Pop! goes the anterior cruciate ligament. ACL tears are not a rare injury in the athletic world. As an athlete, if you haven’t suffered one yourself, you’re likely terrified of the dreaded ACL tear happening to you one day—and rightfully so. Tearing your ACL, having surgery, and working through the rehabilitation process is no easy venture.
流行音乐！前十字韧带消失。前十字韧带撕裂在体育界并不罕见。作为一名运动员，如果您自己没有遭受过这种情况，您可能会害怕有一天可怕的前十字韧带撕裂发生在您身上 - 这是理所当然的。撕裂 ACL、进行手术并完成康复过程并不是一件容易的事。
ACL rehabilitation is an all-encompassing process that takes over nearly every aspect of the injured athlete’s life for the year—and then some. So, why is there such a gap in the quality of rehab plans from physical therapists? Why are there such high ACL reinjury rates for athletes?
ACL 康复是一个包罗万象的过程，几乎涵盖了受伤运动员这一年生活的方方面面——甚至还有一些。那么，为什么物理治疗师的康复计划质量存在如此大的差距呢？为什么运动员的 ACL 再损伤率如此之高？
I tore my ACL in my early 20s during an indoor soccer game, playing on some pretty worn-out turf. Though I played in this adult soccer league for fun, we were losing, and I was frustrated about it—once an athlete, always an athlete. I went in for a sloppy tackle to get the ball, and after winning it, it was all downhill. I did it to myself.
我二十岁出头的时候，在一场室内足球比赛中，在相当破旧的草坪上踢球时，我的前交叉韧带撕裂了。虽然我参加这个成人足球联赛是为了好玩，但我们输了，我对此感到沮丧——曾经是一名运动员，永远是一名运动员。我为了拿到球而采取了一次草率的铲球，赢得球后，一切都在走下坡路。我对自己做的。
My ACL injury was non-contact, as is the case with many. After winning the ball, I planted my left foot firmly and was shielding the ball from another opponent. Somehow, I twisted in the wrong direction and heard the infamous “pop.” Down I went.
我的 ACL 损伤是非接触性损伤，就像许多人的情况一样。赢得球后，我左脚稳稳地站稳，挡住了另一个对手的球。不知何故，我扭向了错误的方向，并听到了臭名昭著的“砰”的一声。我下去了。
While rehabbing, I got connected with the @theaclclub Instagram community and, shortly after, became their social media manager. It was through my own sub-par physical therapy and seeing the struggles of other ACL patients that I realized just how little is known about this specific rehab process—even with between 100,000 and 200,000 ACL tears suffered yearly in the United States alone.
在康复期间，我与 @theaclclub Instagram 社区建立了联系，不久之后，我成为了他们的社交媒体经理。通过我自己低于标准的物理治疗以及看到其他 ACL 患者的挣扎，我意识到人们对这种特定的康复过程知之甚少——即使仅在美国每年就有 100,000 至 200,000 例 ACL 撕裂。
The Biggest ACL Rehab Misconception
ACL 康复最大的误解
Urgency can be the greatest enemy in ACL rehab. Athletes are the population predominantly dealing with this injury, and they’re eager to get back to playing. Many grab hold of the outdated 6–9-month return-to-sport timeline with a tight fist, and unfortunately, their physical therapists or surgeons may tell them the same.
紧迫性可能是 ACL 康复中最大的敌人。运动员是遭受这种伤害的主要人群，他们渴望重返赛场。许多人紧紧抓住过时的 6-9 个月重返运动的时间表，不幸的是，他们的物理治疗师或外科医生可能也会告诉他们同样的事情。
At @theaclclub, I have the great pleasure of being connected with some of the most knowledgeable ACL physical therapists around the world. Two of them—Ravi Patel and Tommy Mandala—spoke with me directly to provide additional insights on how to be successful in your ACL rehabilitation process.
