Following an injury

Return to play following injury: Fingers crossed or an assessment paradigm?

The pressures to return a professional sportsman back to full fitness and competition following injury can be intense.  The pressure factor is multi-faceted and can come from the management and coaches, the player themselves and the media.  Clinicians are also internally driven to deliver an ‘optimal’ rehabilitation programme that is neither too conservative nor too reckless. 

Advances in rehabilitation theory and practice have progressed exponentially over the last 15 years. For example, the return to play (RTP) time for players following ACL reconstruction has more than halved (Shelbourne and Nitz, 1990; Delay et al, 2001; Francis et al, 2001).  However, identifying when it is ‘safe’ for an athlete to return to full unrestricted activity remains controversial.  More recent studies have suggested that full recovery is not always used as an indicator for a player to return to training and competition, the use of RTP evaluations following injury is variable and there is a high incidence of re-injury in certain sports such as Rugby Union (Beardmore et al, 2005).

This presentation will cover end stage rehabilitation for the lower limb with specific reference to ACL rehabilitation.  Strategies for developing the explosive lower limb power necessary for many sports will be presented. The use of Functional Performance Tests (FPT) for pre-season testing, training and rehabilitation programmes will also be discussed. Furthermore, FPTs may also assist in identifying a safe return to play, thus minimising the risk of re-injury.


Beardmore AL, Handcock PJ, Bentley S (2005) Return-to-play after injury: practices in New Zealand rugby union. Physical Therapy in Sport (In press)

Delay BS, Smolinski RJ, Wind WM, Bowman DS (2001) Current practices and opinions in ACL reconstruction and rehabilitation: results of a survey of the American Orthopaedic Society for Sports Medicine. American Journal of Knee Surgery 14:85-91

Francis A, Thomas RdeWM, McGregor A (2001) Anterior Cruciate ligament rupture: reconstruction surgery and rehabilitation. A nation-wide survey of current practice. The Knee 8: 13-18

Shelbourne KD, Nitz P (1990) Accelerated rehabilitation after anterior cruciate ligament reconstruction. American Journal of Sports Medicine 18: 292-299

Zoë Hudson PhD MCSP

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