ACL tears are catastrophic injuries that are the kiss of death to many athletes. The result of ACL tears range from never playing again, to playing but never at the same level of competitiveness, to bouncing back and becoming an even better athlete than before the injury.
Why do some athletes thrive and others fail to every step foot back on the field after an ACL tear?
The rehab you do after an ACL tear sets the stage for the level of play you are able to return to. Poor rehab (or poor effort / attendance during rehab) = a slower, weaker, less athletic, more injury-prone you when you go back to your sport.
This article provides a brief summary of the four stages of ACL rehab. If any of these stages are botched, or you move on from one stage to the next too soon, you won’t play your best or maximize your athletic potential down the road.
After surgery, you can expect your knee to be swollen and not to -bend very well.
Swelling is actually a good thing in the short-term, but it needs to be managed carefully. Too much swelling, or swelling hanging out longer than it should, can be detrimental to the healing process.
Regaining mobility is also critical part of the rehab process. Your knee should get to the point where it can fully bend. If it doesn’t, that’s bad news and puts you at risk for long term pain and tearing your ACL again.
Your leg muscles control and support your knee. After tearing an ACL, you lose a significant amount of strength, which leaves you exposed for another knee injury.
Making your hamstrings, quads, and glutes on both sides strong is protective of both knees.
Needless to say, strength is also a big part of athleticism. Not the whole equation, but a big part of it. If you want to become a better athlete than you were before the tear, you’ll likely need to get as strong or stronger than you were before the tear.
Balancing refers to equal strength between legs. Both legs will get smaller and weaker after an ACL tear, but the side with the tear is going to lose more. If one leg is significantly stronger than the other, you’re more likely to get hurt and likely aren’t as athletic as you would be if you had two strong legs instead of one.
After regaining mobility and strength, it’s time to move like an athlete. Jumps and other explosive movements are added to the program at this point.
The type of movements you need to successfully rehab are dependent on your specific deficits and your sport. Every athlete will be a little different here, but, in general, all athletes need to run, jump, and cut off one foot, so these are the categories of exercises that get the most work.
If you spend too little time in this stage of rehab, or you enter it too soon (before you are strong enough to handle it), you won’t achieve as high a level of play as you otherwise would. In my opinion, athletes tend to focus too much on pure strength and 1RMs and not enough on developing their explosive nature, which leaves room on the table for athletic development.
At this point, you and your therapist both feel like you’re ready to play again. Before that happens, you have to pass certain tests.
There is no standard test or evaluation that everyone agrees is the best for clearing an athlete to play.
In other words, physical therapists all do their own thing and use their own judgement about when an athlete is ready to play again.
This is NOT a great system. Without objective measures to determine if your body can handle playing again, it’s up to the PT to make their best judgement call. Without data to rely on, sometimes they’ll be wrong and put you back out there before you’re ready.
That leaves you just waiting to get hurt again.
Instead, we use objective data from our technology to tell when you’re ready to play. We measure strength, muscle balance, and muscle function in functional movements to be absolutely certain you’re ready to go.
Once you’re cleared from PT and ready to get after it again, getting after it is what you must do. If you’re truly healthy and good to go, you shouldn’t have to hold back in training.
Run fast, lift hard, and jump high in training, and you’ll get faster, stronger, and more explosive.
With the right rehab to set you up, and the right training plan afterwards, there’s no reason why you can’t surpass your previous level of athletic performance.
But it all starts with the right rehab.