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Alarming underutilisation of rehabilitation in athletes with anterior cruciate ligament reconstruction: four ways to change the game
  1. Hege Grindem1,
  2. Amelia JH Arundale2,
  3. Clare L Ardern2,3
  1. 1 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  2. 2 Division of Physiotherapy, Linköping University, Linköping, Sweden
  3. 3 Faculty of Health Sciences, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Hege Grindem, Norwegian School of Sport Sciences, Pb 4014,Ullevål Stadion, 0806 Oslo, Norway; hege.grindem{at}

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Alarming underutilisation of rehabilitation after ACL reconstruction (ACLR) was highlighted in a recent study.1 These Australian trends are not unique, but support the emerging realisation that athletes may be overtreated with ACLR surgery, but undertreated when it comes to rehabilitation. We use the term undertreated to describe insufficient rehabilitation—either because athletes are discharged too soon or because the rehabilitation content is inadequate.

Among non-elite athletes with ACLR, only 5% received rehabilitation1 that followed evidence-based guidelines2: ≥6 months’ rehabilitation, including agility and landing exercises, and a structured return to sport (RTS). Most athletes were undertreated: 45% (50 of 111) never saw a clinician after the third postoperative month and 70% (78 of 111) never did agility or landing exercises.1 When clinical practice does not follow evidence-based guidelines, we are not offering the best to our athletes.

Evidence-based rehabilitation restores function

Outcomes following ACLR are mainly dictated by the athlete, the rehabilitation clinician and the orthopaedic surgeon. And the rehabilitation clinician might be the central player in this trifecta.1 Almost a year …

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  • Contributors HG proposed the initial idea and wrote the first draft. All authors contributed equally to subsequent versions of the editorial and approved the submission of the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.