在@theaclclub，我很高兴能与世界上一些知识最渊博的 ACL 物理治疗师建立联系。其中两人——拉维·帕特尔 (Ravi Patel) 和汤米·曼达拉 (Tommy Mandala)——直接与我交谈，提供了有关如何在 ACL 康复过程中取得成功的更多见解。
“No one should be cleared before nine months post-op, based on the mountains of research and evidence to show that should be our minimum cut-off,” says Ravi Patel, physical therapist, performance coach, and founder of The ACL Athlete. “Time alone will not do anything for us.”
“根据大量的研究和证据，任何人都不应该在术后九个月内康复，这应该是我们的最低限度，”物理治疗师、表现教练兼 ACL 运动员创始人拉维·帕特尔 (Ravi Patel) 说。 “光靠时间对我们没有任何帮助。”
As has been found by Sports Health, delaying return to sport to align with ACL graft integration and maturation decreases reinjury risk, which is why it’s recommended to wait until 9 to 12 months after surgery. But even that timeline can be too soon if the athlete is not engaging in an ACL rehab plan that will fully prepare them to return to sport.
Sports Health 发现，延迟恢复运动以配合 ACL 移植物的整合和成熟可以降低再次受伤的风险，这就是为什么建议等到手术后 9 至 12 个月。但如果运动员没有参与 ACL 康复计划，为他们重返运动做好充分准备，那么即使这个时间表也可能太早了。
Where the ACL Rehab Process Falls Short
ACL 康复过程的不足之处
“One of the biggest challenges faced by ACL patients is the tendency for their physical therapist to underload them early in the process and then rapidly overload them in the middle- to late-phase,” said Tommy Mandala, physical therapist and founder of All in ACL.
“ACL 患者面临的最大挑战之一是，他们的物理治疗师倾向于在治疗早期使他们负荷过轻，然后在中后期迅速使他们超负荷，”物理治疗师兼 All in 创始人 Tommy Mandala 说道。前交叉韧带。
Mandala continued, “Early in their rehab, many ACL patients are given low-level exercises, like leg lifts, bridges, clamshells, and band walks—which do very little to prepare them for higher-level activities.”
曼达拉继续说道，“在康复初期，许多 ACL 患者接受了低水平的锻炼，如抬腿、桥式、蛤壳式和弹力带行走，这对他们进行更高水平的活动几乎没有帮助。”
It’s true. Aside from the hamstring curl, leg press, and knee extension machines, I didn’t utilize weights at all in my early rehab. Most of the exercises I saw included what Mandala mentioned, as well as indoor biking and bodyweight squats. By the time I hit three months post-op, I was starting to run on the treadmill without ever performing a strength test. It’s no wonder I felt so weak and unstable, but I didn’t know any better.
这是真的。除了腿筋弯举、腿举和膝盖伸展机之外，我在早期的康复中根本没有使用重量。我看到的大部分练习包括曼陀罗提到的，以及室内自行车和自重深蹲。术后三个月时，我开始在跑步机上跑步，但从未进行过力量测试。难怪我感到如此虚弱和不稳定，但我不知道更好。
Video 1. Performing leg raises post-surgery.
视频 1. 术后进行抬腿。
And similar to my experience, when the “standard ACL timeline” allows, athletes are rapidly overloaded with more complex moves like lunges, jumping, running, and even returning to sport. The struggle is that most ACL patients don’t know any better and are doing their best with the resources they have available to them.
与我的经验类似，当“标准 ACL 时间线”允许时，运动员会迅速超负荷地进行更复杂的动作，如弓步、跳跃、跑步，甚至重返运动。困难在于，大多数 ACL 患者对此一无所知，只能利用现有的资源尽力而为。
“Early progressive overload and continued patience as you rebuild strength symmetry before getting into those more dynamic movements are the key to success in ACL rehab,” Mandala concluded.
