Q: My 15 years old daughter had anterior cruciate ligament (ACL) surgery a year ago. She plays basketball wearing a knee brace for protection, which she will keep for the next five months. However, in order to get her speed back, we were suggested that she should do speed training with a certified trainer. The doctor says that her knee is strong. Is it possible after ACL surgery to do speed training?

A:The goal of rehabilitation after ACL surgery is to restore normal joint motion and strength while protecting the ligament graft. Appropriate rehabilitation is crucial to the success of ACL surgery. The thigh muscles atrophy very quickly, in less than 6 weeks after surgery. The return to full activity requires 80% return of thigh strength and the ability to perform sport - specific agility duties. We also delay return to sports for at least 6- 9 months after surgery to allow maturation of the graft. We also give a functional knee brace after ACL surgery for sports, although no data support this practice. In your case, I advice to wear the knee brace for protection for the next five months, have a good physiotherapist/trainer for the initial time to train her thigh, hamstring muscles, good range of knee motions especially knee extension, needed for sports activities like basketball. Your knee is strong from the first day after surgery and more aggressive rehabilitation will greatly decrease the complications. The only thing, which could damage your knee, is prolonged immobilisation/inappropriate and inadequate rehabilitation.