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Vol. 56. Issue 212.
(October - December 2021)
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Vol. 56. Issue 212.
(October - December 2021)
Special article
Return-to-sport following anterior cruciate ligament reconstruction in team sport athletes. Part I: From initial injury to return-to-competition
Azahara Fort-Vanmeerhaeghea,b,
Corresponding author

Corresponding author at: Faculty of Psychology, Education Sciences and Sport (FPCEE) Blanquerna, Ramon Llull University, c/ Císter, 34, 08022 Barcelona, Spain.
, Jordi Arboix-Alióa, Alicia M. Montalvoc
a Ramon Llull University, FPCEE and FCS Blanquerna, Department of Sport Sciences, Barcelona, Spain
b Segle XXI Female Basketball Team, Catalan Federation of Basketball, Esplugues de Llobregat, Spain
c College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Tables (2)
Table 1. Relationship between the main modifiable risk factors for non-contact ACL injury and their associated corrective neuromuscular training strategies.
Table 2. Return to sport proposal centered on layup in basketball and based on “approaching levels”. The table shows examples tasks to improve strength and neuromuscular control during a lay-up with contact in basketball using “approaching levels”. The table shows a progression in specificity of tasks emphasizing three basic areas or fundamental motor skills (Linear displacement, single-leg jump and fight) for specific development of a lay-up with contact in basketball (Specific motor skill) (Video 1).
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Additional material (1)

There is a high incidence of non-contact anterior cruciate ligament (ACL) injury in team sports, especially among adolescent females. This injury is associated with an increased risk of developing osteoarthritis later in life and a decrease in lifetime physical activity. Traditionally, return-to-sport (RTS) programs following ACL injury have focused on restoring the athlete's general health and tissue healing. We will propose a framework that views RTS as a two-part process: first, recovery of general health after ACL reconstruction (ACL-R) (rehabilitation) and then return to competition (RTC) after ACL-R, all of which occurs on a continuum. The objective of Part I is to stablish the foundation to propose an evidence- and experience-based guide on RTS following ACL reconstruction in athletes participating in team sports, specifically for later phases. First, we describe the causes of and risk factors associated with ACL injury. Next, we describe the specific characteristics of team sports that predispose athletes to ACL injury. Finally, we present a progressive framework to successfully return athletes to a pre-injury level of competition that also minimizes risk of reinjury. In Part II we will focus on how to put the proposed framework into practice when return team sport athletes to play following ACL-R.

Return to play
Sports injuries
Structured training


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