Enhancing ACL Rehabilitation in Indian Athletes: Evaluating the effects of Blood Flow Restriction Training on Muscle Strength, Hypertrophy and Functional Performance

Anterior Cruciate Ligament (ACL) injuries are common among young Indian athletes and often result in persistent deficits in muscle strength and functional performance despite structured conservative rehabilitation. Quadriceps and hamstring weakness, impaired functional capacity, and delayed return to sport increase the risk of re-injury and limit athletic performance. Blood Flow Restriction (BFR) training has emerged as a novel rehabilitation strategy that enables strength and hypertrophy gains using low-intensity exercise, thereby reducing joint stress and potentially enhancing recovery outcomes.This study aims to evaluate the effectiveness, safety, and feasibility of adding BFR training to a conventional rehabilitation program in young Indian athletes with unilateral ACL injuries managed conservatively. The primary objective is to compare changes in quadriceps and hamstring muscle strength between the BFR group and a control group receiving conventional exercise alone. Secondary objectives include assessing functional performance, return-to-sport readiness, adherence, and adverse events. This will be a single-blind, randomized controlled trial involving 60 Indian athletes aged 18–35 years with MRI-confirmed unilateral ACL injury. Participants will be randomly allocated to either a 8-week BFR-assisted rehabilitation program or a standard rehabilitation program. Outcomes will be assessed at baseline, 4 weeks, and 8 weeks using isokinetic strength testing, muscle hypertrophy measures, functional performance tests, and validated patient-reported outcome measures.