ACL RETURN TO RUN & PLAY CRITERIA


 
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We share these protocols in the hope of upskilling the entire industry and creating shared guidelines on reducing risk of re-ruptures in change of direction running sports. We highly recommend you see a Sports Physiotherapist with experience in ACL rehabilitation to individualise your program

Getting you back in the game

Our protocols are created using worldwide best practice, recent evidence from trusted sources and universities, as well as close collaboration with Melbourne's best orthopaedic surgeons & physiotherapists who work in elite sports.

*All of the following criteria are not to be taken as advice, as individual athletes, surgeries, graft types etc differ. The sports that athletes want to return to also vary in requirements. 

 

RETURN TO RUN

ACL return to run requirements to reduce risk of re-rupture for straight line, no change of direction running:

  • max distance single leg hop = 40% of height
  • Patient reported confidence during max single leg hop= "confident"
  • Diagonal bounding quality of movement left to right for 10m= "very good"
  • High quality of movement single leg squat to box x10
  • High quality of movement single leg arabesque x10
  • Strength : quads= single-leg leg press = 80% of BW, Hamstrings single leg glute bridges x20

 

NOTE- In the majority of commonly used surgical techniques, the bone tunnels that are drilled take between 8-12 weeks to heal to a satisfactory level for running forces. We DO NOT recommend a purely tick-box/ progression based rehab when returning to run. Time for healing is very important at this stage! *Discuss with an experienced Physiotherapist.

 

EXAMPLE DISCHARGE CRITERIA FOR RETURN TO PLAY

  1. Triple crossover hop  = min 100% of unaffected side (limb symmetry index)
  2. Max distance single leg hop = 100% of unaffected side
  3. Isokinetic muscle testing quads and hamstrings 98% of unaffected side @ 60 and 180 deg s 
  4. Triple hop (limb symmetry index >98%)
  5. Running T test (<11sec)
  6. Appropriate load management return to game intensity (eg 20 mins, 35 mins, 60mins, 70 mins, 80 mins)
 
 

If you have had an ACL repair, and have not addressed the following vital (generalised) principles of rehab before returning to training, please call an Optimus Health Physiotherapist to discuss:

- Single leg strength compared to bodyweight

- Hopping on two legs

- Hopping on one leg

- Triple hops

- Triple crossover hops

- Single leg max distance hops

- Bounding

- 20x single leg bridges

- 20x single leg squats to box

 

Please call for a FREE discussion with an Optimus Physiotherapist. We have physios who regularly oversee ACL return to run programs in collaboration with Personal Trainers, Strength & Conditioning coaches and other Physiotherapists.

More information on Physiotherapy can be found at the Australian Physiotherapy Association website.