We welcome Michael O’Doherty of Chiropractic Moves to give us some wise words on how to return to sport after a serious knee injury…
So you’ve had a bad knee injury and you’ve been through the surgery and done some rehab, but how do we decide when it is time to go back to sport? It’s always been a tricky question to answer but we now have a few good tests to make this decision easier. What kind of tests should we use?
MRI, CT Scans and X-rays are very useful when diagnosing an initial injury but they really don’t offer much value when deciding whether an injury is healed. If you really want to know what will happen when your foot hits the field, when you have to make a sharp pivot to the right, or a jump to the left, then we have to put you through your paces. If you have runners knee, take a look at our runner’s knee recovery plan.
Functional Tests After a Knee Injury
For the case of knee surgery we tend to use functional tests. We get you to use your knee and see what it can do. There are a few of these tests around now which are quite useful to us, and we’ll use them in different ways. Some tests tell us when you’re ready for the next bit of rehab to begin and some are more useful for finalising things. By using a combination of these tests and using measuring your performance improvement over time we can get a pretty good idea of when you’re ready to go. Give support and relieve knee pain during everyday and sporting activities with our range of knee straps.
A few Weeks After Knee Injury
The best tests are functional, they make you work your knee in a controlled way so that we can see how it is performing. A few weeks after surgery once the swelling has gone down we want to see that you can put some weight through your knee. If you think you may have a knee injury but can’t quite pin point what is wrong, take a quick look on our guide to knee injuries.
Six Weeks After Knee Injury
Around 6 weeks we can take two bathroom scales and place them next to each other and have you perform a squat on them. If the weight measurement on each scale is about the same side to side then we can see that you are starting to use that knee properly again, but this is early stage stuff. You’re ready for some exercises, not the sports field.
Sixteen Weeks After Knee Injury
Around 16 week mark we might take some baseline readings, so we have something to compare to at the end of the rehab programme. Hopping tests are good here; a single leg hop for distance then a triple hop for distance, a 6m hop for time and a crossover hop where you jump back and forth over a midline can be scored and timed. This gives a really good idea of your control and your readiness for more weight bearing. A good performance in tests like these may get you back onto the training field, but not the adrenaline fuelled twists and turns of competition.
Final Tests
When we’re looking at getting you back into game form then we can step it up, these tests might include something like a 10 second series of tuck jumps. This test can be scored for leg position, foot landing position, and jumping technique. If these tests look good, and your hopping tests from 16 weeks have improved then we’re looking good for competition again.
But to sum up we can’t really know by looking or doing a scan that a knee is ready for sport. Your clinician may use a different combination of tests than those in this article but the take away message should be that the joint needs to be tested repetitively to be cleared for action.
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References
Phys Ther. 2007 Mar;87(3):337-49. Epub 2007 Feb 20. Hop testing provides a reliable and valid outcome measure during rehabilitation after anterior cruciate ligament reconstruction. Reid A, Birmingham TB, Stratford PW, Alcock GK, Giffin JR.
J Strength Cond Res. 2006 May;20(2):345-53. The effects of plyometric vs. dynamic stabilization and balance training on power, balance, and landing force in female athletes. Myer GD1, Ford KR, Brent JL, Hewett TE.
Author bio: Michael O’Doherty is a Doctor of Chiropractic at Chiropractic Moves, He’s dedicated to providing the most effective and up to date treatment techniques available in a friendly and relaxed environment and passionate about the role of chiropractic care in the management of sports injuries and optimising performance.