By: 7 August 2019
Young athletes may need one-year break from sport after knee surgery

After surgical reconstruction of the anterior cruciate ligament, young athletes are now recommended to undergo at least a year’s rehab and thorough testing before resuming knee-strenuous sport. Research shows that those who return to sport relatively soon after surgery incur a highly elevated risk of a second ACL injury.

“What’s absolutely essential is to let the rehab take time. Every month’s wait represents a huge gain,” says Susanne Beischer, PhD student at Sahlgrenska Academy, University of Gothenburg, Sweden, who works as a clinical physical therapist.

An anterior cruciate ligament (ACL) injury is the most common form of injury to the knee joint. In her research, Beischer focused on adolescents’ and young adults’ return to sport after surgery.

Up to 30 per cent proved to have suffered a second ACL injury, in the same or the other knee, shortly after returning to their sport. However, there were major differences depending on how long they had refrained from playing.

Of those who had returned to sport within nine months after surgery of the cruciate ligament, nearly a third (10 of 33 individuals) were injured again. Among those who waited nine months or more, the proportion suffering a new injury was considerably lower (8 of 126).

In total, 729 members of the two age groups of sports participants, adolescents (age 15-20) and young adults (age 21-30), were included in the various sub-studies in the thesis. Their rehabilitation in primary care was individualised by the respective physical therapists in charge.

Of the adolescents studied, half had returned to sport again as usual only eight months after surgery, while the young adults waited longer. Regardless of age group, only a quarter regained their previous thigh-muscle strength and jumping capacity before resuming their sporting activities.

Young sports participants, especially those below the age of 20, are recommended to extend their rehabilitation to at least nine months – preferably a year or more – and to ensure their strength and jumping capacity are restored before they return to sport. To determine whether a person is ready to return, physical therapists are recommended to assess patients by using questionnaires and tests of thigh-muscle strength and jumping capacity.

“It’s important for the physical therapist and orthopaedic surgeon early on, before the operation, to tell the patient that rehab takes time. It’s a matter of having the right expectations,” Susanne says.

Source: University of Gothenburg

Reference: “Patience you must have, my young athlete”: Rehabilitation-specific outcomes after anterior cruciate ligament reconstruction;