ACL Re-Injury: (originally published April 9, 2018)
Absolutely shattering news from a few weeks back with scans confirming Tom Liberatore has ruptured his 2nd ACL in 3 years. His recent ACL injury is to his right knee, which is the opposite side to which he injured in 2016 (left knee). Some of us are left asking a few questions; like is the opposite side more likely? Was he 100% ready to return to play? Let’s have a look at some of the answers and statistics.
The biggest risk factor for ACL injury is PREVIOUS ACL injury, whether that be to the re-injured limb or opposing limb. Individuals who have a previous ACL injury are 4-6 times more likely to sustain an injury than those with no ACL injury history
Injury recurrence is more than 2x likely to occur on the OPPOSING limb than the previously injured limb. Individuals are often compensating for their injury for such prolonged periods of time to protect the injured knee that they force additional loads through the un-injured leg, and therefore even when fit-to-play can favour the un-injured side sub-consciously through habit.
So how can we prevent re-injury?
Returning both limbs to similar testing results for a variety of test batteries; including strength, power, agility and the like. The 10% rule is often used as the golden standard, however is this variance too much? Should it be dropped to <5%?
Our opinion is that force plates/transducers and in-depth movement analysis should be the golden standard for return to play; as they arguably produce the most accurate and reliable data. For example: a single leg hop and single-leg leg press should be performed with force plates and data analysed. If the results show the individual is able to exhibit results that are <10% in variance, they should be deemed sufficient to play.
Force-testing batteries should be the final battery; given the individual has re-learned how to accelerate and decelerate, jump and land, and cut sufficiently on both sides.
A solid on-going physical preparation program in key; if you fail to maintain and improve your strength levels through tailored programming you are setting up to fail. Strengthening your quad: hamstring ratio and gluteal group is essential to reduce the likelihood of re-injury.
What are you doing to prevent re-injury? Contact us for a proper physical preparation program, preventing injury comes before performance. You can’t perform from the sidelines.