On-field rehabilitation after anterior cruciate ligament injury in contact team sports: a scoping review of exercises, progression and key principles.

OBJECTIVES

To map and summarise the existing scientific literature on on-field rehabilitation (OFR) exercises, progression and principles supporting athletes' return to contact team sports after anterior cruciate ligament (ACL) injury.

DESIGN

Scoping review.

DATA SOURCES: PubMed, CINAHL, AMED, Cochrane, SPORTDiscus, PEDro, Scopus and Embase Library were searched in April 2025.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Sources of any design published between 2010 and 2025 that described or evaluated OFR for athletes returning to contact team sports after ACL injury or reconstruction, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines; studies involving athletes of any age, sex or competition level were eligible.

RESULTS

The search identified 6880 records; 38 sources met the inclusion criteria. Most sources were descriptive and focused predominantly on football, with limited representation of basketball, rugby and ice hockey. OFR was commonly described using multistage (2-5 steps) frameworks progressing from linear running and controlled drills to multidirectional movements, sport-specific skills and practice simulations. Progression was primarily criterion-based rather than time-based, guided by minimal pain or swelling, restored knee range of motion, adequate strength and limb symmetry, and tolerance to running loads. Several articles applied the control-chaos continuum. Collaboration between physiotherapists, coaches and athletes was emphasised, although roles, responsibilities and organisational structures were rarely described.

CONCLUSION

The current OFR literature after ACL injury is largely descriptive, emphasising staged, criterion-based progression and multidisciplinary collaboration. However, actionable guidance on roles, responsibilities and organisational structures is minimal, underscoring the need for empirical studies to establish and evaluate standardised OFR practices.

TRIAL REGISTRATION NUMBER: 10.17605/OSF.IO/T6UN2.