Returning to Sports After ACL Tear
A Summary of ACL Injury and Repair
This week marks the return of Tiger Woods to professional golf after a major knee injury. Woods reportedly suffered an anterior cruciate ligament (ACL) tear and a stress fracture of the tibia (shin bone). Woods reportedly underwent surgical reconstruction of the injured ligament in June 2008, following his dramatic victory in the U.S. Open, and returned to action on February, 25th 2009. So, Wood's recovery time from this severe knee injury is approximately 9 months. This raises the question of how quickly an athlete can return to the field of play. Thirty years ago, the answer was, “possibly never”. Surgical techniques and rehabilitation plans at that time generally did not allow for a return to pre-injury strength and stability of the knee following ACL surgery. As a result, may pro athletes were either greatly diminished for the remainder of their careers, or didn't return at all. However, advances in techniques have changed that.
What is an ACL Tear
There are four ligaments that stabilize the knee – two cruciate, or crossing, ligaments, and to collateral, or side, ligaments. One of the two cruciate ligament passes in the front of the joint (anterior cruciate), and one in the back (posterior cruciate). The collateral ligaments are on the inside (medial collateral) and outside (lateral collateral) of the joint. The ACL stabilizes the joint during pivoting moves during sports. A tear of the ACL leaves the joint unstable, making running and change of direction difficult. Additionally, the instability leaves the knee vulnerable to subsequent bone and cartilage damage.
Treatment of ACL Tears
The vast majority of athletes with ACL tears are treated surgically. Repair involves creating a new ligament with one of three different structures. The new ligament can be created from a piece of the patellar tendon (the tendon that holds the kneecap in place), from part of the hamstring tendon, or from autologous tissue (a donor/transplanted graft).
Recovery from ACL Repair
An important component of ACL repair is the rehabilitation that takes place after surgery. Even the best surgeon can only affect what happens in the operating room. After surgery, it is up to the patient to perform diligently during physical therapy and rehabilitation, in order to optimize the final result of reconstruction. Initially, physical therapy concentrates on slowly increasing the range of motion of the joint. Muscle strength is then addressed. Strengthening exercises include non weight bearing activities, such as swimming, cycling and weighted exercises such as leg extensions and leg curls.
Return to Sports Activity
Depending on progress, athletes can resume non-demanding activities such as walking or light running 2 to 4 months after surgery. Participation in more demanding sports requiring pivoting or cutting may resume 6 to 7 months after surgery. However, despite these guidelines, some athletes report more lengthy recoveries, with full maximum post operative results occurring 12 to 24 months after surgery.
Recovery from ACL Tear
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