ACL Rehabilitation: How Can We Lessen Injury Rates?

Abstract

Rehabilitation is commonly used following anterior cruciate ligament (ACL) injury, though specific protocols are widely varied. Regardless of whether the injury is managed operatively or nonoperatively, quadriceps strengthening and return to full range of motion are the main focus points of rehabilitation, both to regain function and prevent future injury. Preoperative ACL rehabilitation has been shown to improve clinical outcomes. Home exercise programs can also provide good clinical outcomes when compared to traditional in-person physical therapy. A multitude of specific modalities (bracing, functional testing, neuromuscular training, electrostimulation, cryotherapy, and blood flow restriction therapy) may also provide benefit in ACL rehabilitation. Analysis of biomechanics during rehabilitation allows for customization of rehabilitation approaches, provides insight on muscular deficiencies, and helps ACL-injured patients re-establish functionality with the goal of preventing future ipsilateral or contralateral injury. Given the lack of consensus on rehabilitation protocols following ACL injury, the purpose of this review was to examine the efficacy of a variety of protocols and specific modalities and discuss their roles in the prevention of future ACL injury.