Physical preparation and return to performance of an elite female football player following ACL reconstruction: a journey to the FIFA Women's World Cup

Matt Taberner; Nicol van Dyk; Tom Allen; Neil Jain; Chris Richter; Barry Drust; Esteban Betancur; Daniel D Cohen

doi:10.1136/bmjsem-2020-000843

Physical preparation and return to performance of an elite female football player following ACL reconstruction: a journey to the FIFA Women's World Cup

BMJ Open Sport Exerc Med. 2020 Dec 1;6(1):e000843. doi: 10.1136/bmjsem-2020-000843. eCollection 2020.

Authors

Matt Taberner¹, Nicol van Dyk², Tom Allen³, Neil Jain⁴, Chris Richter^{5

6}, Barry Drust⁷, Esteban Betancur⁸, Daniel D Cohen^{8

9}

Affiliations

¹ School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
² High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.
³ Performance and Research Department, Arsenal Football Club, London, UK.
⁴ The Manchester Institute of Health and Performance, Manchester, UK.
⁵ Sports Surgery Clinic, Dublin, Ireland.
⁶ University of Roehampton, London, UK.
⁷ School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
⁸ Sports Science Center (CCD), Colombian Ministry of Sport (Mindeporte), Colombia.
⁹ Masira Research Institute, Universidad de Santander, Bucaramanga, Colombia.

Abstract

ACL injuries are among the most severe knee injuries in elite sport, with a high injury burden and re-injury risk. Despite extensive literature on the injury and the higher incidence of injury and re-injury in female athletes, there is limited evidence on the return to sport (RTS) of elite female football players following ACL reconstruction (ACLR). RTS is best viewed on a continuum aligning the recovery and rehabilitation process with the ultimate aim - a return to performance (RTP_erf). We outline the RTS and RTP_erf of an elite female football player following ACLR and her journey to the FIFA Women's World Cup, including the gym-based physical preparation and the on-pitch/sports-specific reconditioning. We used the 'control-chaos continuum' as a framework for RTS, guiding a return above pre-injury training load demands while considering the qualitative nature of movement in competition. We then implemented the 'RTP_erf pathway' to facilitate a return to team training, competitive match play and a RTP_erf. Objective information, clinical reasoning and shared decision-making contributed to this process and helped the player to reach her goal of representing her country at the FIFA Women's World Cup.

Keywords: ACL; Football; female; performance; rehabilitation.