In this article, I explain how we approach ACL rehab for hockey players including the 5 phases based on the Melbourne ACL guide.
An ACL reconstruction is a significant hurdle for any athlete, and field hockey players are no exception. The sport's dynamic movements, quick changes of direction, and demanding agility require a robust and carefully managed rehabilitation process. While surgery is a crucial first step, the journey back to the pitch is long and requires a structured approach. That's where the 5-phase model comes into play, guiding athletes from post-op recovery to full-fledged competition. This model, focusing on Rebuild, Reactivate, Restore, Return, and Retain , ensures a gradual and safe progression, minimizing the risk of re-injury and maximizing long-term performance in field hockey. VIDEO 1. Rebuild (Weeks 0-6): Laying the Foundation for Recovery This initial phase prioritizes minimizing pain and swelling, protecting the surgical graft, and initiating basic movement. Key objectives include: Controlling Inflammation: Ice, compression, and elevation are vital.Restoring Range of Motion: Gentle exercises to regain knee flexion and extension.Activating Muscles: Isometric exercises to engage the quadriceps and hamstrings.Weight Bearing Progression: Gradually increasing weight bearing as tolerated.Focus on very basic movements, and keeping the knee stable. This phase is about establishing a solid foundation for the subsequent stages. 2. Reactivate (Weeks 6-12): Building Strength and Stability for Field Hockey The reactivity phase focuses on increasing strength and stability in the knee joint, crucial for the demands of field hockey. Key objectives include: Progressive Strength Training: Introducing resistance exercises like squats, lunges, and leg presses.Neuromuscular Control: Exercises to improve balance and proprioception (awareness of joint position). This is very important for the quick changes of direction required in field hockey.Cardiovascular Fitness: Low-impact activities like cycling or swimming.Begin to restore normal walking and light jogging patterns. The goal is to prepare the knee for the dynamic demands of field hockey's running, tackling, and pivoting. 3. Restore (Weeks 12-24): Functional Movement and Sport-Specific Training for Field Hockey This phase bridges the gap between basic rehabilitation and sport-specific training. Key objectives include: Advanced Strength and Power Training: Plyometrics, agility drills, and sport-specific movements relevant to field hockey, such as side shuffles, cone drills, and jumping.Running and Agility Drills (Off-Pitch): Simulating running patterns, changes of direction, and tackling movements.Increased Intensity: Gradually increasing the intensity of exercises and drills.Introduction of very basic stick work, and controlled ball handling drills. The emphasis is on restoring functional movement patterns and preparing the athlete for the specific demands of field hockey. 4. Return (Weeks 24+): On-Pitch Integration and Skill Development This phase marks the return to the pitch, but it's a gradual and carefully monitored process. Key objectives include: Individualized On-Pitch Program: Starting with basic running and agility drills, progressing to more complex movements with the stick and ball.Skill Development: Practicing passing, shooting, dribbling, and tackling.Controlled Contact Drills: Gradually introducing contact and physical play.Game Simulations: Replicating game situations with increasing intensity.Return to Play is based on passing very specific functional testing. This phase focuses on reintegrating the athlete into the team environment and refining their skills. 5. Retain (Ongoing): Long-Term Performance and Injury Prevention This final phase focuses on maintaining fitness, preventing re-injury, and optimizing long-term performance. Key objectives include: Continued Strength and Conditioning: Regular strength training, agility drills, and cardiovascular exercise.Injury Prevention Strategies: Incorporating proprioceptive exercises, flexibility training, and proper warm-up and cool-down routines.Monitoring and Maintenance: Regular check-ups with the medical team and ongoing assessment of knee function.Proper load management during training and competition. This phase emphasizes the importance of ongoing commitment to fitness and injury prevention to ensure a long and successful career in field hockey.
