Context: : Despite an increase in the literature, few definitive guidelines are available to determine when an athlete has been fully rehabilitated after anterior cruciate ligament reconstruction (ACLR). Objective: : To examine countermovement jump and isokinetic dynamometry measures to (1) identify which measures can best distinguish between ACLR and control participants and (2) provide normative values for identified measures in young adult male multidirectional field-sport athletes. Design: : Cross-sectional study. Setting: : Orthopaedic hospital. Patients or Other Participants: : Young adult male multidirectional field-sport athletes (n = 118) who had undergone unilateral patellar-tendon graft ACLR at least 6 months earlier and healthy male participants (n = 44) with no previous knee injury. Intervention(s): : Single-legged countermovement jump (SL CMJ). Main Outcome Measure(s): : Three-dimensional biomechanical analysis of the SL CMJ and mean peak concentric knee-extension and -flexion torque using isokinetic dynamometry (ISO) were compared in the 2 groups. A stepwise logistic regression was carried out to identify the best predictors of ACLR- or control-group membership (SL CMJ height, limb symmetry index, peak power, joint power contribution, ISO peak torque, limb symmetry index variables). Results: : The control group differed strongly from the ACLR group in isokinetic knee-extension peak torque (d = –1.33), SL CMJ performance (d > 0.4), and limb symmetry measures in both ISO and jump outcomes (d > 1.1). The combination of measures from both ISO and SL CMJ identified group membership with an accuracy of 89%. Conclusions: : Rehabilitation of ACLR patients may be complete when they achieve isokinetic knee-extension peak torque of 260% (±40%) body mass, SL CMJ performance of >17 cm (±4 cm), and reach-limb symmetry measures of >90% in both strength and jump outcomes. The outcomes in the control group can inform return-to-play criteria for young adult male multidirectional field-sport athletes after ACLR.

Sport scientists could benefit from knowing about the processes underpinning machine learning (ML) and its practical applications, as it has substantial implications for our field. ML has already h...

ACL injuries are among the most severe knee injuries in elite sport, with a high injury burden and re-injury risk. Despite extensive literature on the injury and the higher incidence of injury and re-injury in female athletes, there is limited evidence on the return to sport (RTS) of elite female football players following ACL reconstruction (ACLR). RTS is best viewed on a continuum aligning the recovery and rehabilitation process with the ultimate aim — a return to performance (RTP_erf). We outline the RTS and RTP_erf of an elite female football player following ACLR and her journey to the FIFA Women’s World Cup, including the gym-based physical preparation and the on-pitch/sports-specific reconditioning. We used the ‘control–chaos continuum’ as a framework for RTS, guiding a return above pre-injury training load demands while considering the qualitative nature of movement in competition. We then implemented the ‘RTP_erf pathway’ to facilitate a return to team training, competitive match play and a RTP_erf. Objective information, clinical reasoning and shared decision-making contributed to this process and helped the player to reach her goal of representing her country at the FIFA Women’s World Cup.

The purpose of this study was to determine changes in two tests of lower limb isometric posterior chain force (IPC-F) following 90 min of match-play in elite youth soccer players and the interaction between relative strength and recovery profile. 14 players (age: 16 ± 2 years) performed 3 × 3 second IPC-F tests unilaterally at 30° and 90° of knee and hip flexion pre- and post-match, +24 h, +48 h, and +72 h post-match. Peak force was recorded for both limbs, combined and expressed relative to bodyweight (N/kg). A two-way repeated measures analysis of variance was performed to determine differences in force output between joint angles, time intervals and subjects. As there was no interaction between angle and time (p = 0.260), we report the change between timepoints as mean ∆ in 90° + 30° IPC-F. Relative to pre-match IPC-F, there were significant decreases post (∆ = −18%; p > 0.001) and at +24 h (∆ = −8%; p = 0.040), no significant difference at +48 h (∆ = 0%; p = 0.992) and a significant increase at +72 h (∆ = +12%; p = 0.005). There was a large inter-individual variability in recovery profile at both angles and substantial differences between post-match deficits at 90° (−10.8%) compared to 30° (−20.7%). Higher pre-match IPC-F was correlated with the magnitude of IPC-F deficits at both angles and all time points (r = 0.56 to 0.70, p = < 0.01) except for post-match 90°. Regular IPC-F monitoring to determine the magnitude of match-induced fatigue and track recovery may help inform decision-making regarding modifications to individual players training load, particularly as there is a large inter-individual variability in response to competition. Further research is warranted to better understand and address the finding that stronger players showed larger force deficits and slower recovery following match-play.