![]() Acute fatigue is associated with temporary alterations in neuromuscular function including decrements in peak force, rate of force development (RFD), and decision-making ability 11,12. Similarly, accumulation of residual fatigue increases incidence during congested match periods 10. In relation to acute fatigue, time dependent increases in incidence are evident during match-play 9. We believe the CCC is an ideal model for on-pitch rehabilitation following ACLR, targeting potential modifiable risk factors for re-injury whilst building running loads and performance to pre-injury levels (or beyond).Įpidemiological evidence in elite football is highly suggestive of an association between fatigue and injury. WHY WE THINK THE CONTROL-CHAOS CONTINUUM FITS END-STAGE REHABILITATION AFTER ACLR This process can be informed by global positioning systems 7, combined with a gradual increase in qualitative characteristics of in-competition movement providing incremental perceptual and neurocognitive challenges 8. The CCC progresses from high control to high chaos, underpinned by sports-specific conditioning and the concept of returning players to retrospective (pre-injury) chronic running loads. We recently proposed the ‘control-chaos continuum’ (CCC Figure 1) 6, an adaptable RTS pathway developed for on-pitch rehabilitation in football. training loads that players have been used to performing pre-injury) are vital elements of the rehabilitation pathway but are suggested to be overlooked components of RTS criteria 2. Sports-specific physical preparation and return retrospective chronic loading (i.e. Even if this suggests completely safe return requires approximately two years, would this be implemented in team sports? However, there are limits to the influence of the performance/medical team’s objective data, clinical experience and literature evidence 4,5. However, risk management is key in the high-pressure environment of professional sport where team success is the goal but must be balanced with protecting the player’s health.The balance of risk : and benefit potentially represents competing interests which require shared decision-making between performance/medical team, player and coach/club. with minimal risk of re-injury) RTS may require up to two years following ACLR 5. Is it possible that current rehabilitation approaches fail to fully prepare athletes for the demands of their sport, hindering the success of a return to performance? No consensus exists regarding the optimal rehabilitation and re-injury riskremains high 3,4. ![]() – Written by Matt Taberner, Tom Allen, and Emma Constantine, UK and Daniel D Cohen, Colombiaĭespite the enhanced knowledge around rehabilitation and large body of research defining return to sport (RTS) criteria following anterior cruciate ligament (ACL) injuries 1 RTS following ACL reconstruction (ACLR) is a complex process 2. ![]() BUILDING A PATHWAY FOR RETURN TO PERFORMANCE FOLLOWING ACL RECONSTRUCTION
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