The decision of an athlete returning to sport should be a collaborative effort between the athlete, parents, coach, and surgeon. Athletes tend to get antsy when return to sport (RTS) is becoming a reality. In addition to collaboration, ultimately the RTS decision needs objective functional testing in order to confidently return an athlete to prior level of sport.
RTS is multi-factorial and can often take 1-2 years to feel comfortable in the proper return. Most are not functionally ready to return to their sport even though they are cleared by their physician. It seems in the industry of medicine, that “time” is falsely used as the number one decision maker for RTS versus specific criteria needing to be met that include functional tests of strength, power and endurance. In a recent research article by renowned ACL researcher Tim Hewett, it showed that at 6 months, 2 patients (3.2%) passed all RTS criteria. At 9 months, seven patients (11.3%) passed all RTS criteria. Twenty-nine patients (46.8%) did not pass the strength criterion on an Isokinetic test at 60°/s at 9 months after ACL reconstruction (ACLR). These are eye opening results and supports our clinical experience over the last 10 years that ACLR athletes are usually not ready to return to sport under 9 months post-surgery. The research also shows that athletes who did not meet all RTS criteria before returning to their sport had a 4x greater risk of sustaining an ACL graft rupture compared with those who met all RTS criteria (Isokinetic testing at 60 deg, running T-Test, Single Leg Hop, triple hop, triple crossover hop tests, knee psychological exam, and running mechanics).
At Wright Physical Therapy, we understand the obstacles that exist from when therapy is complete to when an athlete is ready to return to sport after injury. Although the actual rehabilitation typically does not extend past 12 weeks, it is after rehab that the real strength, power, endurance and agility activities should really start taking shape. Unfortunately, several patients are left to fend for themselves on what the next steps are in the RTS process, without the necessary guidance.
At Wright Physical Therapy, we have created a specific RTS program through our Human Performance division, SCiATHLETE. Through collaboration with our doctors of physical therapy and licensed Human Performance Specialists, we address the biomechanical risk factors through proper stretching, strengthening/resistive training, neuromuscular training, agility/balance training, plyometric training, and running techniques. This program closes the gap between skilled physical therapy and an athlete being physically and mentally ready to return to sport.
Research also provides adequate evidence that this type of program is successful in reducing non-contact knee injuries. In 2015 Donnell-Fink et al determined the effectiveness of knee and ACL injury prevention programs significantly reduced the risk of knee injuries by 27% and ACL injuries by 51%.
Interval Return to Sport Programs:
At Wright Physical Therapy we have created specific programs for specific sports in order to ensure that the athlete transitions safely back to sport. Our therapy is tailored to the athlete and the specific position that they play. Our research based interval sports programs have set benchmarks that need to be reached before progressing to the next step which leads to full participation in sport. These interval programs will have you back to your sport safely and quickly.