Rehabilitation and return-to-sport after ACL injury in a female athlete: A case reflection and review of sex-specific challenges

Title : Rehabilitation and return-to-sport after ACL injury in a female athlete: A case reflection and review of sex-specific challenges

Abstract:

This case report and literature review highlight a 27-year-old female who sustained an Anterior cruciate ligament (ACL) injury following a sporting event. She described the injury as one of the most painful experiences of her life and faced significant physical and psychological challenges associated with it.

ACL injury is a common debilitating condition that affects the knee by compromising its stability. Female athletes are disproportionately affected due to inherent anatomical and hormonal differences, namely oestrogen. Due to lower bone mineral density, increased ligament laxity, and smaller bone size compared to males, they become more susceptible to such injuries.

The subject of my study, Mrs. S.B., was a former high school athlete. She sustained her injury following a traumatic fall, resulting in immense pain and emotional distress. S.B reported feelings of low self-worth, which was worsened by recent changes in her personal life. Support from her family, especially her in-laws, played a crucial role in her rehabilitation journey. The anatomical (wider pelvis, narrower intercondylar notch), biomechanical (dynamic knee valgus), and hormonal (oestrogen-related ligament laxity) differences informed her personalised rehabilitation plan. The injury markedly affected her daily living, including reliance on a wheelchair, and raised concerns about fulfilling her daily roles as a newlywed.

The Multidisciplinary Team (MDT) focused primarily on restoring functional capacity through physiotherapy, including early mobilisation, neuromuscular training, and progressive strengthening alongside pharmacological management for pain control. Although her injury forced cessation of competitive sports, she was given counselling and therapy alongside advice on pursuing alternatives. The injury had affected her psychologically, including depressive episodes, highlighting the need for holistic care for such individuals.

Biography:

Afreen Azad is a Year 2 medical student at Aston Medical School, Birmingham, UK. She is the founding president of the Aston Medical Leadership Society and serves as a Peer-Assisted Learning (PALs) leader. She also delivered an oral presentation at the International Forum on Quality and Safety in Healthcare in Utrecht and has a publication in BMJ Open Quality. Her academic interests include clinical leadership, patient safety, and musculoskeletal health. She is committed to integrating leadership and quality improvement into her medical training and future clinical practice.