Return to Sport Following Anterior Cruciate Ligament Reconstruction: Women's Soccer

Authors

  • Lenore Herget DPT, SCS, MEd, CSCS Massachusetts General Hospital Sports Physical Therapy, Boston, Massachusetts USA

DOI:

https://doi.org/10.53646/jwsm.v2i2.27

Keywords:

soccer, ACL, reconstruction, rehabilitation, protocol, female, athlete

Abstract

Soccer is largely recognized as the most popular sport in the world. It involves speed, agility and endurance, requiring its athletes to sprint, explode to the ball, change direction and maintain high thresholds of work for prolonged periods. In the United States, as many as 80,000 high school female athletes experience ACL injuries each year. Females tend to be more at risk for ACL injury for a multitude of reasons including biomechanical, neuromuscular activation patterns, strength imbalances and hormonal factors. Athletes and their families are becoming increasingly aware of this risk and the subsequent risk of not returning to their pre-injury level of play; thus, necessitating both preventative and post injury rehabilitation programs aimed at maximizing function and minimizing subsequent injury. A program that focuses on neuromuscular activation patterns, proprioception and balance training, functional strength, agility, landing techniques and quality of footwork is best for mitigating risk of ACL injuries in female soccer players. This post-surgical ACL reconstruction rehabilitation program for the female soccer player has been divided into five phases, each phase a progression and building upon its preceding phase. The phases range from early post-operative care to late stage, pre-clearance to return to sport guidance and have been constructed based on evidence informed guidelines focusing on maximizing function post operatively in a safe, efficient manner while minimizing risk for re-injury.

References

Mancini SL, Dickin C, Hankemeier DA, Rolston L, Wang H. Risk of Anterior Cruciate Ligament Injury in Female Soccer Athletes: A Review. Journal of Orthopedics and Orthopedic Surgery. 2021;2(1):13-21. doi:10.29245/2767-5130/2021/1.1128

Women’s Football Member Associations Survey Report. (2019).

Herzog MM, Marshall SW, Lund JL, Pate V, Mack CD, Spang JT. Incidence of Anterior Cruciate Ligament Reconstruction Among Adolescent Females in the United States, 2002 Through 2014. JAMA Pediatr. 2017;171(8):808-810. doi:10.1001/jamapediatrics.2017.0740

Fernandez WG, Yard EE, Comstock RD. Epidemiology of lower extremity injuries among U.S. high school athletes. Acad Emerg Med. 2007;14(7):641-645. doi:10.1197/j.aem.2007.03.1354

Silvers-Granelli H. Why Female Athletes Injure Their ACL’s More Frequently? What can we do to mitigate their risk? International Journal of Sports Physical Therapy. 2021;16(4). doi:10.26603/001c.25467

Gupta AS, Pierpoint LA, Comstock RD, Saper MG. Sex-Based Differences in Anterior Cruciate Ligament Injuries Among United States High School Soccer Players: An Epidemiological Study. Orthopaedic Journal of Sports Medicine. 2020;8(5):232596712091917. doi:10.1177/2325967120919178

DiStefano LJ, Dann CL, Chang CJ, et al. The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls’ Soccer (2005–2006 Through 2013–2014) and National Collegiate Athletic Association Women’s Soccer (2004–2005 Through 2013–2014). Journal of Athletic Training. 2018;53(9):880-892. doi:10.4085/1062-6050-156-17

Allen MM, Pareek A, Krych AJ, et al. Are Female Soccer Players at an Increased Risk of Second Anterior Cruciate Ligament Injury Compared With Their Athletic Peers? The American Journal of Sports Medicine. 2016;44(10):2492-2498. doi:10.1177/0363546516648439

Nagelli C v, Hewett TE. Should Return to Sport be Delayed Until 2 Years After Anterior Cruciate Ligament Reconstruction? Biological and Functional Considerations. Sports Med. 2017;47(2):221-232. doi:10.1007/s40279-016-0584-z

Lucarno S, Zago M, Buckthorpe M, et al. Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Female Soccer Players. The American Journal of Sports Medicine. 2021;49(7):1794-1802. doi:10.1177/03635465211008169

Yanguas Leyes J, Til Pérez L, Cortés de Olano C. Lesión del ligamento cruzado anterior en fútbol femenino. Estudio epidemiológico de tres temporadas. Apunts Medicina de l’Esport. 2011;46(171):137-143. doi:10.1016/j.apunts.2011.02.006

Renstrom P, Ljungqvist A, Arendt E, et al. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med. 2008;42(6):394-412. doi:10.1136/bjsm.2008.048934

Mancini SL, Dickin C, Hankemeier DA, Rolston L, Wang H. Risk of Anterior Cruciate Ligament Injury in Female Soccer Athletes: A Review. Journal of Orthopedics and Orthopedic Surgery. 2021;2(1):13-21. doi:10.29245/2767-5130/2021/1.1128

Joseph AM, Collins CL, Henke NM, Yard EE, Fields SK, Comstock RD. A multisport epidemiologic comparison of anterior cruciate ligament injuries in high school athletics. J Athl Train. 48(6):810-817. doi:10.4085/1062-6050-48.6.03

Agel J, Arendt EA, Bershadsky B. Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: a 13-year review. Am J Sports Med. 2005;33(4):524-530. doi:10.1177/0363546504269937

Giza E, Mithofer K. Injuries in women’s professional soccer. British Journal of Sports Medicine. 2005;39:212-216.