“在进行更有活力的运动之前，早期渐进式超负荷和持续耐心重建力量对称性是 ACL 康复成功的关键，”Mandala 总结道。
Progressive overload—just like in weightlifting. An ACL tear is a significant injury, and it requires you to rebuild gradually. After surgery, muscle atrophy in the injured leg hits quickly. Graduating from low-level bodyweight movements straight into running on that depleted leg is a huge leap. If you take that same drastic leap too soon onto the pitch, you won’t be adequately prepared for the chaos of a full-speed competitive game.
渐进式超负荷——就像举重一样。 ACL 撕裂是一种严重的损伤，需要您逐渐重建。手术后，受伤腿部的肌肉迅速萎缩。从低水平的自重运动直接过渡到用那条疲惫的腿跑步是一个巨大的飞跃。如果你过早地在球场上做出同样的巨大飞跃，你将无法为全速竞技比赛的混乱做好充分的准备。
It’s these huge leaps that lead to high reinjury rates in the first place.
正是这些巨大的飞跃首先导致了高再受伤率。
Another significant problem lies in the lack of proper strength testing from physical therapists. In fact, many athletes go through physical therapy without ever receiving an actual strength test, which measures muscular strength and compares symmetry in each leg.
另一个重要问题在于物理治疗师缺乏适当的力量测试。事实上，许多运动员在接受物理治疗时从未接受过实际的力量测试，该测试测量肌肉力量并比较每条腿的对称性。
“Studies show that successfully passing a series of single-leg hop tests, along with a series of strength tests for your quad and hamstring, all with symmetry of 90% matching the other side, reduces risk of reinjury by 84% when returning to sport,” added Mandala.
“研究表明，成功通过一系列单腿跳跃测试以及一系列股四头肌和腿筋力量测试（所有测试均与另一侧对称性达到 90%），恢复运动后再次受伤的风险可降低 84% ，”曼陀罗补充道。
Don’t make the mistake of letting time be the be-all and end-all measurement of progress or the next steps in your ACL rehab. One day, around four months post-op, my physical therapist said, “Congratulations! It’s your rehab graduation day,” and sent me on my way without any strength testing. I only ever realized I needed a strength test from managing the @theaclclub Instagram account.
不要错误地让时间成为衡量 ACL 康复进度或后续步骤的最重要和最终衡量标准。术后大约四个月的一天，我的物理治疗师说：“恭喜！今天是你康复中心毕业的日子。”然后我就在没有进行任何力量测试的情况下就上路了。我只是意识到我需要通过管理 @theaclclub Instagram 帐户进行强度测试。
“Imagine if I got my doctorate solely based on doing three years of grad school, with no testing. That’s how much of ACL rehab is done. Often, after six months, athletes are cleared to return to sport. No testing or criteria has been met, but rather, it’s because they’ve reached a six-month point with their surgeon or rehab professional,” Patel told me.
“想象一下，如果我仅仅通过三年的研究生学习而获得博士学位，没有进行任何测试。这就是 ACL 康复的完成程度。通常，六个月后，运动员就可以重返运动场。没有达到任何测试或标准，而是因为他们已经与外科医生或康复专家进行了六个月的治疗，”帕特尔告诉我。
It’s what is accomplished from both a physical and mental preparation standpoint, criteria-based testing, rehab, and training during this time—and beyond—that will ultimately influence successful return to sport and activities.
在此期间及之后，从身体和精神准备的角度、基于标准的测试、康复和训练所完成的工作将最终影响成功恢复体育和活动。
7 Best Practices for Successfully Returning to Sport
成功重返运动的 7 个最佳实践
Seeing such high ACL reinjury rates can feel discouraging for athletes. Of course, full-speed games are unpredictable, and things that are out of your control can always happen. But you have more power over your ACL rehab than you may think. Heed these seven best practices from a pair of physical therapists specializing in ACL RTP for successfully returning to sport.
