Anterior Cruciate Ligament (ACL) injuries are quite common in sports, but what happens after the injury?
A majority of ACL injuries occur without contact from another player, but rather with cutting or pivoting activity. While this type of injury can be devastating, the good news is we have seen patients come back to that same high level of competition as before their injury.
Torn ACL rehabilitation prior to surgery
Also known as “pre-hab”, physical therapy prior to surgery is an important step for improved outcomes. Although therapy cannot “repair” the ligament, it can improve motion and strength as well as decrease swelling. In addition, during these sessions you will be trained to do the exercises and self-care you should be doing immediately following surgery.
ACL reconstruction surgery
Prior to surgery, you and your surgeon will discuss what type of ACL graft is most appropriate for you. Common grafts are the patellar tendon, the hamstring tendon, the quadricep tendon, or graft from a donor. Each one has its pros and cons and the decision should be made on an individual basis. Your surgeon will guide you in this decision.
In addition to an ACL repair, there are other common knee injuries that may need to get repaired or surgically addressed, for example meniscal tears, collateral ligament tears, etc.
Immediate post-surgery rehabilitation
The key to this phase of rehabilitation:
- Restore your range of motion, especially getting that knee straight
- Get the quadricep (thigh muscle) firing immediately
- Decrease swelling about the knee
- Minimize pain
- Improve gait mechanics, at first with crutches and a knee brace.
Immediate Post-Operative Rehabilitation 0- 2 Weeks
At this stage, we work on strength to allow the brace to be discontinued as your strength and motor control improves. We will work with you to get you walking normally again. We will continue to progress your strength and to more weight bearing exercises like squats and step ups. It is very important to strengthen your quads and hamstring as well as your hip muscles for proper recovery.
Continued rehabilitation: 4+ months
During this phase, we teach you to focus on good form and not allowing motions that put your ACL repair at risk for failure. We follow your surgeon’s protocol to introduce progressively complex exercises such as single leg exercises, balance drills, agility and plyometric drills, and sports specific drills. We will continue to train your entire body throughout the rehabilitation process to keep you from losing strength and endurance overall. We want to assure that you do not return to activity and suffer another injury due deconditioning.
When it is appropriate, we will put you through a battery of tests to compare your surgical leg to your non-surgical leg. These tests are scored and discussed with you and your surgeon.
Typical return to sport is nine months, although every case is different. Returning to play too soon puts you at risk for a second ACL injury. You should wait until your surgeon clears you to return to play.
