Reviewed by Tyler Tice, PT, DPT, OCS, ATC
Introduction/Background
The article introduces a four-stage plyometric training program as part of criterion-based rehabilitation for athletes post-ACLR. It emphasizes the importance of aligning plyometric tasks with the patient’s functional recovery status, considering factors like task intensity, momentum, ground contact time, and surface. The goal is to enhance neuromuscular function, movement quality, and reduce injury risk, facilitating a timely return to sport.
Post-ACLR, many athletes struggle to return to their previous performance levels and are at a heightened risk of re-injury. Deficits in neuromuscular performance, such as reduced strength and movement asymmetries, are common. Plyometric training involves rapid muscle lengthening followed by shortening, is highlighted as an effective method to improve explosive performance and neuromuscular control, surpassing traditional resistance training in some aspects.
This article aims to provide clinicians with a guideline on designing and implementing plyometric programs tailored to the ACLR patient’s recovery stage.
Methods
The program is divided into four stages, each aligned with specific phases of rehabilitation:
- Stage 1 (Mid-Stage Rehabilitation): Focuses on foundational movements with low intensity, emphasizing control and technique.
- Stage 2 (Late-Stage Rehabilitation): Introduces moderate-intensity exercises, incorporating more dynamic movements while maintain control.
- Stage 3 (Late-Stage Rehabilitation): Advances to higher-intensity plyometrics, emphasizing power and agility in preparation for sport-specific activities.
- Stage 4 (Return-to-Sport Training): Involves high-intensity, sport-specific plyometric exercises to simulate real-game scenarios, ensuring readiness for return to sport.
Each stage considers task intensity, movement complexity, and the athlete’s ability to perform exercises with proper technique. Progression through stages is based on meeting specific criteria, ensuring safety and effectiveness.
The article emphasizes the importance of continuous monitoring throughout the rehabilitation process. Clinicians should assess movement quality, control in both frontal and sagittal planes, and the athlete’s response to increasing exercise intensity. If an athlete cannot perform tasks with minimum competency, exercises should be simplified. Daily monitoring of pain, swelling, and soreness is recommended to guide progression and prevent setbacks.
Conclusion
Plyometric training is a crucial component of functional recovery post-ACLR. A structured, criterion-based approach ensures that exercises are matched to the athlete’s recovery status, promoting neuromuscular reconditioning and reducing the risk of re-injury. Clinicians are encouraged to integrate this four-stage program into rehabilitation protocols to optimize outcomes for ACLR patients.
References
Buckthorpe, M., and Della Villa, F. (2021). Recommendations for Plyometric Training after ACL reconstruction: A Clinical Commentary. International Journal of Sports Physical Therapy, 16(3), 879-895. https://doi.org/10.26603/001c.23549