The Tokyo 2020 Summer Olympics is finally here, after being postponed for a year. Although strict measures are required throughout the whole tournament, we can anticipate exciting performances from athletes from different nations across the 46 disciplines. It is already very exciting as we see young athletes emerging from the Covid-19 bubble and performing at their level best.

One of our favourite game is Badminton, and we noticed that world ranking no 1 player – Sayaka Hirota – was spotted with heavy knee braces on her right knee. After some research, we found out that she sustained an injury to her Anterior Cruciate Ligament (ACL) during a training camp in June. Her condition is not 100% fit after her injury, but she is moving quite well around the court. She mentioned that she did rehabilitation to her knee after her injury, and she is able to play now.

This is common among many athletes, not just Badminton players. But the question is: can you still play with an ACL injury?

What is the ACL

The ACL is one of the key ligaments that help stabilize your knee joint. It connects your thigh bone (femur) to your shin bone (tibia). The 2 main functions of the ACL are to: It prevents your tibia from sliding out of your femur and provides rotational stability to the knee. The ACL is especially crucial in sports where sudden quick changes in movement and direction is needed. For example: Basketball, Football and Volleyball.

What can you do about it?

First of all, we cannot stress more about the importance of going through knee rehabilitation after an ACL injury. Your therapist will walk you through the stages of rehabilitation, which will depend on the severity of your injury. As a general guide:

First stage: Reducing pain and swelling, protecting the knee from further injuries
Second stage: Progressive knee range of motion exercises, strengthening of key muscles of the lower extremity
Third stage: Progressive strengthening of the muscles of the lower extremity, preparing for functional training
Fourth stage: Functional training specific to sports and movement needs

It is important to note that there are no clear lines seperating the stages, as the needs of rehabilitation changes as we progress. For example, progressive strengthening of the muscles will still be done in the fourth stage, and functional training can be introduced early on before the fourth stage.

Can I return to my sports after an ACL injury?

ACL injuries are differentiated by their severity and subsequently, will determine whether it will be managed non-operatively or operatively.

Nonoperative treatment is typically reserved for those with low functional demands, type and severity of ACL tear, time of injury, and subsequent assessment. Continued monitoring and treatment by an orthopedist and physical therapist is necessary and will only improve their functional status and stability post-injury. Of note, about half of the patients who initially choose the non-operative pathway will later choose to undergo surgical repair. (Evans, 2021)

Athletes and individuals who are younger and more active tend to opt for surgical repair and reconstruction. Other surgical repair/reconstruction candidates are those with significant instability of the knee and/or multiple knee structures injured.

In a recent systematic review, 81% of those involved treated with ACL reconstruction returned to some athletic activity, 65% returned to the preinjury level of competition, and 55% of high-level athletes returned to normal play and competition. Although, it has been reported that of those who undergo surgical repair, overall 90% return to near-normal functioning. (Evans, 2021)

Therefore the decision to return to pre-injury levels depends on the type, severity, subsequent assessments, and physical therapy.

If you are unsure about your knee pain, feel free to reach out to us and we are more than happy to discuss more with you!