Flywheel Resistance Training for Anterior Cruciate Ligament Rehabilitation

Abstract

The tearing or rupturing of the anterior cruciate ligament (ACL) has become an increasingly common injury in athletes, particularly in sports that require sharp, pivoting movements and sports that have high deceleration and landing demands. Optimizing each stage of rehabilitation post ACL reconstruction (ACLR) is crucial for successful recovery and the return-to-play of an athlete. Researchers have highlighted the importance of deceleration training and the role of increased eccentric force production and the ability to attenuate rapid braking forces prior to an athletes return-to-sport. There are many training methods that can provide this eccentric overload; however, the focus of this review is on the utility of flywheel resistance training (FRT) during ACL rehabilitation. Due to the limited research of this topic, a narrative review with a systematic approach was conducted. An overview of the literature that has determined the effects of FRT on ACL rehabilitation post ACLR is discussed, including the current loading parameters, and limitations of the research. From the articles included, FRT Bulgarian split squats have been used across studies and have been shown to be effective in eliciting isometric strength gains and improving between-limb strength asymmetries. FRT has also shown to be successful in jump performance, particularly countermovement jump (CMJ) performance. A new perspectives of late-stage ACL rehabilitation with FRT is then proposed, with practical examples provided.