Rehabilitation Issues in Women With Anterior Cruciate Ligament Deficiency

Abstract

Anterior cruciate ligament (ACL) noncontact injuries occur more frequently in female than in male athletes. Many studies investigated possible predisposing factors such as joint laxity, hormonal influences, lower limb alignment, notch shape and dimension, ligament size, and neuromuscular control. To our knowledge, there are no ACL rehabilitation protocols especially studied for women. Our approach is a time-based and criterion-based progressive rehabilitation protocol, with preoperative, early, and late postoperative phases. Preinjury, preoperative, and postoperative biomechanical quantitative evaluations are used to monitor rehabilitation. Sport-specific epidemiologic observation of noncontact ACL injury mechanism can help in identifying movements and situations that pose a risk to the ACL. These data can be used to modify training and to prevent injuries and re-injuries. In our opinion, it is not necessary to have a gender-specific rehabilitation protocol, but it is necessary to have better sport-specific neuromuscular conditioning, which should include plyometrics, postural balance, and functional agility exercise protocols.