ACL-reconstructed athletes should pay close attention to recent research findings regarding on-field rehab.
A recent 2026 retrospective study from Della Villa et al. of the Isokinetic Medical Group examined the role of on-field rehab on return to play and reinjury rates in male soccer athletes after ACL reconstruction (ACL-R). The study findings showed higher rates of return to play with those athletes completing an on-field rehab return to play framework. This is an important study that expands on the theoretical “Control to Chaos” rehab framework proposed by Taberner et al. .
PHYSICAL BENEFITS
The benefits of this approach allow improved specificity of training for the ACL-reconstructed athlete’s sport of choice which can be used to target technical skills and specific physical qualities. A few examples of these physical qualities may include:
- Aerobic Endurance
- Anaerobic Endurance
- Change of Direction
- Reactive Agility
- Reactive Strength
- Rate of Force Development and Explosiveness
PSYCHOLOGICAL BENEFITS
Many psychological factors are impacted following ACL injury and subsequent ACLR. Many of these factors including kinesiophobia, fear of reinjury, and psychological readiness have been implicated in research evidence attributed to lower rate of return to sport in athletes following ACLR. Implementing on-field rehab may help address many of these factors to allow improved athlete confidence in their ability to perform sport-specific tasks and replicating game demands through graded exposure and progression of neuromuscular demand.
NEUROLOGICAL BENEFITS
One additional benefit from increased on-field training in ACL-reconstructed athletes is the ability to perform dual-tasking and implementing neurocognitive training elements and strategies to address neuroplastic changes that occur following ACL-R that have been highlighted extensively in the work by Dustin Grooms. Research on the ideal methods to target some of these neurocognitive changes continues to emerge and on-field rehab may prove to be an important element of the gold standard formula. We will explore more of these elements and related research evidence in an upcoming post, but key takeaways for ACL-reconstructed patients are that implementing on-field rehab in later stages may prove to enhance success of return to play and rehab outcomes.
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