Mick Hughes:
Sports & Exercise Physiotherapist
M. Sports Physio, B. Physio, B.Ex. Sci.

There isn't a typo in this post. You are reading it correctly.. This research from Haberfield et al 2021 is also consistent with Oiestad et al (2018) who showed that after 15yrs, those who returned to pivoting sports had 60% less chance of radiographic OA changes and had significantly less symptoms compared to those who didn't. Do these results surprise you? I must admit, they surprised me. But one of the possible reasons why makes sense to me. To get back to participating in

This question is a nice topic of debate between researchers & clinicians. A recent review by Bourne et al (2019) showed that there is no current evidence to suggest that there is a link; however Benjaminse et al (2019) recommend that we train our athletes to resist fatigue to reduce ACL injury risk. Whatever side of the fence you sit on however; van Melick et al (2019) showed in a group of ACLR soccer players that fatigue significantly affected movement quality (as per Landin

It wasnt the main purpose of the study, but van Melick et al (2019) reported some nice benchmarks for young, male ACLR patients to strive for prior to being cleared to return to competitive sport (specifically soccer/football). In van Melick and colleague's study, healthy male amateur soccer players (ave age 21yrs) scored on average the following on these performance tests: Single leg CMJ 24cm Single leg hop test 160-170cm Side hop test 55-60 reps We know comparing the ACL in

RFD refers to the ability to produce force quickly and is integral during ACLR rehab - yet is often not trained well enough. It's been shown that 30% RFD deficits are evident between limbs at 6 months post op despite full restoration of maximal knee extensor strength (Angelozzi et al 2013). The problem is typical strength programs (3-4 sets of 8-12 reps) aren't good enough to manipulate RFD. RFD however can be trained via heavy loads (<5 reps per set), and plyometrics and sig

Running is a major milestone to achieve for patients following ACL surgery - yet there's still no perfect answer as to "when". Historically, the advice was to start a running program after 3 months post-op. However, what we're discovering is that time-alone is not a great indicator; but rather showing that your prepared to run is - and will more likely keep the person running consistently after they've started. These are my key criteria to start a running program. Like everyt

It's widely accepted now that passing criteria before returning to sport following ACLR is best practice and is associated with better chances of returning to pre-injury level of sport and lower chances of future knee reinjury. However what is not very well known just yet is what are the most appropriate tests (eg. how many hop tests and what kind, movement quality assessment) and appropriate "pass" criteria (eg. >90% LSI vs >95% LSI) These criteria by Toole et al are a high

A great quick screen you can use to assess function in your athletes with adductor-related or hip-related groin pain. Red light: The player should STOP activity and seek help from a health professional for appropriate load management and strengthening advice Yellow light: The player should be seen by a health professional before training/game and consider modifying activities as well as appropriate strengthening advice Green light: generally speaking, green is a sign to go ah

We often talk about setting benchmarks for return to running and return to sport for the ACLR athlete; but it can be a bit more challenging knowing when the ACLR athlete is ready to return to the training environment, and what things they can do at training. There is no perfect way to go about this, and each athlete will have their own unique pathway back to return to training based on their competitive sport, but as a general rule for team sport athletes, these would be the

It's important that we are having honest discussions with our ACLR patients about what the chances are of them returning to pre-injury level of sport, 2nd ACL injury risk and risk of OA development over time following ACLR. Currently we know: 40-60% of non-professional athletes will return to pre-injury sport within 2 years 2nd ACL injuries in under 20 year olds is approx 30% within 2 years of return to sport Up to 50% of patients will develop symptoms and radiographic OA cha

A great research paper by Hughes and his colleagues. This was a study that directly compared heavy load resistance training with BFR training post ACL rehab. The resistance training program for both groups was an 8 week progressive overload program using only the single leg leg press machine 2x/week. The difference was in the loading parameters: BFR - 4 sets (30 reps, 15 reps, 15 reps, 15 reps) at 30% 1RM: 30 seconds rest between sets HLRT - 3 sets 10 reps at 70% 1RM: 30 seco