Beware of the ‘moving target’ – uninvolved limb strength increases to exceed pre-operative values during rehabilitation after ACL reconstruction in male professional and recreational athletes

Key Points

1. Strength trajectories in the uninvolved limb after anterior cruciate ligament reconstruction (ACLR) differs in professional and recreational athletes.

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BACKGROUND & OBJECTIVE

Criterion for return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) often includes symmetrical quadriceps and hamstrings strength between the involved and uninvolved limb measured using the limb symmetry index (LSI) (1). However, there is inconsistent evidence on how strength changes in the uninvolved limb during rehabilitation and whether the uninvolved limb provides an accurate comparison for strength deficits.

Therefore, this study’s objective was to follow the quadriceps and hamstrings strength of the uninvolved limb during rehabilitation in professional and recreational male athletes after ACLR and to compare the uninvolved limb’s strength to pre-operative levels.

Criterion for return to sport after anterior cruciate ligament reconstruction often includes symmetrical quadriceps and hamstrings strength between the involved and uninvolved limb measured using the limb symmetry index.

Monitoring strength closely after ACLR through a variety of measures (dynamometer, 3-rep max testing etc.) will allow us to tailor our rehabilitation if we are not making ideal strength gains.

METHODS

• This is a prospective longitudinal study from the Aspetar ACL register. Participants included all had ACLR, were male, between the ages of 15-55 years, active (≥ 5 on the Tegner Activity Scale), had no current or previous contralateral knee injury.

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