ACL Return to Sport Testing: What Your PT Should Look at Before Clearing You to Return to Sport

by Nikki Patel, PT, DPT, MS, LAT, ATC

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Target Audience: athletes, coaches, parents

ACL rehabs are typically a long and grueling process that require a lot of hard work, dedication and effort to make sure your athletes are rehabbed to their optimal performance. Coaches/parents are one of the first gatekeepers to seeing these athletes once they return to sport and are discharged from physical therapy. This is especially true if the team these athletes play for doesn’t have an Athletic Trainer on staff.

The purpose of this article is to educate athletes, coaches and parents on the specific return-to-sport testing all physical therapists should complete before they return a post-op ACL athlete back to sport. I’ll also review the secondary measures that I use to assess athletic performance and reinforce my decision as a Physical Therapist when returning my athletes back to sport.

Based on updated literature, the primary return to sport criteria that an athlete must reach to safely play includes:

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Secondary measures are often performed to promote injury prevention, decrease the risk of re-injury and train the athlete to meet the demands of sport, especially if they did not participate in pre-season training with their team. The performance of these tests is not mandatory to actually return an athlete to sport, but are very useful to help determine readiness for return to sport.

Secondary measurements I personally like to look at include:

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To conclude, the health of an athlete should always follow a “checks and balances” system where healthcare workers, athletes, coaches, and parents are working together to make sure any athlete returning to sport is doing so in a safe manner. This involves being transparent with what physical therapists and athletic trainers should be looking at in order to objectively determine an athlete’s readiness to go back to sport. By being transparent, hopefully athletes, coaches and parents can be more aware of what to expect in regard to testing from their PT/ATC.

The video below contains a demonstration of ACL Return to Sport Testing.

If you have additional questions, please feel free to reach out for a consultation with a licensed physical therapist at Evolution Physical Therapy. You can find a full list of our locations here, or you can also explore more of our content around ACL injury prevention or rehabilitation, including ACL Injury Prevention for the Soccer Player and What to Do if You Tear Your ACL.

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