ACL Rehab Protocols

Jessica Savona is expert, having recovered from two anterior cruciate ligament tears in her career. She said the second was easier, having learned how best to do it during the first.

2010 World Champion Aliya Moustafina is back, but not yet with the level of confidence that she showed pre-injury.

Now Peng Peng Lee is in the process, getting her knee back for College gymnastics.

The Journal of Orthopaedic and Sports Physical Therapy just released an issue specifically focusing on the knee. One of the main themes was ligament rehabilitation. They posted some grim statistics from a recent meta-analysis that only 63% of ACL repairs continue on to their pre-injury level of function and that only 44% of these athletes go on to become competitive again. They also quote that the odds of reinjuring the same knee or the opposite knee after surgery range from 3% to 49%. …

EAT. MOVE. IMPROVE. – The Dreaded ACL Tear – Rehab Protocols from JOSPT and Solutions for Coaches and Trainers

Sounds grim.

… On the other hand, ultra-fit and young Artistic gymnasts are far outside norms when it comes to rehabilitation. If they are motivated, they can be back close to 100% within a year.

Ask Savona.

All 3 I mention happened to be injured vaulting twisting Yurchenko on FIG approved competition matting. Is it time to reassess those landing mats?

7 comments ↓

#1 Hannah on 06.06.12 at 4:32 am

Rick what’s your thoughts on lowering the values of, say, DTYs and Amanar’s – I’m not suggesting it NEEDS to be done, I’m just curious as to the opinions on this?

Though they’re not as dangerous as roll-out skills on floor, the injuries do seem to be stacking up?

#2 Clinton on 06.06.12 at 5:29 am

One problem that may come about if you make the mats softer and more forgiving is that gymnasts may start to try harder vaults that they aren’t ready for. I remember 20 years ago, the mats were much harder and gymnasts didn’t try new skills until they could do them with a lot of confidence. Sure, the code had a part in the decision, but the fact that gymnasts knew it was going to hurt if it wasn’t right was also a big factor in not doing a skill until it was well and truly ready.

#3 PT on 06.06.12 at 6:21 am

… Rick, whilst yes, being fit and healthy & well conditioned will definitely assist in recovery for an ACL tear, the gymnasts knees take on quite a substantial amount more force (and torque) than the run-of-the-mill athlete. Genetics would also play a role, i would assume, too.

So I dont think it can be said that gymnasts are outside of these statistics.

#4 WW on 06.06.12 at 10:28 am

I would also just like to point out that for Jessica Savona, the results of her two ACL repairs were quite different. The second one, using an allograft, had a much quicker rehab time than the first.
So perhaps the issue isn’t the fitness (or lack thereof) but the type of repair surgery.
And of course genetics.

#5 coach Rick on 06.06.12 at 11:05 am

She did tell me she felt she knew how to rehab better the second time, too.

Best rate of return to gymnastics.

#6 Marcus on 06.06.12 at 11:34 am

“Is it time to reassess those landing mats?”

More like time to reassess their coaching methods.

#7 coach Rick on 06.06.12 at 12:15 pm

I think you’re being a little unfair there, Marcus.

The Code pushes the girls to do one more half twist. Sooner or later they get a bad landing.

I’d share the blame for all the ACL vault injuries between Code, landing mats and the ethics of coaches willing to take the risk for another 0.7 start.

When the difficulty score is reduced, injuries should be fewer. If we had the DMT mats, injuries would be fewer. Same coaches.

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