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Objective: The purpose of this case report is to describe the chiropractic management of a patient who had postoperative reconstructive surgery for an anterior cruciate ligament (ACL) tear. Clinical Features: A 25-year-old man experienced a rupture of his left ACL, as well as a bucket-handle tear of the medial meniscus and full-thickness tear within the posterior horn of the lateral meniscus, following direct-contact trauma while playing basketball. Intervention and Outcome: Postoperative care included a 12-week functional chiropractic rehabilitation program along with Active Release Technique, Graston Technique, and Kinesio Taping. Following treatment, the patient recorded a 0/10 on the Numeric Pain Scale, recorded improvement on the Patient Specific Functional and Pain Scales, returned to play with no complications, and had complete restoration of range of motion and lower extremity muscle strength. At 1-year follow-up, the patient reported no pain and was fully functional. Conclusion: A multimodal approach to the treatment of a postsurgical ACL repair was successful in restoring functional ability, as well as complete subjective pain relief. Chiropractic care may be a beneficial addition to the care of postoperative patients.

Objective: The purpose of this literature review was to demonstrate, through examples in the current literature, the cumulative and long-term effects of multiple concussions, postinjury protocols, and the efficacy of current and past return-to-play guidelines. Methods: A PubMed search was performed using the keywords and key phrases: concussions and long-term effects, concussions and return to play, and multiple concussions. We limited the search to articles that had been published from August 2007 to August 2012 and were specific to human participants. Of the 450 total articles that the search returned, we selected studies specifically demonstrating athletes who were symptom-free, passed neuropsychological testing, returned to play, and were tested in measures of postural control, transcranial magnetic stimulation, electroencephalographic studies, and magnetic resonance imaging spectroscopy. Results: Selected studies show evidence that, although a previously concussed athlete may be symptom-free and returned to a neuropsychological baseline, the athlete may continue to have prolonged neurological abnormalities that could disqualify them from being ready to return to play. Conclusion: It appears that some neurological deficits persist beyond the current return-toplay standards and that discrepancy exists between common practices of returning athletes to competition and new standards of published research.

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Objective: The purpose of this case report is to describe a chiropractic rehabilitation program for a patient with postsurgical lateral retinaculum release. Clinical Features: A 26-year-old male ice hockey goalie presented 1 month after having lateral retinaculum release surgery for his left knee with residual mild discomfort and edema in his left knee. Intervention and Outcome: The patient was treated using a multimodal approach of both passive and active chiropractic care focusing on the restoration of full range of motion, increased proprioception, balance, strength, and endurance to return the patient to competitive ice hockey.Conclusion: This case study demonstrated that, after 14 weeks of care, the patient was able to return to ice hockey training with no residual symptoms.