ACL REHAB & SPORTS PHYSIOTHERAPY MELBOURNE
HAVE YOU INJURED YOUR ANTERIOR CRUCIATE LIGAMENT (ACL)?
Did you know that a 5 week intense prehab (ACL rehab protocol before surgery) gives you better knee strength and outcomes, both before and after knee surgery? (Fitzgerald 2000, Eitzen 2010).
These effects are still relevant even 2 years later (Eitzen 2009).
To make sure you get the most out of your anterior cruciate ligament reconstruction reconstruction, make sure you get comprehensive pre and post surgery rehab from the sports physiotherapists at Melbourne Sports Physiotherapy.
YOUR ACL PRE-SURGERY REHAB AND ACL POST-RECONSTRUCTION REHAB STRENGTH PROTOCOL INCLUDES:
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Reduction of swelling and pain
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Increasing your range of motion
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Strengthening
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Balance training
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Hopping, jumping and landing practice – yes! This is possible even prior to surgery if you have good rehabilitation
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Prevention of other injuries and compensations in the ankle and hip.
Do I need to have ACL reconstruction SURGERY?
This is a decision only you can make.
Make an informed decision by considering what was injured, what you want, and after discussing it with health professionals such as your Orthopaedic Surgeon and ACL Sports Physiotherapist. Some things to consider are:
1. Does your knee buckle or give way when supporting your weight? If it does give way, especially after a period of ACL rehabilitation, you may be more likely to benefit from surgery.
2. Consider the type of sports and activities you want to do. Surgery is more commonly recommended if you want to return to sports that involve cutting and twisting motions such as AFL, rugby league, netball, skiing and touch football (Myklebust 2005).
3. Have you also injured your meniscus? Combined meniscal tears with an ACL injury may have increased rates of knee osteoarthritis – but not necessarily more pain (Oiestad, 2010). This should be discussed with your surgeon.
4. A recent study of active young adults with ACL injuries found that there were no significant differences between patients who had immediate reconstructive surgery followed by ACL rehab, or those patients who had rehabilitation first, then surgery up to 12 months later (Frobell 2013). This indicates that ACL rehab should be considered as a primary treatment option for these patients.
WHAT'S INVOLVED IN ACL REHAB AND RECOVERY AFTER RECONSTRUCTION SURGERY?
A surgical reconstruction does not mean you don’t have to do rehab! Rehab is essential for recovery after ACL surgery to build up strength and coordination, and prevent reinjury.
There is no fixed time frame for rehabilitation after ACL reconstruction. Although there are very general guidelines, ACL rehab should progress based on how well you perform in tests of strength, coordination, balance, hopping, agility and fitness (Adams 2012, Myer 2006).
Regarding the ACL rehab protocol, for the first 2-3 months, sports physiotherapy is intensive – weekly. But if you are really diligent with your program, the need for regular physio sessions is less.
It is recommended that you have at least monthly reviews for 12-18 months after your ACL reconstruction. This is especially important to keep you on track so that you have full recovery after ACL reconstruction, and are at a reduced risk of re-injury.
WHEN CAN I RETURN TO SPORT AFTER AN ACL RECONSTRUCTION?
Every ACL reconstruction has different time frames depending on your goals. Returning to sport should be based on when you can safely and confidently perform a whole range of tests that assess your physical abilities.
In addition, you should feel confident in the knee (Thomee 2011, Arden 2011), and successfully perform drills and skills that are specific to your sport or activity. Your sports physiotherapist can use a whole series of tests so that you can track your progress, and identify where your physical performance could be improved.
These include specific hopping tests, and strength dynamometer testing, using specific strength testing equipment as part of your acl rehab protocol.
Am I at risk of reinjury after an ACL reconstruction?
Unfortunately there is a small but increased risk in rupturing your repaired ACL when you return to sport. This is true for both your injured and non-injured legs (Hewett 2013). But take heart, this risk can be reduced if you stick to your acl rehabilitation plan for whatever time it takes to improve your physical abilities (Manske 2012). Generally this is between 12-18 months.
View Article References at the bottom of this page.
LEARN HOW OUR PHYSIO TEAM CAN HELP YOU
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training, or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your knee pain or stiffness as part of your acl rehab protocol.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today to learn about our acl rehab program in Melbourne!
You can make an appointment by calling or booking online.
FAQs
What is an anterior cruciate ligament (ACL) injury?
