You can read the full article here.
Tell us more about yourself and the author team.
I am a clinical assistant professor at Florida International University and a Board-Certified Clinical Specialist in Sports Physical Therapy at Nicklaus Children’s Hospital. Our author team is a multidisciplinary group of pediatric sports medicine specialists connected through the Pediatric Research in Sports Medicine (PRiSM) organization.
What is the story behind your study?
At Nicklaus Children’s Hospital, all our athletes who have undergone an ACL reconstruction complete a return to sport test before returning to their sport. Over the years, many of our athletes have returned with a second or third(sometimes more!) ACL or graft injury despite meeting quantitative return to sport criteria (strength and hop distance). Therefore, we thought we needed additional metrics to determine their readiness for a safe return to sport, such as breaking down movement quality. Quality of movement (trunk and knee control) has been an essential topic for ACL injury prevention; however, sparse literature includes quality of movement assessments in return for sport testing. We felt this was a missing link and may be one of the reasons for the increased second ACL injury rates in our patients. So, we decided to add quality of movement assessments to our return to sport test and assess the impact on second ACL injuries.
In your own words, what did you find?
Athletes who demonstrated dynamic knee valgus during the sidestep cut task on their surgical limb were roughly 4 times more likely to suffer a second ACL injury.
What was the main challenge you faced in your study?
This was a retrospective chart review study. As such, we were not able to confirm the presence or absence of re-injury, and it is possible that some patients with a second ACL injury may have followed up with a different physician, which may have underrepresented second ACL injuries in our study.
If there is one take-home message from your study, what would that be?
Clinicians should incorporate neuromuscular training in post-ACL rehabilitation to address dynamic knee valgus in youth athletes during cutting and pivoting tasks.