Montalvo AM, Schneider DK, Yut L, et al. “What’s my risk of sustaining an ACL injury while playing sports?” A systematic review with meta-analysis. Br J Sports Med. 2019;53(16):1003-1012. doi:10.1136/bjsports-2016-096274

Mancini SL, Dickin C, Hankemeier DA, Rolston L, Wang H. Risk of Anterior Cruciate Ligament Injury in Female Soccer Athletes: A Review. Journal of Orthopedics and Orthopedic Surgery. 2021;2(1):13-21. doi:10.29245/2767-5130/2021/1.1128

Devana SK, Solorzano C, Nwachukwu B, Jones KJ. Disparities in ACL Reconstruction: the Influence of Gender and Race on Incidence, Treatment, and Outcomes. Curr Rev Musculoskelet Med. 2022;15(1):1-9. doi:10.1007/s12178-021-09736-1

Parsons JL, Coen SE, Bekker S. Anterior cruciate ligament injury: towards a gendered environmental approach. Br J Sports Med. 2021;55(17):984-990. doi:10.1136/bjsports-2020-103173

Smith HC, Vacek P, Johnson RJ, et al. Risk factors for anterior cruciate ligament injury: a review of the literature - part 1: neuromuscular and anatomic risk. Sports Health. 2012;4(1):69-78. doi:10.1177/1941738111428281

Slauterbeck JR, Fuzie SF, Smith MP, et al. The Menstrual Cycle, Sex Hormones, and Anterior Cruciate Ligament Injury. J Athl Train. 2002;37(3):275-278.

Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Train. 1999;34(2):86-92.

Ford KR, Myer GD, Smith RL, Vianello RM, Seiwert SL, Hewett TE. A comparison of dynamic coronal plane excursion between matched male and female athletes when performing single leg landings. Clin Biomech (Bristol, Avon). 2006;21(1):33-40. doi:10.1016/j.clinbiomech.2005.08.010

Sigward SM, Pollard CD, Powers CM. The influence of sex and maturation on landing biomechanics: implications for anterior cruciate ligament injury. Scand J Med Sci Sports. 2012;22(4):502-509. doi:10.1111/j.1600-0838.2010.01254.x

Lew A, Haratian A. Gender Differences in Anterior Cruciate Ligament Injury: A Review of Risk Factors, Mechanisms, and Mitigation Strategies in the Female Athlete. Orthopaedics and Surgical Sports Medicine . 2021;4(1).

Mountcastle SB, Posner M, Kragh JF, Taylor DC. Gender Differences in Anterior Cruciate Ligament Injury vary with Activity. The American Journal of Sports Medicine. 2007;35(10):1635-1642. doi:10.1177/0363546507302917

Khayambashi K, Ghoddosi N, Straub RK, Powers CM. Hip Muscle Strength Predicts Noncontact Anterior Cruciate Ligament Injury in Male and Female Athletes. The American Journal of Sports Medicine. 2016;44(2):355-361. doi:10.1177/0363546515616237

Beynnon BD, Vacek PM, Newell MK, et al. The Effects of Level of Competition, Sport, and Sex on the Incidence of First-Time Noncontact Anterior Cruciate Ligament Injury. The American Journal of Sports Medicine. 2014;42(8):1806-1812. doi:10.1177/0363546514540862

Brophy RH, Stepan JG, Silvers HJ, Mandelbaum BR. Defending Puts the Anterior Cruciate Ligament at Risk During Soccer. Sports Health: A Multidisciplinary Approach. 2015;7(3):244-249. doi:10.1177/1941738114535184

Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 42(2):311-319.

Monk AP, Davies LJ, Hopewell S, Harris K, Beard DJ, Price AJ. Surgical versus conservative interventions for treating anterior cruciate ligament injuries. Cochrane Database Syst Rev. 2016;4:CD011166. doi:10.1002/14651858.CD011166.pub2

Bizzini M, Hancock D, Impellizzeri F. Suggestions From the Field for Return to Sports Participation Following Anterior Cruciate Ligament Reconstruction: Soccer. Journal of Orthopaedic & Sports Physical Therapy. 2012;42(4):304-312. doi:10.2519/jospt.2012.4005

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Published

2022-08-30

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Articles

How to Cite

Return to Sport Following Anterior Cruciate Ligament Reconstruction: Women’s Soccer. (2022). Journal of Women’s Sports Medicine, 2(2), 70-82. https://doi.org/10.53646/jwsm.v2i2.27

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