Return to Sport Following Anterior Cruciate Ligament Reconstruction: Women’s Indoor Volleyball

Abstract

Women’s volleyball participation has increased over the past four decades resulting in a rise of sports-related injuries during practice and competition. Although volleyball is considered a non-contact sport, the sport requires jumping, landing, pivoting, directional changes, and digging which can lead to an anterior cruciate ligament (ACL) injury and reconstruction. There are limited studies on guidelines for safe return to volleyball competition after an ACL injury. A volleyball-specific functional rehabilitation program is critical for optimal return to sport following ACL reconstruction. A volleyball athlete must be trained and proficient in jumping and landing to serve, hit, and block as well as pivot, cut, and change direction on the court to retrieve balls or prepare a set. Proper landing mechanics from a jump become a crucial part of post-operative ACL rehabilitation to avoid re-injury and ensure safe return to competitive sport. A critical part of ACL rehabilitation is following a criteria-based approach exhibiting progressions in range of motion, mobility, strength, neuromuscular control, agility, and cardiovascular training. Incorporating volleyball-specific skills early in the athlete’s rehabilitation program allows re-training of important skills during a time when then athlete is removed from play. Volleyball-specific tasks can be integrated early in proprioceptive and neuromuscular training drills and eventually progressed towards more challenging court-based tasks as the athlete advances through the phases of their rehabilitation program. Collaboration and communication of a multidisciplinary team made up of physicians, physical therapist, athletic trainers, strength and conditioning specialists, coaches, and parents must work together to determine an athlete’s readiness for return to sport (RTS). It is important to take into consideration the athlete’s sport, risk of re-injury, demands of the sport, and their psychological readiness when facilitating RTS decisions.