Neurosciences and Sports Rehabilitation in ACLR: A Narrative Review on Winning Alliance Strategies and Connecting the Dots

This narrative review explores the significant evolution of sports rehabilitation, tracing its trajectory from basic exercise therapies of the early 20th century to the advanced, neuroplasticity-driven approaches of the 21st century, with a specific focus on anterior cruciate ligament reconstruction (ACLR). The primary aim is to understand how neuroplasticity, motor control, and sensorimotor retraining can optimize recovery, reduce reinjury risk, and enhance long-term athletic performance, and to synthesize current rehabilitation strategies that integrate innovative technologies, such as robotics, virtual reality (VR), and biofeedback systems, to address the neurocognitive deficits that contribute to the alarmingly high reinjury rates (9-29%) observed in young athletes post-ACLR. These deficits include impaired proprioception, motor control, and psychological factors like fear of reinjury. The methodology employed involves a narrative review of peer-reviewed literature from databases including PubMed, Scopus, and Web of Science. The synthesis of findings underscores the importance of holistic rehabilitation approaches, including targeted proprioceptive exercises, dual-task drills, and immersive VR training, in enhancing sensorimotor integration, decision-making, and athlete confidence. Furthermore, this review highlights the critical need for long-term monitoring and interdisciplinary collaboration between neuroscientists, physiotherapists, and engineers to refine rehabilitation protocols and ensure sustained recovery. By leveraging neuroplasticity and advanced technologies, the field can shift from a focus on purely physical restoration to comprehensive recovery models that significantly reduce reinjury risks and optimize athletic performance.