course, the rehabilitation specialist should continually challenge the patient as is appropriate based upon their goals, their levels of strength, amount of healing, and the performance of the given task.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Sports Rehabilitation & Performance Center, Hospital For Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    John T. Cavanaugh & Matthew Powers

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  1. John T. Cavanaugh
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  2. Matthew Powers
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Correspondence to John T. Cavanaugh.

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Both authors declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

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This article is part of the Topical Collection on ACL Rehab

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Cavanaugh, J.T., Powers, M. ACL Rehabilitation Progression: Where Are We Now?. Curr Rev Musculoskelet Med 10, 289–296 (2017). https://doi.org/10.1007/s12178-017-9426-3

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  • DOI: https://doi.org/10.1007/s12178-017-9426-3

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