Return to play: After knee injury

Knee rehabilitation: Return to sport principles

Consult your professional/s for treatment and rehabilitation as these are academic principle guidelines only and not prescriptive.
ASSIC does not dispense medical and/or exercise advice.
Consult your professional regarding exercise, treatment and rehabilitation exercise regimes and medical advise.
The contents of the following web page are principle guidelines and must be utilized under the supervision of a relevant medical and/or exercise professional.

Knee Injury

Knee injury mechanism:

The knee injury mechanism may vary from a varus/valgus/rotational/axial/translational load and be depending on the predominant stressor at the time of the injury a specific or variation of knee ligamentous instability will be present.

Rehabilitation principles & Tests

Rehabilitation

Medical clearance by the respective medical professional is critical.

Example:

AAOS guidelines for return to sport after anterior cruciate ligament (ACL) reconstruction:

Graft incorporation
Functional knee range of motion
Stable knee with no pivot shift
Stable core, hip, quadriceps and hamstring muscle strength
Restored balance
Restoration of functional skill & execution thereof
Confidence in return to sport
Advise to continue ongoing ACL-prevention/movement-retraining program

Range of motion (ROM)

ROM

Test

•Knee flexion & extension

•Active ROM= non-injured side or =/> standard sports specific norms

•Measure goniometer knee flexion & extension

•Straight leg hasty test

Knee ROM

Proprioception

Proprioception	Test
Static & dynamic	Stalk stand

Proprioception on balance mat

Circumference difference

Limb difference

Test

•Analyze limb diameter difference

Accept :<5% difference

Measure thigh circumference:
•Under gluteal crease
•Mid thigh
•Suprapatellar

Agility

Agility	Test
•Compare to pre-injury levels •Assess execution of test	•Five dot drill •T-drill •Ilionois

Muscular strength & endurance

Strength

Test

Dynamic muscle strength & endurance field test

Vertical jump

Broad

Vertical jump testing

Speed

	Test
Speed	40 m sprint

Explosive power

	Test
Focus on forward linear power watch abnormality especially favouring of non-injured leg	•Vertical jump •Standing broad jump

Vertical jump testing

Isokinetic test

Isokinetic	Test
Accurate analysis with comparative muscle strength analysis with<= 5 % difference between the 2 sides	Isokinetic