Neuromuscular rehabilitation of a female Olympic ice hockey player following anterior cruciate ligament reconstruction
by
Tyler TF, McHugh MP.
—
last modified
2009-10-09 15:16
J Orthop Sports Phys Ther. 2001 Oct;31(10):577-87.
STUDY DESIGN: Case study. OBJECTIVE: To demonstrate the unique aspects of
rehabilitating a female athlete participating in ice hockey following anterior
cruciate ligament (ACL) reconstruction. BACKGROUND: The patient was a 28-year-old
female who sustained a traumatic injury to her left knee while playing ice
hockey. After 6 weeks of rehabilitation (15 visits), the athlete elected to
undergo ACL reconstruction following buckling episodes that she experienced
during both skating and walking. METHODS AND MEASURES: Following ACL
reconstruction using a patellar tendon autograft, the patient was treated for 6
months in 44 visits. Initial treatments consisted of effusion management,
neuromuscular control of lower extremity muscles, and regaining passive range of
motion, especially extension. Although instability testing revealed a negative
pivot shift and a 2-millimeter side-to-side difference on KT-1000 examination,
the patient reported a sensation of buckling when she attempted skating at 4
months (27 visits) following ACL reconstruction. Off-ice strength and functional
testing of the lower extremity did not demonstrate deficits. At that time, a
specific neuromuscular program for returning a patient to ice hockey was
implemented. RESULTS: Following 17 physical therapy visits, which combined
sport-specific and sex-specific neuromuscular rehabilitation, the patient was
able to return to competitive ice hockey. Six months following ACL
reconstruction, the patient reported no feeling of instability during skating.
The patient reported a Lysholm score of 100 and Tegner activity score of 9. An
on-ice functional test revealed the athlete's score was 80% of her pre-injury
score. CONCLUSIONS: Failure of static knee stabilizers can be a cause of
instability. Following ACL reconstruction, a neuromuscular rehabilitation program
may prevent residual knee instability once the static stabilizers have been
restored. A sport-specific neuromuscular rehabilitation program for the athlete
participating in ice hockey should be considered.