Adrian D'Costa

RTS from an ACLR has always been (and will be) a hot topic. Years of research are still showing us that on a whole we just aren’t getting it right. BUT we’re getting there.

Recent publications have started to question both the physiological and psychological considerations for returning to sport.


1️⃣Physiologically, there is a good amount of evidence demonstrating the lack of readiness for sport. Many athletes are not meeting the requirements of the test batteries. And subsequently, we are seeing re-ruptures and revisions.

The answer is not just about being strict, although that is something we should all be with respect to returning and educating our patients about the possible risks. There also needs to be various forms of pre-testing such as normative data, pre-season testing and pre-operative testing (for both limbs). We discuss this in more detail in our video so it out.


2️⃣Psychologically, we are seeing the same things. Many athletes are not feeling confident and reassured in their knees' ability to perform during sport. Why is this?

This will vary for every individual, however testing pre and post operatives will allow us to screen for these individuals and delve deeper into WHY it is they feel a certain type of way.

This brings me to my next point which is, ARE WE RUSHING ATHLETES BACK TOO SOON⁉️


Some of the studies in these systematic reviews show athletes returned from 6 months onwards and a larger majority before 9 months!

While early return is impressive. A safe Return with the least likelihood of re-injury is BEST. This may result-open the question of longer return to sport times as proposed by Nagelli and Hewett (2017). There a many factors that will influence this, our Facebook video digs deeper into these issues.

It’s clear that even though we know a lot about ACLs and Return to Sport. There is still a lot in the grey and better questioning of the current body of evidence will lead to better research.

On a final thought, if a player doesn’t pass these physiological and psychological tests, should they return? What’s best for the athlete?

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