Anterior cruciate ligament (ACL) injuries are a hot topic again after RG III underwent reconstruction. And this is his 2nd reconstruction in the last 4 years. While some researchers suggest that a primary ACL reconstruction will not increase a risk of second injury, studies have suggested that there may be an increased risk of re-injuring the same knee or injuring the other knee in up to 20% of those who have undergone a first reconstruction. This means that it is very important for athletes and health care providers to not only rehabilitate the reconstructed knee but also to minimize a risk of another ACL injury after returning to sports. We know from past studies that there are predisposing risk factors including muscle imbalance, poor biomechanics of high risk movement patterns, decreased neuromuscular control, etc. The same approach can be used to prevent a secondary ACL injury. However, a recent study suggests that asymmetries between a reconstructed knee and healthy knee are the key factors to prevent an ACL injury after reconstruction. Especially after a surgery, it is not rare that the athlete presents decreased muscle strength compared to the other healthy knee mostly in quads. Some athletes may have decreased range of motion. When returning to sports, it is very important that the athlete has optimal symmetries in muscle strength and balance, neuromuscular control, biomechanics of trunk and lower extremities, in addition to minimizing other risk factors.
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