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Returning to Basketball After an ACL Tear

returning to basketball post-acl tear
By Fara Rosenzweig

It’s a scenario we have all seen in sports. The star player is driving down the lane and jump stops, he fakes out his defender and is about to go up for a shot. It’s a move he has done countless times before, but this time, his knee isn’t ready. There’s a loud pop and the crowd is silent as they watch the star player fall to the floor, clutching his knee in pain. He tears his Anterior Cruciate Ligament (ACL) and unfortunately, like so many athletes each year, he will be out for the rest of the season.

ACL injuries are common in high-impact sports, like basketball, where athletes do a lot of cutting, jumping, and pivoting. While recovering from an ACL injury is a long, grueling process, with surgery, sound medical treatment, and aggressive rehabilitation, many basketball players are able to return to their sport.

The ACL connects the thighbone to the shinbone and provides stability in the knee for front-to-back movements. This ligament is essential in sports like basketball where athletes cut, jump, and complete change-of-direction moves. When an athlete tears his ACL, he must undergo reconstructive surgery to repair the ligament. Surgery is generally done a few weeks after the injury, once the initial swelling and pain have subsided. Many doctors recommend that high-level athletes do prehab (pre-surgery rehabilitation) with a licensed physical therapist, to strengthen the knee and supporting muscles before the operation.

The torn ligament is replaced with a graft; generally taken from the patellar tendon, hamstring tendon, or a cadaver tendon. Once the athlete’s doctor clears him, when pain and swelling are reduced, he may begin physical therapy. The rehabilitation process can take anywhere from six to 12 months. In the initial three to four weeks, the physical therapist will focus on restoring range of motion, with the goal of full extension (straight leg) and flexion (90-degree bend), and balance.

When an athlete has regained mobility in his knee, he can begin strength-training exercises. The physical therapist will use the stationary bike and stair climber to help the athlete build strength in his knee and the supporting muscles.

Once the athlete has regained his strength (at about three to four months), he can begin sport-specific training. Since basketball is a dynamic, high-impact sport, this phase should consist of functional movements like running, jumping, and cutting that will allow the athlete return to basketball. This process should include cardio-conditioning drills, ball-handling drills, and free throw shooting.

Although every individual is different, an athlete can expect to be back at practice about eight to nine months after surgery. According to Sports Injury Clinic, players should be restricted to practice situations and drills before returning to competitive practice. Keep in mind that the effects of an ACL injury aren’t only physical, but also mental. An athlete may have less confidence or be more timid when he returns to the court, a gradual but aggressive physical therapy plan can help an athlete rebuild both his mental and physical capacities. In addition to conditioning, warming-up and strengthening exercises to reduce the risk of re-injury, doctors and physical therapists also recommend that athletes wear an ACL brace to help stabilize the knee.

What do NBA players like Derrick Rose, Corey Brewer and Jamal Crawford have in common? They have all come back from ACL injuries, in fact according to emedicinehealth, the success rate for the surgical reconstruction of an ACL injury is between 75 and 95 percent. While it’s a season-ending injury that can be devastating to teams and players, with proper treatment and rehabilitation an ACL tear does not have to be a career-ending injury.