ACL Rehabilitation: Norman's Story

Norman is a 30 year old male who sustained a right ACL rupture and is rehabilitating through a standard physiotherapy program after reconstructive surgery. Plantiga insoles alongside Plantiga’s standardized tests help measure Norman’s progress over the course of his program.

  • Walk Test - Norman aims to become mobile as soon as possible after his surgery, so to assess the progress of his first few week of rehabilitation, his walking speed and asymmetry are monitored consistently.

       >  Walking Speed - Immediately after rehabilitation, Norman exhibits an average
           walking speed of 0.4 m/s. Over time, he reaches a healthy walking speed of 1.0
           m/s (around 12 weeks post-op). By 17 weeks post-op, Norman’s walking speed
           normalizes around 1.2 m/s. 

       >  Walking Asymmetry - Immediately after rehabilitation, Norman exhibits a left
           asymmetry of 25%. By 12 weeks post-op, it decreases to be within a normal
           range, roughly 10% left asymmetric. By 20 weeks post-op, Norman’s

asymmetry is 0% and through his physiotherapy program, he has strengthened

his injured leg to the point where he is occasionally overcompensating,

resulting in a right asymmetry, still within the normal range.  

  • Run Test - Around 12 weeks post-op, Norman is presenting normal asymmetry and velocity ranges for walking, as well as good walking quality (lack of dynamic knee valgus, full knee extension, absence of patella-femoral pain). He can begin lightly jogging.

       >  Running Speed - Norman begins running at 4 m/s. Every few physiotherapy
           sessions, the the quality of Norman's running mechanics will be assessed
           before increasing the speed. By 20 weeks post-op, Norman is up to running at
           6 m/s. 

       >  Running Asymmetry - At 12 weeks post-op, when he had just started light
           jogging, Norman presented a left asymmetry of 18%. By 17 weeks post op,
           Norman has decreased his left asymmetry to be within a normal range of
           roughly 10%. 

  • Consecutive Countermovement Jump (CCMJ) Test - Norman’s strength is progressing well, and he is showing very good mechanics in all of his physiotherapy exercises. He can begin two legged jumps at roughly 12 weeks post-op.

       >  CCMJ RSI - Norman begins his jump tests with a reactive strength index (RSI)

of 0.3. By 19 weeks post-op, Norman has increased his CCMJ RSI to 0.6 and is
           showing good jumping mechanics. Due to this increase in RSI alongside

proper jumping mechanics, he is ready to add single leg jumps to his

rehabilitation program. By 24 weeks post op, Norman has increased to an RSI

of 0.8, a value within 10% of his baseline RSI, indicating that if he is showing

good mechanics in his single leg jumps, he is ready to begin gradual return to

play. 

       >  CCMJ Asymmetry - Norman begins jumping with a 20% left asymmetry. By 20
           weeks post-op, he has decreased his asymmetry to roughly 14%, and by 24
           weeks post-op he is back into the normal asymmetry range of less than 10%. 

Summary:

After 24 weeks of rehabilitation, Norman is close to his baselines and he can begin the return to play process. With Plantiga’s objective measurements and a tailored rehabilitation program, Norman is confident in the final stages of his ACL rehab and has the peace of mind that he is not at risk of re-injury when returning to sport.