A Biomechanical Perspective on Rehabilitation of ACL Injuries in Handball

Handball sport is a good example of a highly strenuous body-contact team sport with a strong emphasis on running speed, jumping, abrupt changes in direction and throwing in which enormous forces are developed around the knee joint. Due to handball’s intrinsic need for abrupt changes in direction and unplanned action management, as well as the high game intensity, anterior cruciate ligament (ACL) rupture is one of the most frequent devastating injuries among handball players. Moreover, an incomplete or insufficient rehabilitation program following an ACL injury may increase the risk of both re-injury and injury of the unaffected contra lateral knee. Thus, the identification of functional, biomechanical and neuromuscular deficits before discharging these patients from rehabilitation appears to be crucial for ACL re-injury prevention in this population. However, the scientific literature has still several concerns that despite previous conscientious scientific efforts made, remains sparse and to be clarified yet. This cornerstones are: the optimums rehabilitation type for successful ACL injury recovery, and the gold standard for an evidence based, objective and clinically feasible criteria for a save and competitive return to play after the suffering of this knee injury. Through a biomechanical approach to ACL injury management this chapter aims to help the clinician to understand the main biomechanical and functional aspects to deal when treating with an ACL injured handball player.