Unfortunately the research shows that a very high percentage of athletes with an ACL tear will go on to re-tear the same knee or injure the ACL in the other knee. ACL re-tear rates are approximately 20-25% and that means one in every four to five athletes are suffering a second ACL tear.
And almost 30% of young athletes who returned to pivoting and cutting sports after ACLR suffered a second ACL injury in the 24 months after ACLR and RTS.
There are many potential reasons why you may have re-injured your ACL. Let’s review them:
You are at risk
The scientific literature is fairly clear on many of the reasons why some of you are at risk for developing an ACL tear. In many it has to do with your landing mechanics, the orientation of their leg, and in women it has to do with their hormonal variations during their ovulation.
Surgical failure, technical issues or poor graft choice
An ACL reconstruction is a technically challenging procedure. ACL surgery is not as simple as it may seem. It requires attention to detail and a lot of experience. Volume matters. You need to be under the care of a ACL professional who performs many each year. Unfortunately the average surgeon only performs a handful of ACL surgeries each year.
You weren’t ready to return yet.
Many people are under the misconception that simply having the surgery and having your wounds and incisions heal is all that is necessary to enable you to return to sports after ACL surgery. By far the most important part of the ACL process is rehabilitation. The most important people to work with during the ACL recovery process are your physical therapist (and your athletic trainer).
Regaining your normal strength is only a small part of the overall recovery process. You will need to learn proper landing mechanics, jumping and pivoting mechanics and the entire lower half of your body will need to be properly educated to minimize the risk of another injury.
The psychological or emotional part of the recovery can not be ignored and plays a huge role in the successful return to the playing field.
ACL physical therapy should be done with a physical therapist that is up to date with research and understands all phases of rehab. Volume matters.
Physical therapy for ACL reconstructions should be done with an ACL professional who understands all facets ACL rehabilitation. Recovering from ACL reconstruction is an extremely lengthy process and is one of the most challenging injuries to overcome. It takes a significant amount of time to regain symmetrical muscle strength and confidence to restore an athlete’s ability to return to sport. This could also mean referring to a strength coach who understands high level movements and strengthening. In reality it’s recognizing your limitations to do what’s right for the patient. The physical therapist and athletic trainer should be able to confidently determine when an athlete is safe to return to play through a battery of return to sport testing.
If you go to soon you risk the chance at re-injuring.
