The combination of high-speed play and collision contact in football means that ACL tears and other knee injuries will always be a part of the game. Shelbourne Knee Center helps football players and other athletes recover from ACL surgery physically and mentally and ensure safe return to play.
A Team Approach
After ACL surgery, football players typically have physical therapy at an outpatient center that’s separate from the orthopedic practice. Physical therapists work from a prescription for physical therapy and the physician’s notes.
Shelbourne Knee Center uses a team approach to ACL rehabilitation. “Physical therapists and our athletic trainer see patients with our physicians, can communicate with them face-to-face on a daily basis, and have access to X-rays,” says Scot Bauman, PT, DPT.
Shelbourne Knee Center has seven physical therapists and one athletic trainer on staff, and an on-site gym. Each injured football player has a personal physical therapist or athletic trainer who provides education, support, and coaching from pre-op through post-op rehab.
Bauman and other physical therapists at Shelbourne Knee Center also collaborate and communicate regularly with the football team’s athletic trainer, physicians, and often coaches.
Groundbreaking Surgical Technique
The team approach, a groundbreaking surgical technique, and a research-based ACL rehab program that starts before surgery enables football players to return to sport sooner. Use of a contralateral patellar tendon graft allows for a faster, more predictable recovery, according to research on ACL patients at Shelbourne Knee Center (1).
At Shelbourne Knee Center, the average time to return to football after ACL surgery is 4-6 months (2,3) compared to an industry average of 9-12 months.
“Taking the graft from the contralateral knee eliminates the need with an ipsilateral graft to wait 6-8 weeks to reach full range of motion before starting strengthening,” says Bauman.
Using a contralateral graft also splits the rehab between the two legs. The goal for the ACL knee is to improve extension and range of motion (ROM) equal to the other knee before strengthening begins. Rehab for the contralateral knee focuses on improving strength.
“Athletes get to point where they feel both knees are the same. If they are doing all of the work on one leg, they will have one knee that feels better,” says Bauman.
Criteria-Based Return to Football
Most physical therapists focus on return to football (or other sports) at a certain time post-surgery. Shelbourne Knee Center requires the injured athlete to meet specific physical criteria and be ready mentally to return to sport.
“We allow the athletes to do what their knees will allow them to do. That’s the best way for them to gain confidence in terms of feeling physically and mentally ready to return to sport,” says Bauman.
Gradual Progression in Return to Football
Gradual return to football begins when the athlete reaches symmetry between the two knees:
- Normal ROM.
- Swelling.
- Strength.
Once the athlete has met the criteria for return to sport, the physical therapist or athletic trainer coordinates this with the football team’s athletic trainer. Levels of return to sport are:
- Functional activities specific to the sport.
- Individual agility drills.
- Sport-specific agility drills.
- Practicing in game-like situations.
- Full competition.
The physical therapist or athletic trainer informs the team athletic trainer when the athlete is ready for the next level of return to sport. Together, they monitor the athlete’s progress and resolve any problems.
“The full progression for return to football takes about 1-2 months,” says Bauman.
For more information about ACL rehabilitation, please call 888-FIX-KNEE.
References:
- Shelbourne DK. Thirty-five Years of ACL Reconstruction, presentation at Andrews University, February 2018.
- Shelbourne KD, Sullivan AN, Bohard K, Gray T, Urch SE. Return to basketball and soccer after anterior cruciate ligament reconstruction in competitive school-aged athletes. Sports Health.2009;1:236 – 241.
- Shelbourne KD, Gray T. Anterior Cruciate Ligament Reconstruction with Autogenous Patellar Tendon Graft Followed by Accelerated Rehabilitation. A Two- to Nine-Year Followup. Am J Sports Med.25:786-795, 1997.