Citation

Capin JJ, Behrns W, Thatcher K, Arundale A, Smith AH, Snyder-Mackler L. J. Orthop. Sports Phys. Ther. 2017; 47(5): 324-333.

Affiliation

University of Delaware, Newark, DE.

Copyright

(Copyright © 2017, Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association)

DOI

10.2519/jospt.2017.7245

PMID

28355976

Abstract

Synopsis Limited literature exists pertaining to rehabilitation of ice hockey players seeking to return-to-sport after anterior cruciate ligament reconstruction (ACLR). The purpose of this clinical commentary is to present a criterion-based, return-to-ice hockey progression for athletes after ACLR. First, we review pertinent literature and provide previously published guidelines on general rehabilitation after ACLR. Then, we present a four-phase, on-ice skating progression with objective criteria to initiate each phase. During the early on-ice phase, the athlete is reintroduced to specific demands, including graded exposure to forward, backward, and crossover skating. In the intermediate on-ice phase, the emphasis shifts to developing power and introducing anticipated changes of direction within a controlled environment. During the late on-ice phase, the focus progresses to developing anaerobic endurance and introducing unanticipated changes of direction, but still without other players or contact. Finally, once objective return-to-sport criteria are met, non-contact team drills, outnumbered and even-numbered drills, practices, scrimmages, and games are progressively reintroduced during the return-to-sport phase. Recommendations for off-ice strength and conditioning exercises complement the on-ice progression. Additionally, we apply the return-to-hockey progression framework to a case report of a female collegiate defensive ice hockey player who returned to sport successfully after ACLR. This criterion-based return-to-hockey progression may guide rehabilitation specialists managing athletes returning to ice hockey after ACLR.

Language: en

Keywords

clinical practice guidelines; ice skating; knee; rehabilitation; return-to-sport