Why we include ACL-RSI in your Return-to-Sport testing

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Jointli Resources
15 Oct 2026

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Recovering from an ACL reconstruction is a physical grind. You spend months rebuilding quad strength, practicing landing mechanics, and passing hop tests.

But there is often a hidden barrier that physical tests can't see: Psychological Readiness.

You can have a knee that is physically 100% healed, but if you don't trust it, your risk of re-injury or poor performance can remain high. That is why we use the ACL-RSI (Anterior Cruciate Ligament – Return to Sport after Injury) scale.

What is the ACL-RSI?

Unlike our other tests, this one doesn't involve jumping or lifting. It is a 12-item questionnaire designed to measure your mental readiness to return to sport.

It looks at three specific "psychological domains":

1. Emotions: Are you nervous or fearful about playing?
2. Confidence: Do you trust your knee to hold up under pressure?
3. Risk Appraisal: How likely do you think you are to get hurt again?

Why "The Mental Game" Matters

Research shows that psychological readiness is one of the strongest predictors of whether an athlete actually returns to their pre-injury level of sport.

If you score low on the ACL-RSI, it indicates you might be suffering from kinesiophobia (fear of movement). This fear causes athletes to subconsciously protect their knee, leading to:

• Altered movement patterns (favoring the "good" leg).
• Hesitation during critical moments (like cutting or tackling).
• Increased risk of a second ACL injury.

What your score tells us

The questionnaire gives us a score out of 100.

• High Score (>65-70): Suggests you are mentally confident and ready to handle the chaos of sport.
• Low Score (<60): Suggests that even if your muscles are strong, your brain is still protecting the knee.

If your score is low, we don't just clear you. We adjust your rehab to build confidence through exposure therapy, gradually introducing more chaotic and sport-specific situations until your trust matches your strength.

The Bottom Line

By using the ACL-RSI, we ensure you aren't just physically capable of playing, but mentally ready to dominate.