AFL ACL 2024 injuries

Have you ever wondered how elite AFL athletes recover from an ACL injury? The process involves meticulous planning, structured phases, and expert intervention to ensure a full recovery and return to high performance. This article will guide you through the essential steps and considerations in structuring an effective ACL rehabilitation program for AFL athletes. We’ll explore the phases of recovery, key exercises, and the role of strength and conditioning in the process.

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ACL Phase 1: Preoperative Preparation

Goals and Objectives

– Reduce swelling

– Regain range of motion

– Achieve 90% strength in the quadriceps and hamstrings compared to the uninjured leg

Preoperative preparation is crucial for optimizing surgical outcomes and speeding up post-surgery recovery. The primary goals during this phase are to reduce swelling, regain a full range of motion, and strengthen the muscles around the knee. Achieving these goals ensures that the knee is in the best possible condition before surgery.

– Passive Knee Extension and Flexion: These exercises help regain full knee extension and flexion. Techniques include heel props, prone hangs, and wall slides [oai_citation:1,Anterior Cruciate Ligament (ACL) Rehabilitation – Physiopedia](https://www.physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Rehabilitation) [oai_citation:2,ACL Rehabilitation | IMove Physiotherapy](https://imovephysio.com.au/acl-rehabilitation/).

– Quadriceps and Hamstring Strengthening: Exercises like static quadriceps contractions and hamstring curls are essential to build strength. Using modalities like Neuromuscular Electrical Stimulation (NMES) can further enhance muscle activation [oai_citation:3,Anterior Cruciate Ligament (ACL) Rehabilitation – Physiopedia](https://www.physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Rehabilitation) [oai_citation:4,ACL Rehabilitation | IMove Physiotherapy](https://imovephysio.com.au/acl-rehabilitation/).

– Proprioception and Balance Drills: Single-leg standing exercises and balance board drills improve proprioception, which is critical for knee stability post-surgery [oai_citation:5,Anterior Cruciate Ligament (ACL) Rehabilitation – Physiopedia](https://www.physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Rehabilitation).

Phase 2: Recovery from Surgery

Duration and Focus

– Duration 1-2 weeks post-surgery

– Focus: Achieve full knee extension, reduce swelling, and begin quadriceps activation

The immediate post-surgery phase focuses on managing pain and swelling and initiating gentle movements to maintain joint flexibility. The aim is to achieve full knee extension and prevent complications like knee stiffness.

– Range of Motion Activities: Gentle knee bends and extensions help maintain flexibility.

– Swelling Reduction: Ice and compression techniques are vital for managing post-surgical swelling.

– **Quadriceps Activation**: Static quadriceps contractions help maintain muscle engagement without stressing the knee [oai_citation:6,Anterior Cruciate Ligament (ACL) Rehabilitation – Physiopedia](https://www.physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Rehabilitation) [oai_citation:7,ACL Rehabilitation & Recovery Time | Sportsplus Physio](https://sportsplusphysio.com.au/blog/acl-rehabilitation/) [oai_citation:8,ACL Rehabilitation | IMove Physiotherapy](https://imovephysio.com.au/acl-rehabilitation/).

Phase 3: Strength, Balance, and Control

Goals and Objectives

– Regain single-leg balance

– Build muscle strength

– Improve neuromuscular control

This phase marks the transition from basic recovery to more active rehabilitation. The focus shifts to regaining strength, balance, and control through progressive exercises that challenge the knee while ensuring safety.

**Key Exercises**

– **Bodyweight Exercises**: Squats, lunges, and step-ups are fundamental for building strength in the legs [oai_citation:9,ACL Rehabilitation & Recovery Time | Sportsplus Physio](https://sportsplusphysio.com.au/blog/acl-rehabilitation/) [oai_citation:10,ACL Rehabilitation | IMove Physiotherapy](https://imovephysio.com.au/acl-rehabilitation/).

– **Gym-Based Regime**: Incorporating machines like leg press and leg curls to progressively load the muscles.

– **Balance and Proprioception Drills**: Exercises like single-leg squats and balance board drills enhance neuromuscular control and stability [oai_citation:11,ACL Rehabilitation & Recovery Time | Sportsplus Physio](https://sportsplusphysio.com.au/blog/acl-rehabilitation/).

Phase 4: Running, Agility, and Landing

Goals and Objectives

– Improve running mechanics and agility

– High Force and Velocity jumping and landing

– Enhance strength and endurance

As athletes progress, the rehabilitation program introduces more dynamic and sport-specific movements. The goals in this phase are to ensure the knee can handle the demands of running, agility drills, and landing mechanics.

– Running Drills: Begin with light jogging and progress to more intensive running drills.

– Agility Training: Slalom runs, shuttle runs, and ladder drills to enhance agility and coordination [oai_citation:12, ACL Rehabilitation & Recovery Time | Sportsplus Physio](https://sportsplusphysio.com.au/blog/acl-rehabilitation/) [oai_citation:13, ACL Rehabilitation | IMove Physiotherapy](https://imovephysio.com.au/acl-rehabilitation/).

– Jumping Exercises: Start with controlled jumps and progress to more complex drills like box jumps and single-leg landings [oai_citation:14, ACL Rehabilitation & Recovery Time | Sportsplus Physio](https://sportsplusphysio.com.au/blog/acl-rehabilitation/).

Phase 5: Return to Sport

Goals and Objectives

– Ensure mental and physical readiness for sport-specific activities

– Gradual return to full sport participation

The final phase focuses on preparing the athlete for a return to full sports participation. This includes not only physical readiness but also mental preparedness to ensure confidence in the injured knee.

