WELLNESS
How Soon to Return to Sports After completing all the hard work of physical therapy, what is the return-to-sport timeline? For recreational and elite athletes, it is 9-12 months; however, for those younger than 20 years old, 12-24 months is recommended. For every month you delay returning to sport after ACL reconstruction, the risk of re-injury is reduced by 51 percent, until nine months post-operatively. Portland-based USA Ski Team downhill skier Jaqueline Wiles returned to competition in December 2019, 22 months after her extensive knee injury February 2018 and she competed in downhill skiing last month at the Winter Olympics.
Your best bet for safely returning to sport is to go through comprehensive return-to-sport testing. In one study of 62 patients, only 3.2 percent passed all RTS testing criteria six months after surgery, and only 11.3 percent passed nine months after. It is important to note that you can still re-injure even after passing testing. However, your risk is greatly reduced if tested at nine months and all testing criteria is passed. Even professional athletes are at four times more risk of a second knee injury by not meeting all criteria before returning to their sport.
The Risk of Re-Injury The data regarding re-injury post-surgery shows the greatest risk is between one and two years after procedure. Healing of the ACL graft (the “new” ligament the doctors repaired) takes 12 months if the surgeon uses an autograft (your own tissue — usually a part of your quadricep tendon, patella ligament, or hamstring tendon) and 24 months if your surgeon uses an allograft (donor cadaver tissue). Women more commonly re-injure, but the most concerning statistic is a 21 percent re-injury rate for those under age 25. For all genders, there is a 20 percent re-injury rate for those that return to sport at any point in time. And a second ACL surgery has a higher failure rate, decreased patient satisfaction, requires prolonged physical therapy, and there is an even longer delay in returning to sport and ultimately there is an overall performance decline.
Decreasing the Risk of an ACL Injury Research supports the importance of injury reduction programs such as SportsMetrics™ to decrease the risk of an injury in the first place, as well as decrease risk of an additional injury. These programs can reduce injury from 40 to 65 percent. SportsMetrics™, developed by Dr. Noyes, is a training and warmup program which includes dynamic warm up, strengthening, and plyometrics (jump and hop training). SportsMetrics™ has also been shown to increase performance. The performance benefits of these programs include increased performance for power, strength, sprint time, agility, single leg hop, and jump height. In closing, once you are given the go-ahead to return to sport by your physical therapist and surgeon, it’s imperative to continue your strengthening and injury reduction program. And before each session, complete a dynamic warm-up incorporating exercises to legs, your knee, and new ACL to handle the demands of your sport.
Instructor Spotlight MAC’s Fitness and Wellness staff works to help keep members healthy and thriving Patrick Fisher joined MAC in 2021. He is a veteran of the United States Navy and studied health sciences at Portland Community College.
A certified personal trainer through the American Council on Exercise, he holds a group exercise certification from Les Mills. Patrick specializes in mobility, stability, strength, endurance, and injury prevention. He can also assist in nutrition, weight management, swimming, cycling, and running. He currently teaches Spin and SHIFT format classes at MAC. What’s your teaching approach or philosophy?
My teaching style and philosophy is: 1. Mobility. 2. Stability. 3. Strength. 4. Power. What is your background/training? My background includes Ironman triathlons, ultradistance triathlon, marathon running, long-distance cycling on mixed surfaces, strength and conditioning, and swimming. What are some things you like to do outside of work?
My favorite activity currently outside of MAC is photography.
MARCH 2022
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