Applying Differential Learning During Rehabilitation After Anterior Cruciate Ligament Injury: A Basketball Single-Case Study

Background/Objectives: Differential learning (DL) amplifies natural fluctuations in movement execution and, in its more extreme forms, facilitates repetition-free training with minimal external feedback. While increasingly recognized in the field of skill acquisition, its application in anterior cruciate ligament (ACL) rehabilitation remains underexplored. Methods: This study examined the application of DL in the rehabilitation of an 18-year-old trained basketball player following left-ACL reconstruction. The athlete completed a 42-week rehabilitation program in which DL principles were incorporated throughout the pre-operative, early, mid-, and late phases, culminating in return to sport. Training included differential mobility work, motor control, plyometric exercises, and sport-specific drills. Functional recovery was evaluated using single-leg hop tests, change-of-direction tasks, and sprint performance, while self-reported knee function was monitored via the International Knee Documentation Committee (IKDC) questionnaire. Results: Results indicated substantial improvements in both functional performance and psychological readiness. The IKDC score increased from 13.8% at baseline to 95.4% postoperatively, reaching the normal functional range. An ACL-RSI score of 85.2%, and inter-limb asymmetries were reduced to below 10%. Strength, agility, and sprint performance exceeded pre-injury levels. Conclusions: DL again shows potential as an effective approach to facilitating recovery and return to sport after ACL reconstruction, but larger controlled studies are needed for validation.