Return to Sport Following ACL Reconstruction

It's widely accepted now that passing criteria before returning to sport following ACLR is best practice and is associated with better chances of returning to pre-injury level of sport and lower chances of future knee reinjury.

However what is not very well known just yet is what are the most appropriate tests (eg. how many hop tests and what kind, movement quality assessment) and appropriate "pass" criteria (eg. >90% LSI vs >95% LSI)

These criteria by Toole et al are a high standard to set for our patients and a great place to start.

Side note: only 14% of these athletes (mean age 17yrs) passed all these benchmarks. Also 20% sustained 2nd ACL injury within 4 months of returning to sport.

BUT there are other things one could consider for returning to sport.

I also take into account 9 months minimum since surgery, vertical hop test, psychological readiness (ACL-RSI), movement quality assessment (LESS) and at least 4 weeks of unrestricted training.

How about you?

What criteria do you set for your ACLR athletes before they return to sport?

If you're interested in learning more about ACL injury rehab in young athletes, consider taking Learn.Physio online ACL masterclasses here