How Far Have Physical Therapists Come on Anterior Cruciate Ligament Issues?

If you are wondering about collegiate sport injuries, the National Collegiate Athletic Association collects injury data through its Injury Surveillance System.  I believe the most current report on injuries is from 2007.  I was actually quite surprised by the data in Figure 4.  Anterior cruciate ligament (ACL) injuries get all the press, but ankle ligament injuries are quite a bit more prevalent.  Anyways, the topic this time is ACL injuries.

What do we know about ACL injury prevention?  Better yet, how often are preventative strategies incorporated within sporting programs (whether the local sport and recreation organization, middle school, high school, collegiate, competitive traveling teams)?  Is there any data on whether it matters if athletes playing the same sport all year round or whether athletes playing different sports concurrently have an effect on ACL injuries?

Once an injury happens, what happens next?  Surgery or no surgery?  As with subgrouping people with back pain, it is becoming apparent the same can be said for people who have had an ACL injury.  Personally, I have just a tad bit of confusion around copers and noncopers.  I mean, if some noncopers are really copers, then that means there might be the potential for unnecessary surgical intervention, right?  And the idea of "adapters" really muddies the water for me!  I will assume there is something available to assist in the decision-making process to help choose the best clinical path in return to the highest level of function.

No matter which route is taken by the injured person, physical therapy services will be warranted to help the person move through the process from being unable to participate fully in life to enjoying life again.  At some point though, a decision needs to be made as to whether the person is ready for sport or not.  What evidence is out there to assist in determining readiness to play?

On February 18 from 10:30-2 pm there is an awesome group presenting on "ACL injury - Multidisciplinary Approach to Prevention, Treatment & Assessment of Outcomes in 2010."  The listed presenters are: G. Kelley Fitzgerald, PT, Freddie Fu, MD, Douglas Robertson, MD, Timothy Hewett, PhD, Christopher Harner, MD, Sandra Shultz, ATC, James Irrgang, PT, Richard Joreitz, PT, Lynn Snyder-Mackler, PT, and Kevin Wilk, PT.

photo by toddsmithdesign via Flickr

~Selena