看到如此高的 ACL 再次损伤率会让运动员感到沮丧。当然，全速游戏是不可预测的，你无法控制的事情总是可能发生。但您对 ACL 康复的掌控力比您想象的要大。留意两位专门从事 ACL RTP 的物理治疗师的这七个最佳实践，以成功重返运动。
1. Quad Strength Is Key
1.股四头肌力量是关键
The importance of quad strength is severely underlooked in ACL rehab, yet after surgery, this is the spot where you’ll immediately start noticing a difference. As a soccer player, I always prided myself on my strong quads. So, it was completely shocking when my surgical leg went from firm and strong to that of a hot dog within a week’s time. Even just flexing the quad and lifting my leg after surgery felt like mission impossible.
在 ACL 康复中，股四头肌力量的重要性被严重忽视，但手术后，您会立即开始注意到这种差异。作为一名足球运动员，我一直为自己强壮的股四头肌感到自豪。因此，当我的手术腿在一周内从坚固有力变成热狗般时，我感到非常震惊。手术后，即使只是弯曲股四头肌和抬起腿，也感觉像是不可能完成的任务。
Atrophy takes over, so regaining quad strength is extremely important. After all, every 1% increase in quad strength is a 3% decrease in risk of a re-tear.
萎缩开始出现，因此恢复股四头肌力量极其重要。毕竟，股四头肌强度每增加 1%，再次撕裂的风险就会降低 3%。
Mandala said, “Gaining strength in this rehab, while maintaining a quiet knee, free of swelling, is the name of the game in successful return to sport.”
曼达拉说：“在这次康复中获得力量，同时保持膝盖安静、无肿胀，这是成功重返运动的关键。”
2. Vet Your Physical Therapist
2. 审查你的物理治疗师
Many folks make the mistake of going to their nearest surgeon and the recommended physical therapist and hoping for the best. It’s essential that you vet your ACL care team, including your surgeon and physical therapist. You’re not expected to know everything, but there are important questions to ask your physical therapist before you commit to working with them.
许多人都会犯这样的错误：去看最近的外科医生和推荐的物理治疗师，并希望得到最好的结果。您必须审查您的 ACL 护理团队，包括您的外科医生和物理治疗师。你不需要知道一切，但在你承诺与你的物理治疗师合作之前，有一些重要的问题需要询问他们。
Mandala, amongst many other specialized physical therapists, encourages asking the number one question: “How many ACL patients do you work with per year?”
曼达拉和其他许多专业物理治疗师一样，鼓励提出第一个问题：“您每年治疗多少名 ACL 患者？”
A physical therapist who sees upward of five ACL patients each year is a good number to aim for. It’s a unique injury, and athletes need to work with someone who helps ACL patients regularly and understands the process. Unfortunately, the traditional healthcare model can limit even the best clinicians.
物理治疗师每年会诊治 5 名以上 ACL 患者，这是一个不错的目标。这是一种独特的损伤，运动员需要与定期帮助 ACL 患者并了解该过程的人合作。不幸的是，传统的医疗模式甚至会限制最好的临床医生。
Here are some other important questions to ask your physical therapist:
以下是需要询问您的物理治疗师的其他一些重要问题：
- What criteria do you use for return to sport?
您重返运动的标准是什么？ - How long should it take to get back to sport? (Watch if they say less than nine months.)
需要多长时间才能恢复运动？ （注意他们是否说少于九个月。） - How heavy can you load me during rehab? (Fifty pounds and heavier needs to be available.)
康复期间你可以给我负重多少？ （需要提供五十磅及以上的重量。） - How do you measure quad strength or force gauge? (Words to look for: handheld dynamometer or an isokinetic dynamometer/Biodex.)
如何测量四边形力量或测力计？ （要寻找的词：手持测力计或等速测力计/Biodex。） - What tools do you have access to during rehab? (Helpful items can be blood flow restriction cuffs and electric stimulation.)
在康复期间您可以使用哪些工具？ （有用的物品可以是血流限制袖带和电刺激。） - What are your keys for patients during recovery? (Recommendations can include being around teammates, journaling, sports psychologist, nutrition, etc.)
