Of those who do complete protocols, the best athletes are able to manipulate their performance to satisfy the test application rather than attaining quantifiable maximums. Specificity for return to play protocol completion is low because many athletes cannot complete the tests even without knee injury. Up to 70% of healthy athletes are unable to pass qualitative standards for ACL return to play.
The solution to this variability is utilization of a video posture analyzer but these units are expensive and inefficient and, therefore, hard to find. Since assessing movement quality is subjective there is great variability from practitioner to practitioner in their ability and commitment to encouraging proper movements. Some practitioners make insufficient subjective analyses for appropriate release. There are difficulties to this standard protocol methodology, however:ġ: The protocols are difficult to achieve & assess: Challenging physical procedures exist within return to play protocols from ACL reconstruction including quality assessed single leg triple hop tests, single leg squats and change of direction. Clearly the first thing therapists, trainers, coaches, and parents can do to ensure their athlete is best suited for return to play is to make sure they've completed standard protocols. If an athlete does complete published protocols for ACL reconstruction return to play, their likelihood for re-rupture could reduce by 15%. It has been shown that the main reason for these high re-injury rates is lack of rehabilitation protocol completion before release to athletics. Although orthopedic surgical techniques have improved greatly in the past few decades, recovery is still slow (6 – 12 months) and re-injury rates for athletes are higher than most (20-40%) Anterior Cruciate Ligament (ACL) reconstruction surgery is one of the most damaging experiences an athlete can go through.
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