Anterior Cruciate Ligament: Page 6 – Return to Sport
Power with Ballistics and plyometrics (Return to Sport)
Plyometrics and ballistic training are essential, high-intensity components of modern rehabilitation that bridge the gap between traditional strength training and the explosive, rapid movements required for daily life or sports. While both focus on power development, plyometrics utilise the stretch-shortening cycle (rapid eccentric lengthening followed by a concentric contraction) to improve elastic energy storage, whereas ballistics (like medicine ball throws) emphasise accelerating a load through the entire range of motion.
Key benefits in rehabilitation include:
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Rapid Force Production: Both methods improve the rate of force development (RFD), allowing injured muscles to produce maximum force quickly.
Increased Muscle Fiber Recruitment: These exercises target fast-twitch (Type II) muscle fibres, which are often deactivated after injury or due to disuse.
Improved Nervous System Efficiency: They enhance motor-unit firing frequency and synchronisation, resulting in faster and more coordinated muscular contractions.
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Functional Transfer: Because they mimic real-world activities (jumping, cutting, throwing), they help rebuild sport-specific skills and functional movement patterns.
Increased Tendon Stiffness: Plyometric training is effective at increasing tendon stiffness, which improves force transmission to the bone.
Reconditioning of Tissues: They help restore, strengthen, and decondition muscles and tendons that have weakened after an injury.
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Enhanced Deceleration/Absorption: A critical aspect of rehab is teaching the body to absorb forces. Plyometrics enhance the ability of muscles, tendons, and ligaments to handle high impact, thus protecting joints.
Improved Neuromuscular Control: They enhance proprioception and joint position sense, which are often impaired after injury.
Reduced Inhibition: By desensitizing the Golgi Tendon Organ (GTO), these exercises allow muscles to generate higher forces without premature inhibition, aiding in "bulletproofing" the body against future injuries.
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Bridging the Gap: They provide a safe, graduated progression for athletes to return to high-impact activities, reducing fear of re-injury (kinesiophobia).
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Plyometrics: Ideal for improving reactive ability, jump height, and sprint speed via elastic energy, typically utilising body weight.
Ballistics: Better for developing "strength-speed" by allowing a wider range of loads (e.g., medicine balls, weighted vests) to be used, with an emphasis on maximal acceleration throughout the movement.
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Progression is Crucial: To avoid reinjury, these should be introduced in a, low-to-high intensity, and high-volume-to-low-volume manner.
Prerequisites: Adequate strength, full range of motion, and pain-free movement are required before beginning.
Recovery: 48-72 hours of recovery between sessions is recommended to allow the nervous system and tissues to repair.
Ballistics
Ballistic exercises, which involve explosive, high-velocity movements where an object or the body leaves the ground (e.g., jump squats, medicine ball throws, kettlebell swings), are best programmed with low volume to maximise power output and minimise injury risk.
The core focus is on speed and intent, not fatigue.
General Guidelines for Ballistic Exercise:
Sets: 3–5 sets.
Reps: 1–5 repetitions per set.
Intensity/Load: 30–60% of 1RM is often recommended for maximum velocity, though some, like Olympic lifts, may go higher (85-95%).
Rest: 2–5 minutes between sets to allow full ATP (energy) recovery.
Key Programming Considerations:
Quality over Quantity: Stop the set when speed or power drops, as fatigue diminishes the benefit of the movement.
Frequency: 1–3 sessions per week, with at least 48–72 hours of recovery between sessions.
Box Jumps
Broad Jumps
Ballistic Hop
Plyometrics
Plyometric exercises, or "jump training," are explosive movements designed to increase power, speed, and muscular strength by utilising the muscle's stretch-shortening cycle. By rapidly stretching a muscle (eccentric) and immediately contracting it (concentric), these high-impact, rapid movements improve athletic performance, agility, and coordination. For effective plyometric training, perform 2–3 sessions per week, aiming for 3–6 sets of 2–5 repetitions per exercise to maximise power. Focus on maximum intensity, low-volume, and long rest periods (2–3 minutes) between sets to allow full recovery. Total volume should be roughly 80–100 touches per session.
Key Guidelines for Plyometric Volume
Intensity Over Volume: Plyometrics are designed for speed and power, not endurance. If speed decreases, reps are too high.
Reps & Sets Structure
High Intensity (e.g., Depth Jumps): 3–5 sets of 2–5 reps.
Moderate Intensity (e.g., Jumping lunges): 3–4 sets of 5–8 reps.
Low Intensity (e.g., Pogo Hops): 3–4 sets of 10–15 reps.
Rest Periods: Rest 60 seconds or more between sets to maintain explosive quality.
Progression: Start with 2 sets of 5 reps to build foundation, increasing to 3–4 sets as technique improves.
Safety Note: Ensure proper landing mechanics (soft knees) to prevent injury, especially when increasing intensity.
Pogo Hops
Jog on the Spot
Mini Star Jumps
Split Star Jumps
Higher level Plyometric exercises
Burpees
Jumping Lunges
Plyometric Press Up
Plyometric jumping press-up
Box drop to broad jump