您对患者康复期间的关键是什么？ （建议可以包括与队友在一起、写日记、运动心理学家、营养等） - Will I see more than one provider? (Personal preference is to see the same provider or work with a few different ones within the practice you trust.)
我会看到多个提供商吗？ （个人偏好是看同一家提供商或在您信任的实践中与几个不同的提供商合作。）
Patel stated, “People assume that their healthcare system is set up to take care of them from start to finish, but it’s not, and you have to be your own advocate—from vetting surgeons to physical therapists to any other professionals involved, as most are not experts in ACL rehabilitation.
帕特尔表示：“人们认为他们的医疗保健系统是为了从头到尾照顾他们而建立的，但事实并非如此，你必须成为自己的倡导者——从审查外科医生到物理治疗师，再到任何其他相关专业人士，因为大多数人不是 ACL 康复方面的专家。
Get ahead of this. Do your research and find an ACL expert to guide you on your journey. Don’t assume the system will take care of you, and always be your own advocate. And lastly, choose what is truly needed over what’s available or convenient. I promise you will thank yourself in a year,” he concluded.
领先一步。进行研究并找到 ACL 专家来指导您的旅程。不要以为系统会照顾你，永远做你自己的拥护者。最后，选择真正需要的东西，而不是可用或方便的东西。我保证一年后你会感谢自己。”他总结道。
3. Understand What You Need to Succeed
3.了解成功需要什么
Having worked with many ACL patients, Patel advises that ACL patients need three things in this process to return to sport successfully.
在与许多 ACL 患者合作后，帕特尔建议 ACL 患者在此过程中需要做好三件事才能成功恢复运动。
- Making sure the patient has solid evidence-based and criteria-driven testing every 4–6 weeks. This includes range of motion, functional positions, quadriceps and hamstring isolated strength, jump, deceleration, and change of direction profiling.
确保患者每 4-6 周接受一次可靠的基于证据和标准驱动的测试。这包括运动范围、功能位置、股四头肌和腿筋的孤立力量、跳跃、减速和方向变化分析。 - Appropriate planning and programming for the patient’s specific needs and gaps to help meet the proper criteria being tested and sport demands.
针对患者的具体需求和差距进行适当的规划和安排，以帮助满足正在测试的适当标准和运动需求。 - Having expert support each step of the way.
每一步都有专家支持。
4. Do Your Homework 4.做好功课
Your rehab homework, that is. ACL rehabilitation is like having a full-time job you didn’t ever apply for. Of course, you have to attend your physical therapy sessions with a focused mind and a ready-to-work mentality. But you also have to work on your own time.
那是你的康复作业。 ACL 康复就像拥有一份您从未申请过的全职工作。当然，您必须以专注的精神和准备工作的心态参加物理治疗课程。但你也必须利用自己的时间工作。
“Two physical therapy visits per week for an hour per session is still less than 2% of your week. Your success in ACL rehab is dependent upon what you do with the other 98% of the week!” Mandala declared.
“每周两次、每次一小时的物理治疗仍然不足一周时间的 2%。您 ACL 康复的成功取决于您一周其余 98% 的时间所做的事情！”曼陀罗宣说。
5. Don’t Underestimate the Early Post-Op Days
5. 不要低估术后早期的日子
The early days of ACL rehab are more important than you might think, and their significance is often underestimated. The immediate post-op days can be painful and full of exhaustion. You may even be scared to hurt yourself somehow. But this is where the foundation is built.
ACL 康复的早期阶段比您想象的更重要，但其重要性常常被低估。术后几天可能会很痛苦并且充满疲惫。您甚至可能害怕以某种方式伤害自己。但这就是基础的建立之处。
“You can easily make this process two times longer if you don’t focus on those basics early, such as getting the knee quiet and strong.” Patel went on. “People assume the knee just needs to heal, which is partially correct. The other part is doing your job to make sure your range of motion is perfect, quads are firing on all cylinders, your walking is normal, and you’ve got your pain and swelling under control.”
