What Are We Missing? The Influence of Fatigue.

The following is another article written for the online, video-based physical therapy continuing education company MedBridge

Recently, a lot of attention has been paid to re-injury and return to sport following anterior cruciate ligament reconstruction (ACLR) and the results continue to be less than exceptional. A recent case series of elite collegiate athletes who suffered ACL injuries prior to and during their college careers continually found difficulty returning to sports participation (Kamath et al., 2014). Of the 35 athletes who had undergone ACLR prior to enrollment in college, the rate of re-operation on the involved limb was 51.4%, the rate of re-rupture of the ACL graft was 17.4%, and contralateral ACL rupture was 20.0% within this population of athletes. Similarly, those who underwent ACLR during college had a 20.4% re-operation rate, 1.9% suffered re-rupture of the ACL graft, and 11.1% of these athletes underwent ACLR on the contralateral limb. In agreement with these findings, a prospective cohort study of 456 collegiate athletes conducted by Rugg and colleagues found that athletes entering college with a history of ACLR had a 892.9-fold increase in knee surgery compared to those who entered college without undergoing surgery. Unfortunately, these findings are not isolated to collegiate athletes as professional (Busfield et al., 2009) and high school athletes (McCullough et al., 2012) alike have similar statistics. Considering these numbers, it points to inadequate or premature return to athletic participation, which may be because we are overlooking a very important aspect of athletic competition… [Continue Reading]

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