The ACL journey is a long one, anywhere from 9- 18 months depending on your sport, and how much rehab you have had. The big question revolves around returning to sport.
The first thing you need to understand is that your return to sport should be done on the basis that you have done everything you could possibly do in your rehab, and that your risk is minimal to none, no matter what option you take. Determining your risk is the tricky part, but there are a number of tests that you can do to determine your risk
- Strength tests
Strength tests are a good one to start with. During your rehab, you should have been doing exercises that targeted your quad, glute, and hamstring strength. Here are few tests that you can do
- Sit to stand to failure (tests glute and quad endurance)
- Hamstring bridge to failure (tests hamstring endurance)
- Calf raise to failure (tests calf endurance)
Other considerations for strength include making sure your squat, and deadlift max are at where they were pre- injury.
2. Balance tests
Balance and proprioception are two important attributes to have. This relates to understanding where your body is in space, and where it is moving to without actually looking at it. Many ACL injuries occur due to poor biomechanics, or poor cutting and landing patterns.
A good balance test is the Y- Balance test, pictured below. By balancing on one leg, and moving as far as you can in the three different directions, you can test to see how much difference there is between in the affected and unaffected leg. Ideally, they should be equal
3. Hopping/plyometric tests
Plyometric tests are important to do prior to returning to tests, and there are a popular series of tests that you can do to find out how confident you are with these types of tests
- Single leg leap- leap forward as far as you can on the one leg
- Triple hop- Three hops forward on the one leg, minimizing the time spent on the ground during the hop
- Box hop- Counting how many hops you can do side to side, in 30 seconds. Ideally 60.
4. Functional tests
This form of testing is the hardest to implement, but essentially we want to test your running and change of direction. The most popular tests is the T- Test, set up in the picture below. Ideally, you want to complete it in under 10 seconds. Research shows that those can complete it in under 10 seconds, are less likely to have an ACL injury, compared to those that do not.
The more you can test yourself, and find discrepencies between your injured and uninjured legs, the better you can prepare yourself to return to sport.
In the end, the best question you can ask yourself is this:
“If I return to sport now, and I ruptured my ACL again, will there be anything I regret not doing? Or have I done everything I possibly could have?”