On-field Rehabilitation Part 1: 4 Pillars of High-Quality On-field Rehabilitation Are Restoring Movement Quality, Physical Conditioning, Restoring Sport-Specific Skills, and Progressively Developing Chronic Training Load

Outcomes following long-term injuries such as anterior cruciate ligament rupture are unsatisfactory. To improve outcomes, we must improve rehabilitation practices. One aspect of the return-to-sport process that has received limited attention is on-field rehabilitation. This article is part 1 of a 2-part series aimed at discussing the important elements of on-field rehabilitation and illustrating how they can be applied across a 5-stage on-field rehabilitation program following anterior cruciate ligament reconstruction. The intention of on-field rehabilitation is to support athletes in their transition back to sport after injury, from standard rehabilitation to return to the team or practice. In part 1, we describe 4 pillars of high-quality on-field rehabilitation: (1) restoring movement quality, (2) physical conditioning, (3) restoring sport-specific skills, and (4) progressively developing chronic training load. In part 2, we describe how these pillars may be combined into a 5-stage on-field rehabilitation program to help athletes transition to team practice and match play following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 2019;49(8):565-569. doi:10.2519/jospt.2019.8954.