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Everything I read says I should be back on the playing field within a year of my ACL repair. But here it is 15 months later and I'm still not at full speed. Do other athletes really make it back sooner or is that just a carrot they put out before us as incentive?

The timeline currently used for athletes after anterior cruciate ligament (ACL) surgery goes something like this. Rehab and recovery after surgery takes a good four to six months for everyone. Sports specific training is designed to return athletes to their sport by the end of a year's time. The real question isn't can they get back into action within 12 months of the surgery, but rather, can they participate at their preinjury level? A recent study conducted at the Musculoskeletal Research Centre at the La Trobe University in Australia actually took a look at this question. They asked, are most athletes really back on the field, court, or track by the end of 12 months? They collected data on over 500 athletes who were treated by a single surgeon for an ACL rupture. They all had the same surgical procedure so at least from a surgical point-of-view, the playing field was "level" so-to-speak. They also analyzed the results to see if there were any specific factors that could predict who would do well and how soon athletes did, indeed, return to their sports participation. Some of the items reviewed included 1) whether the athlete was engaged in seasonal versus year-round sports, 2) how soon the surgery was done after the injury, and 3) whether sex (male versus female) made a difference. In other words, were men or women more likely to return-to-sports before the end of the first year? Patients were contacted after the end of a full 12-months following surgery. They were asked if they had returned-to-sport (or attempted to return) and their current playing status. If they had not yet returned-to-sport, they were asked why not and if they intended to return (and how soon). As it turns out, two thirds of the 503 athletes had not attempted participating fully in competitive sports at the time of follow-up. About half of those 335 athletes had attempted training and/or modified competition. Most of these folks were male. The other half (some men but mostly women) had made no attempt at sports activity. Some patients had given up because of the knee problems. An equal number gave up sports for other reasons. A large number (159 patients -- an equal number of men and women) still planned to return to competitive sports but 84 had no intention of doing so. The results of this study showed the expectation of return-to-sports within 12 months of ACL surgery may not be realistic. The authors note that using the preinjury level of participation as the key measure may be somewhat restrictive but it is a more accurate reflection of real life for athletes. More study is needed to clear up some of these differences before we will know for sure. For now, it looks like many athletes may need more than the traditional six to 12-month break from sports after ACL reconstruction.


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