Successful return to play remains a challenge for a soccer player after ACL reconstruction. In addition to a successful surgical intervention, a soccer-specific functional rehabilitation program is essential to achieve this goal. Soccer-like elements should be incorporated in the early stages of rehabilitation to provide neuromuscular training specific to the needs of the player. Gym-based and, later, field-based drills are gradually intensified and progressed until the player demonstrates the ability to return to team practice. In addition to the recovery of basic attributes such as mobility, flexibility, strength, and agility, the surgically repaired knee must also regain soccer-specific neuromuscular control and conditioning for an effective return to sports.
When straight line running is good, then proprioceptive training is introduced. This includes running in circles, figure ‘8’s, zig-zags, etc. This is the most important phase because this type of activity not only helps return to sport, but is has been shown to decrease subsequent ACL rupture or re-rupture.
Athletes can lower their risk of torn ACL by participating in performance drills that focus on improving lower extremity strength, agility, flexibility, and power. My #ACLInjury Reduction Program developed and designed for female soccer players can be applicable for all athletes both male and female.
Studies show that within one year of ACL reconstruction surgery: * Only one-third of athletes return to their previous level of competition. * Less than 50 percent return to the same level of play within two to seven years. * Only 81 percent will return to any level of athletic participation.
Functional training is a key element in regaining the soccer-specific neuromuscular control necessary to perform skills ranging from basic to soccer- specific drills. Particular attention should be given to the quality of the movement patterns and stabilization strategies.
Patellofemoral Instability other wise known as Dislocated or Subluaxtion of the Patella. The injury can come from a direct blow or a noncontact twisting of the knee.
The most common mechanism for a patellar dislocation is a forceful inward rotation of the body on a planted foot. Athletes may describe the feeling as the knee giving out.
In an acute patellar dislocation, when a tear of the MPFL is identified, surgical repair (fixing the original ligament) of the MPFL may be a good treatment option. In the young athletic population, recurrence rates for patients treated conservatively are high with some studies reporting 40%.
Proper stabilization of the patella is also affected by the soft tissue structures (ligaments and muscles) surrounding the knee. The medial patellofemoral ligament (MPFL) is a continuation of the deep retinaculum and vastus medialis oblique (VMO) muscle fibers (inner portion of the quadriceps muscle) on the inside of the knee.
Return time varies depending on the degree of soft-tissue damage. A return to sport might require almost three months. A post-op recovery requires a period of bracing followed by physical therapy and post-PT training, delaying return time for up to six months.
In recurrent or chronic patellar dislocations, it may be necessary to perform reconstruction of the MPFL. Reconstruction differs from repair in that graft tissue (such as a hamstring tendon) is used to replace or reinforce the MPFL.
Surgery tends to have excellent results in preventing further dislocations, however athletes may have residual pain.
✅ Demands proportional bending of the ankle, knee, and hip in order to control the high eccentric loads and properly absorb shock and make a play.
✅ Effective stopping demands a high level of eccentric strength (lowering phase).
✅ Correct stopping plays a primary role in injury prevention.
✅ Teach proper stopping technique In terms of stopping and starting, it requires reactive strength, which is the ability to quickly absorb an eccentric load and change direction to extend the leg to accelerate.
✅ Inadequate leg and core strength will limit the quality of movement.
To learn the proper way to jump and land to prevent #ACL injury, you must first know the wrong way to jump and land.
When your knees come together while jumping, excessive stress and strain are placed on your knee, and your shin bone may rotate slightly. This rotation and strain through your knee joint may place your ACL under considerable stress, and this stress may lead to an ACL sprain or full tear.
Landing mechanics are the opposite of the takeoff mechanics. Use as many joints as possible to reduce force on landing. If no subsequent takeoff is required, then flexion should be relatively deep to absorb shock.
A jump (two-foot landings) either forward (Broad Jump) or lateral jump should be done with focus on landing body weight over both legs and landing similtaneously.
As a part of a warm up routine, lateral band walking engages many of the deep muscles that are involved in stabilization of the pelvis.
Doing this before working out can help improve hip stability and knee joint stabilization. This, in turn, improves overall body mechanics and movement efficiency during a workout or competition.
This preparation is particularly helpful for any athlete who engages in sports that require running jumping, pivoting and twisting.
A weak glute medius muscle can lead to problems in the knee joint, and is often the underlying reason for knee pain and injury, particularly #ACLinjuries.
A strong glute medius not only stabilizes the hip, but it helps maintain proper tracking in the knee joint, by reducing lateral stress on the knee.
Performing the lateral band walking exercise protects the knee by training correct movement patterns at the knee joint (so it doesn’t cave in or out). Maintaining proper tracking is important when landing a jump safely. Many experts believe improper knee movement biomechanics is one factor that explains why female athletes have a disproportional incidence of ACL injuries.