The Warrior Athlete Part 2—Return to Duty in the US Military: Advancing ACL Rehabilitation in the Tactical Athlete. Issue 3 (September 2019)

• Record Type: Journal Article
• Authors: Peebles, Liam A.; O'Brien, Luke T.; Dekker, Travis J.; Kennedy, Mitchell I.; Akamefula, Ramesses; Provencher, Matthew T.
• Is Part Of: Sports medicine and arthroscopy review. Volume 27:Issue 3(2019)
• Publication Date: 2019-09
• Subjects: anterior cruciate ligament -- return to duty -- closed kinetic chain -- open kinetic chain -- blood flow restriction -- inertial measurement units; Sports medicine -- Periodicals; Arthroscopy -- Periodicals; 617.1027
• DOI: 10.1097/JSA.0000000000000237
• Languages: English
• ISSNs: 1062-8592

Abstract

Abstract : Rehabilitation following an anterior cruciate ligament reconstruction is a crucial component of the healing and recovery process and full return to duty/play in the tactical modern-day warfighter. The burden of anterior cruciate ligament injuries and subsequent loss of readiness in these military warfighters highlights one of the most significant gaps in musculoskeletal injury care today. Emphasis must be placed on early weight-bearing and range of motion (ROM), namely in this athlete population, to best facilitate a timely care and recovery process. Preoperative rehabilitation should commence immediately following the diagnosis of an anterior cruciate ligament tear, because one of the best predictors of postoperative ROM is preoperative ROM. Recent advances in rehabilitation technology such as Alter-G treadmills, inertial measurement units, and blood flow restriction therapy systems, have demonstrated success in the early rehabilitation of tactical athletes. Alter-G treadmills allow for early weight-bearing with reduced impact and progression in ROM following operative management, while inertial measurement units have been applied to tailoring rehabilitation protocols specifically to an athlete's unique functional deficits. When used in conjunction with a fined tune rehabilitation protocol, implemented by a well versed clinical team, these treatment techniques can greatly expedite the return to duty process and limit long-term complications.