What is the reinjury rate for athletes after ACL reconstruction?
- About 1 in 5 athletes sustain a second ACL injury, either to the same leg again or to the other leg.
Why is the reinjury rate so high for young athletes?
- One of the reasons reinjury rates are so high is a lack of standardization when it comes to return to sport criteria. It’s well established that achieving certain strength, power, and symmetry thresholds, along with waiting to return to sport until at least 7-9 months post-op, protects against reinjury. Unfortunately, athletes rarely undergo a rigorous testing battery to determine their readiness to return to sport, and they often return too quickly.
What are the common risk factors for reinjury?
- Some risk factors are out of your control, such as the structure of your knee and your age. Other risk factors are within your control, and many stem from incomplete recovery. For example, inadequate rehabilitation can result in physiological deficits in strength, neuromuscular control, and aerobic fitness as well as psychological factors like lack of confidence and fear of reinjury. Young athletes with these deficits who play sports involving jumping, landing, pivoting, and cutting are at especially increased risk.
Will this program stop me from injuring my ACL again?
- It’s impossible to guarantee that you will not injure your ACL again. Some injuries are simply out of our control. However, completing this program as prescribed and passing the final test out should greatly reduce your chances of reinjury. One study showed that athletes who achieve the recommended strength and power standards reduced their risk of reinjury over 6-fold.
My doctor already cleared me to return to all activities. Should I still do this program?
- If you have never completed a return to play or return to sport progression, this program is very appropriate for you. Even if you are far out from surgery, this program will help reduce your risk factors for a second injury and build confidence to return to vigorous sporting tasks.
I had pain after performing one of the workouts. Is this normal?
- Muscle soreness is normal; pain is NOT normal for any of these workouts. If you are having pain, it could be a sign you are not ready to perform certain activities or may be performing a movement incorrectly. We recommend reaching out to your physical therapist or surgeon if these symptoms persist.
What if I don’t have access to all of the equipment?
- The app’s store has a link to items you can purchase to fill out your home equipment offering. The required workouts are designed such that most exercises can be completed with minimal or no equipment. Feel free to get creative with adding weight by holding household items and using sturdy furniture to stand on for other exercises. Agility ladders are used in all workouts so we highly recommend this one purchase to complete the program in its entirety.
If I fail a “test out,” does that mean I am behind?
- Not at all. This program is meant to challenge you and raise your abilities to a higher standard. Depending on your past exercise experience, it may take more practice to achieve these goals. We expect many users to fail at least one test out because sometimes it takes longer than 3 or 4 weeks to build appropriate levels of strength and power before moving on to the next phase. Trust the process and know the added time is helping push you to greater heights.
I think I passed the “test out,” but the next phase did not unlock. What’s going on?
- First, make sure you logged your data correctly. The testout calculation requires an entry for each leg, and both need to be on the same level. For example, if you were able to do Level 3 with your uninvolved leg, make sure you log stats for Level 3 on your involved leg, too. If it looks like everything was put in correctly, reach out to your PT (or the ACL Care Pro team) to get a code to move on to the next phase.
Why are some workouts “optional”?
- Not everyone has access to gym equipment, so we don’t want that to limit anyone from making progress. That’s why the gym-specific training day is marked as “optional” and the rest of the program is created to assure continued progress even without gym access. That said, the optional training day is highly recommended. Even if you can’t get to a gym, we still recommend performing upper body exercises and cardio on this day to keep building your capacity.
What if I don’t document all of my “workout” and “test out” information?
- The documentation of the “workout” is mostly for your own information. It's good to know what exactly you did during your last workout so you can aim to beat it on your next one. Conversely, the “test out” documentation is required to move forward onto the next phase. The test out documentation is also the information that is used for your final “test out report,” which can be used to show your PT, surgeon, and/or coaches what you have achieved and your readiness to return to full activity.
Why are some of the “test out” exercises repeated from phase to phase?
- Each phase builds on skills achieved in previous phases. The limb symmetry requirements for strength that are necessary to pass Phase 2 are greater than the symmetry requirements necessary to pass Phase 1, and so on. If a test is repeated, the minimum passing standard has been raised compared to previous phases.
My physical therapist, trainer/coach, or surgeon wants to know more information about this program. Is there any information I could send them?