An anterior cruciate ligament (ACL) injury is a tear or sprain of the ACL, one of the major
ligaments in the knee joint. The ACL connects the thigh bone (femur) to the shin bone (tibia) and helps stabilise the knee. Anterior cruciate ligament injuries can range from mild, such as a small tear, to severe, such as when the ligament tears completely or separates from the bone.
What causes an ACL tear?
ACL tears commonly occur during sports that involve sudden stops, changes in direction, jumping, or landing. Examples include soccer, basketball, football, tennis, and downhill skiing. The ACL can be injured when an athlete rapidly decelerates, pivots, or lands awkwardly from a jump. ACL injuries can also result from direct contact, like a tackle in football.
What are the symptoms of an ACL injury?
Common signs and symptoms of an ACL tear include:
- A loud "pop" or popping sensation in the knee
- Severe knee pain and inability to continue activity
- Rapid swelling within the first few hours after injury
- Loss of range of motion in the knee joint (difficulty achieving full knee extension or knee flexion)
- A feeling of instability or "giving way" when bearing weight
- Knee stiffness
What is involved in ACL rehab after reconstructive surgery?
ACL rehab after reconstruction surgery involves a progressive program to restore knee strength, stability, and range of motion. Physiotherapy begins soon after surgery and continues for several months.
Key components of the ACL rehab protocol include:
- Reducing knee pain and swelling with ice, elevation, and anti-inflammatory medications
- Regaining full knee extension and flexion range of motion through heel slides, prone hangs, and other exercises
- Strengthening the quadriceps, hamstrings, hip abductors, and other leg muscles with exercises like straight leg raises, bridges, step-ups, and squats
- Improving balance and proprioception with single-leg stance and wobble board exercises
- Gradually progressing to running, jumping, and agility training
- Transitioning back to sport-specific drills and full return to sport testing
The full ACL rehab process can take 8-12 months or more. It's important to follow the rehabilitation protocol and avoid returning to high-demand activities too soon to prevent reinjury.
How long does it take to return to sports after ACL surgery?
It usually takes 9 to 12 months for a patient to return to sports participation after ACL reconstruction, depending on the type of sport, the patient's progress with physiotherapy, and performance on return to sport tests. Patients must regain full range of motion, quadriceps and hamstring strength, and knee stability before being cleared for unrestricted sports.
What are some potential complications of ACL reconstruction?
Potential complications of ACL reconstruction surgery include:
- Infection
- Knee stiffness or loss of motion (arthrofibrosis)
- Graft failure or reinjury
- Pain or weakness in the knee
- Nerve or blood vessel injury
- Blood clots
- Knee arthritis
Following the post-operative ACL rehab protocol and avoiding a premature return to sports can help minimise the risk of these complications.
How can I prevent an ACL injury?
While some ACL tears are unavoidable, preventive measures can reduce the risk, especially for athletes. These include:
- Proper warm-up before physical activity
- Regular strength and conditioning for the legs and core
- Neuromuscular training to improve balance and coordination
- Learning proper landing and pivoting techniques
- Wearing appropriate, well-fitted footwear
- Using proper sports equipment, like ski bindings
Female athletes may benefit from additional preventive training, as they have a higher risk of ACL injury compared to males in certain sports.
References:
- Adams, D., et al., Current Concepts for Anterior Cruciate Ligament Reconstruction: A Criterion–Based Rehabilitation Progression. The Journal of orthopaedic and sports physical therapy, 2012. 42(7): p. 601.
- Ardern, C.L., et al., Return to the Preinjury Level of Competitive Sport After Anterior Cruciate Ligament Reconstruction Surgery Two-thirds of Patients Have Not Returned by 12 Months After Surgery. The American journal of sports medicine, 2011. 39(3): p. 538-543.
- Eitzen, I., Holm, I., & Risberg, M.A. (2009). Preoperative quadriceps strength is a significant predictor of knee function two years after anterior cruciate ligament reconstruction. British Journal of Sports Medicine, 43(5): 371-376.
- Eitzen, I., Moksnes, H., Snyder-Mackler, L., & Risberg, M. A. (2010). A progressive 5-week exercise therapy program leads to significant improvement in knee function early after anterior cruciate ligament injury. Journal of orthopaedic & sports physical therapy, 40(11), 705-721.
- Fitzgerald, G. K., Axe, M.J. & Snyder-Mackler, L. (2000). A decision-making scheme for returning patients to high-level activity with nonoperative treatment after anterior cruciate ligament rupture. Knee Surgery, Sports Traumatolgoy, Arthroscopy 8(2): 76-82.