Return to Rock Climbing After ACL Reconstruction: A Case Report.

BACKGROUND: Currently, there is a lack of research on the rehabilitation process and return to sport for rock climbers after anterior cruciate ligament (ACL) reconstruction. The unique nature of this injury in the sport, the high incidence of this injury, and the challenges associated with returning to a sport that involves high-impact falls and distinct physical demands require a targeted rehabilitation approach. CASE PRESENTATION: A 50-year-old female recreational rock climber sustained a full-thickness ACL tear from a fall. She initially opted for conservative management with physical therapy (PT) but ultimately ended up having ACL reconstruction 3 months later. She reinitiated PT 2 days after surgery until 36 weeks, at which time she had successfully returned to rock climbing. The patient was full weight-bearing immediately after surgery, with a brace for the first month. OUTCOME AND FOLLOW-UP: Outcome measures included self-report questionnaires, dynamometry, and performance tests specific to the demands of climbing to determine appropriate sport progressions. DISCUSSION: This case study fills a gap in the literature by presenting a successful, sport-specific rehabilitation protocol for rock climbers after ACL reconstruction. Clinicians can utilize this example to create tailored rehabilitation programs that address the unique demands of rock climbing, ensuring a safer and more effective return to the sport. This can, in turn, be generalized to other high-impact rotational load sports. JOSPT Cases 2025;5(3):138-155. Epub 10 July 2025. doi:10.2519/josptcases.2025.0117 ABSTRACT FROM AUTHOR