Investigating Why Some Athletes Face Challenges in Recovering Post-ACL Surgery
New insights into brain and muscle interactions reveal why some athletes struggle to recover fully after ACL reconstruction, highlighting the role of neural pathways in rehabilitation outcomes.
Recent research from Edith Cowan University (ECU) has shed light on the complex factors influencing athletes' recovery after anterior cruciate ligament (ACL) reconstruction. While ACL injuries are widespread, especially in Australia, rehabilitation outcomes vary significantly among individuals.
A key concern in recovery is a condition known as atherogenic muscle inhibition (AMI), a dysfunction affecting the muscles around the knee. AMI involves impaired maximal voluntary activation, meaning many athletes are unable to fully engage their muscles during movement, which can hinder successful return to sport.
Dr. Colin Sylvester, an ECU Masters student and registrar at the Australasian College of Sport and Exercise Medicine, explains that AMI is linked to the brain's functioning. His recent study, published in Sports Medicine and Health Science, found that within two weeks after ACL reconstruction, certain pathways in the brain become more active. These changes can influence how effectively muscles are activated.
The study involved brain stimulation testing on athletes with fully ruptured ACLs, both before and after surgery. Results indicated that although the direct connection from brain to muscle remained largely unchanged, the internal pathways within the brain that govern muscle activation became more active following surgery. Intriguingly, this increased activity suggests the brain works harder post-surgery, potentially contributing to voluntary activation deficits.
Understanding these neural changes is crucial because they may explain why some athletes struggle to regain their pre-injury performance levels. Dr. Sylvester emphasizes that effective rehabilitation should involve collaboration with physical therapists knowledgeable about ACL injuries and recovery progression.
While the research is still in early stages, it points toward the importance of considering brain-muscle dynamics in post-surgical rehabilitation strategies. Future studies aim to better understand how these neural mechanisms can be targeted to improve muscle activation and functional outcomes after ACL reconstruction.
Source: https://medicalxpress.com/news/2025-10-uncovering-athletes-struggle-acl-surgery.html
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