TY - JOUR T1 - Additional perspectives on ‘ACL rupture is a single leg injury but a double leg problem…’ JF - British Journal of Sports Medicine JO - Br J Sports Med SP - 993 LP - 995 DO - 10.1136/bjsports-2017-098974 VL - 53 IS - 16 AU - Anna Trulsson Y1 - 2019/08/01 UR - http://bjsm.bmj.com/content/53/16/993.abstract N2 - Additional perspectives on Commentary bjsports-2017-098502: ‘ACL rupture is a single leg injury but a double leg problem: too much focus on “symmetry” alone and that’s not enough!’1 In the Commentary ‘ACL rupture is a single leg injury but a double leg problem…’, the authors argue that measurements of limb symmetry underestimate deficits. I mainly agree with the authors, but reason for when and how symmetry measurements should be used and also for the use of versatile test batteries. To choose adequate functional tests in the clinic and to design new test-batteries and rehabilitation programmes for individuals with ACL injury, I propose to look for answers and solutions in the extensive literature on motor control. Therefore, basics of motor control are recapitulated.No consensus exists on how to decide when to return to sports.2 Often, strength and hop tests are used, calculating an LSI (the ratio of injured/non-injured sides), and LSI >90% is frequently suggested as a cut-off criteria.3 However, individuals with ACL reconstruction rarely reach 90% symmetry.4 Moreover, impaired capacity on both sides after ACL injury is well known, underestimating deficits measured as LSI. Therefore, measurements of preinjury capacity or normative data of non-injured controls have been suggested, since they may be more sensitive in predicting second ACL injuries.5 Therefore, to meet the concerns of the double leg problem I argue for that when LSI is used, it should be interpreted in combination with applicable normative data of controls or … ER -