Have you heard of neuroplasticity? Defined, neuroplasticity is the ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury. This has become an area of increased focus in ACLR because we know there are changes that occur in the higher centers (brain) after an ACLR. If these changes are not addressed as a part of our rehab, then they can remain and increase the athlete's risk of reinjury with return to sport (RTSport). At this point you may be saying to yourself, not my patients. With the functional training that I do, by the time they are ready for RTSport, we have addressed this. Have you?
Some recent studies have highlighted a sobering fact. We are not as good as we think we are. King et al Am J Sport Med 2019 performed 3D motion capture on 156 athletes that were 9 months post op ACLR and compared those to healthy controls. The subjects performed:
- Bilateral vertical drop jump test
- Single leg vertical drop jump test
- Single leg hop for distance
- Planned and unplanned change in direction task
Neuroplasticity also known as brain plasticity or neural plasticity is the ability of the brain to change throughout one's lifetime. We know, for example, in stroke patients, that the brain has the ability to adapt and change as a result of the neural insult to the brain and can remap neural pathways so that non-damaged areas can take on some of the function of the damaged sections. That is neuroplasticity. In neuro rehabilitation settings we know this and can deploy certain techniques that will aid in this facilitating this process or neural adaptation in the brain. This aids to improved function despite the initial neural insult. In sports medicine, we rarely think about the changes that occur in the higher centers (in the brain) with an orthopedic injury.
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