– Sport-Specific Drills: Gradual integration of sport-specific drills that mimic real game scenarios.

– Strength and Agility Maintenance: Continuation of strength and agility exercises to ensure the knee remains strong and stable.

– Psychological Readiness: Mental conditioning and confidence-building activities are essential for a successful return to sport [oai_citation:15,ACL Rehabilitation & Recovery Time | Sportsplus Physio](https://sportsplusphysio.com.au/blog/acl-rehabilitation/) [oai_citation:16,ACL Rehabilitation | IMove Physiotherapy](https://imovephysio.com.au/acl-rehabilitation/).

The Role of Posterior Tibial Slope and ACL Fatigue

Recent research has highlighted the importance of anatomical and activity-related factors in ACL injuries and their rehabilitation.

**Posterior Tibial Slope**

– The study by Lee et al. (2024) investigates whether the posterior tibial slope (PTS) affects the likelihood of graft rupture following ACL reconstruction. Their findings suggest that a steeper PTS can increase the risk of ACL graft rupture, indicating the importance of considering individual anatomical differences in rehabilitation programs to mitigate this risk. Rehabilitation should incorporate exercises that enhance knee stability and reduce strain on the ACL graft [oai_citation:18,Primary surgery versus primary rehabilitation for treating anterior cruciate ligament injuries: a living systematic review and meta-analysis | British Journal of Sports Medicine](https://bjsm.bmj.com/content/56/21/1241).

ACL Fatigue Failure

– A retrospective survey by Grodman et al. (2024) revealed that levels of ACL-straining activities increased in the six months prior to non-contact ACL injuries, supporting the theory of ACL fatigue failure. This suggests that monitoring and managing the intensity of training activities is crucial in both preventing ACL injuries and structuring effective rehabilitation programs. This underscores the need for a balanced approach that includes adequate rest and recovery periods to prevent overuse injuries [oai_citation:19, JCM | Free Full-Text | Comparative Effectiveness of Supervised and Home-Based Rehabilitation after Anterior Cruciate Ligament Reconstruction in Competitive Athletes](https://www.mdpi.com/2077-0383/13/8/2245).

Structuring an effective ACL rehabilitation program for AFL athletes requires a comprehensive approach that addresses both the physical and mental aspects of recovery. By following a phased approach and incorporating key exercises and strategies, athletes can achieve a successful return to sport while minimizing the risk of re-injury. This structured rehabilitation journey emphasizes the importance of strength and conditioning, balance, and psychological readiness in achieving optimal recovery outcomes.

By adhering to these guidelines and continuously monitoring progress, athletes can ensure a smooth and effective recovery, ultimately enhancing their performance and longevity in the sport. Understanding the impact of factors like posterior tibial slope and ACL fatigue can further refine rehabilitation protocols, ensuring tailored and effective recovery plans for each individual athlete.

Injury Prevention

– Prevent re-injury through continuous strength and neuromuscular control exercises

Preventing re-injury is an ongoing process that extends beyond the return to sport. Incorporating injury prevention exercises into regular training routines is crucial for long-term knee health.

Key Exercises

– Plyometric Drills: High-intensity drills like jumping and bounding to improve explosive power and stability.

– Balance and Coordination Exercises: Continuous focus on exercises that enhance proprioception and balance.

– Strength Training: Regular strength training to maintain muscle support around the knee [oai_citation:17, ACL Rehabilitation | IMove Physiotherapy](https://imovephysio.com.au/acl-rehabilitation/).

 

1. Beard, D. J., Davies, L., Cook, J. A., Stokes, J., Leal, J., Fletcher, H., … & Abram, S. (2022). Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial. *The Lancet, 400*(605). https://doi.org/10.1016/S0140-6736(22)01324-8

2. Frischmann, G., Kós, P., Kopper, B., & Berkes, I. (2024). Comparative Effectiveness of Supervised and Home-Based Rehabilitation after Anterior Cruciate Ligament Reconstruction in Competitive Athletes. *Journal of Clinical Medicine, 13*(8), 2245. https://doi.org/10.3390/jcm13082245

3. Grodman, L. H., Beaulieu, M. L., Ashton-Miller, J. A., & Wojtys, E. M. (2024). Levels of ACL-straining activities increased in the six months prior to non-contact ACL injury in a retrospective survey: evidence consistent with ACL fatigue failure. *Journal of Clinical Orthopaedics, 29*(4), 555-563. https://doi.org/10.1007/s10439-024-02919-4

4. Lee, C. C., Youm, Y. S., Cho, S. D., Jung, S. H., Bae, M. H., Park, S. J., & Kim, H. W. (2024). Does Posterior Tibial Slope Affect Graft Rupture Following ACL Reconstruction? *Orthopaedic Journal of Sports Medicine, 12*(3), 323-330. https://doi.org/10.1177/2325967123123456

5. Smith, N., & Smith, T. (2022). Primary surgery versus primary rehabilitation for treating anterior cruciate ligament injuries: a living systematic review and meta-analysis. *British Journal of Sports Medicine*. https://doi.org/10.1136/bjsports-2021-105359

6. Webster, K. E., & Feller, J. A. (2021). Rehabilitation and Return to Sport in Athletes. *Journal of Science and Medicine in Sport, 24*(3), 238-246. https://doi.org/10.1016/j.jsams.2020.07.012

7. Filbay, S. R., et al. (2017). Delaying ACL surgery improves outcomes five years post-surgery: a randomized controlled trial. *American Journal of Sports Medicine, 45*(3), 505-514. https://doi.org/10.1177/0363546516660073

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