Recommendations for hamstring function recovery after ACL reconstruction

Review written by Dr Teddy Willsey info

Key Points

  1. Early emphasis on quadriceps strengthening in ACL rehabilitation has potential to overshadow the need for hamstring strengthening.
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BACKGROUND & OBJECTIVE

Considerable deficits have been reported in hamstring function in the early post-operative period following anterior cruciate ligament (ACL) repair, as well as in the return to sport (RTS) period (1). Although hamstring strength deficits are larger in those with hamstring tendon autograft (HTG), they are still of high concern in those with patellar tendon autograft (PTG).

Early emphasis on quadriceps strengthening in ACL rehabilitation has potential to overshadow the need for concomitant hamstring strengthening. Deficits in knee flexion and hip extension strength can be detrimental to injury risk upon RTS, highlighting the need for a continual focus on the posterior chain during ACL rehabilitation (2).

The aim of this paper was to discuss important alterations of the hamstring muscles after ACL reconstruction (ACLR), consider their implications for program design, and guide clinicians on how to apply this information.

Considerable deficits have been reported in hamstring function in the early post-operative period following ACL repair.
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Hamstring strengthening during ACL rehabilitation should be periodized and carefully planned, exposing patients to increasing muscle lengths, intensities and velocities over time.

METHODS

The authors wrote a review article utilizing 217 papers on a variety of topics on ACLR, hamstring injury, and the lower extremity. The paper provided a sample template for ACLR rehab, an example of periodized progression through exercise prescription, and

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