“如果你不尽早关注这些基础知识，比如让膝盖保持安静和强壮，你很容易就会使这个过程延长两倍。”帕特尔继续说道。 “人们认为膝盖只需要愈合，这在一定程度上是正确的。另一部分是做好你的工作，确保你的运动范围是完美的，股四头肌全力运转，你的行走正常，并且你的疼痛和肿胀得到控制。”
Hitting these key points early and over-excelling in the post-op phase will allow you to have an easier mid and late stage.
尽早抓住这些关键点并在术后阶段表现出色将使您在中后期阶段更加轻松。
6. Prioritize Patience 6. 耐心优先
As social media manager for @theaclclub, a community with more than 30,000 followers, I’ve received many messages asking how to speed up the ACL recovery process. Spoiler alert: you can’t, and you shouldn’t. No athlete wants to hear about the importance of patience, but it truly is a virtue that will serve you well in ACL rehab.
作为拥有超过 30,000 名关注者的社区 @theaclclub 的社交媒体经理，我收到了许多询问如何加快 ACL 恢复过程的消息。剧透警告：你不能，也不应该。没有运动员愿意听到耐心的重要性，但这确实是一种美德，对您的 ACL 康复很有帮助。
“Don’t rush trying to get back—play the long game, instead. You can’t rush biology. This recovery takes time not only to heal but also to physically and mentally get back to better than before. Don’t beat yourself up if it takes over a year to feel that. Your older self will also appreciate that you didn’t rush back,” Patel encouraged.
“不要急于想回来——而是要打持久战。你不能急于生物学。这种恢复不仅需要时间来治愈，还需要身体和精神恢复到比以前更好的状态。如果需要一年多的时间才能感受到这一点，请不要责怪自己。年长的自己也会感激你没有急着回来，”帕特尔鼓励道。
7. Conquer Your ACL Rehab
7. 征服你的 ACL 康复
ACL rehabilitation is a tough battle that can certainly feel overwhelming—especially if it’s your first major injury. There are so many things learned from simply going through it, and we all have different resources available to us. Take your ACL rehab process one step and one day at a time while doing all you can to be your best advocate.
ACL 康复是一场艰苦的战斗，肯定会让人感到不知所措——尤其是如果这是您第一次严重受伤。从简单的经历中可以学到很多东西，而且我们都有不同的可用资源。一步一步、一天一天地进行您的 ACL 康复过程，同时尽您所能成为您最好的倡导者。
Since you’re here… 既然你在这里……
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……我们有一个小小的请求。阅读 SimpliFaster 的人比以往任何时候都多，每周我们都会为您带来来自致力于培养更好运动员的教练、运动科学家和物理治疗师的精彩内容。请花点时间在社交媒体上分享文章，让作者提出问题和评论，并在适当的时候链接到文章（如果您有博客或参与相关主题的论坛）。 — SF
References 参考
Mandala, Tommy. All in ACL.
曼陀罗，汤米。全部在 ACL 中。
Patel, Ravi. The ACL Athlete.
帕特尔、拉维. ACL 运动员。
Friedberg RP and d’Hemecourt PA. “Anterior cruciate ligament injury.” Uptodate. 2023.
Friedberg RP 和 d’Hemecourt PA。 “前十字韧带损伤。”最新。 2023 年。
Brinlee AW, Dickenson SB, Hunter-Giordano A, and Snyder-Mackler L. “ACL Reconstruction Rehabilitation: Clinical Data, Biologic Healing, and Criterion-Based Milestones to Inform a Return-to-Sport Guideline.” Sports Health. 2021;14(5):770–779.
Brinlee AW、Dickenson SB、Hunter-Giordano A 和 Snyder-Mackler L。“ACL 重建康复：临床数据、生物治疗和基于标准的里程碑，为重返运动指南提供信息。”运动健康。 2021；14(5)：770–779。
