Early Stage Post ACL Injury Rehabilitation Program

Early Stage Post ACL Injury Rehabilitation Program

March 12th

The Anterior Cruciate Ligament (ACL) is one of the four major ligaments of the knee. These ligaments help dynamically stabilize the knee. An anterior cruciate ligament injury is a common knee injury that occurs in athletes when the ligament is stretched or torn due to unexpected forces. This can happen due to an awkward landing, twisting or contact from another person. The ACL specifically is responsible for controlling forward and rotational movement of the lower leg. Important for running, change of direction, jumping and landing in these chosen sport  

ACL ligament injury can be both a partial or complete tear, depending on the severity of the injury. A tear in the ACL typically will lead to reduced structural support of the knee and therefore result in instability. The scale of instability in the knee from the direct injury depends on the individual and varying factors such as the person’s training age, the amount of lower limb muscle mass and overall general health.  

Following ACL injury, you may benefit from surgery to repair the torn ligament. Although in some cases non-operative, ‘conservative management’ is indicated. This decision is made in conjunction with the orthopaedic surgeon and the client’s clinician. In a recent 2018 study by Krause and colleagues it was found that in terms of functional outcomes, it is not possible to conclude whether surgery or conservative management (non-operative) of ACL rupture produces better results. Highlighting not all ACL injuries require surgical intervention, and in some cases athletes can return to their full function without needing to go under the knife.

Rehabilitation at Kinematics

The timeline of everyone’s rehabilitation depends on the severity of the injury and the type of management approach. For surgical management, it is expected that you will take up to 12-24 months before returning to your chosen sport or activity, due to the varying nature of each individual’s differences. For conservative management, the duration again will vary, and it is up to the team at Kinematics to assist with guiding you to return safely without risking further injury to your affected knee.

For both the surgical and non-surgical pathway it is crucial to undergo a full assessment and tailor an evidence based rehabilitation program, focusing on strength, stability and proprioceptive outcomes of the knee and lower limb in order to achieve normal function once again. In addition to this, current evidence strongly supports immediately starting exercise-based rehabilitation (pre-hab) prior to having surgery. This ensures maintenance of muscle strength and prevention of muscle wastage due to fear of movement post-injury. This is also an important period that may guide the entire team around you to establish if surgical or non-surgical management is the best pathway for your individual recovery.

An anterior cruciate ligament (ACL) injury is a common knee injury that often occurs in athletes, particularly those who play high-impact sports like soccer, basketball, and football.

The ACL is a ligament in the knee that helps to stabilise the joint during movement. Early-stage rehabilitation after an ACL injury or post-op ACL repair is critical to help reduce pain, improve range of motion, and prevent further damage to the knee.

Here are some of the key steps involved in early-stage rehabilitation after an ACL injury +/or post-operative repair:  

1. Range of Motion Exercises: Range of motion (particularly regaining full knee extension) exercises may include gentle stretching and flexing of the knee joint to help prevent stiffness and improve flexibility.
2. Proprioceptive Training: Involves exercises that improve balance, coordination, and body awareness. This can help reduce the risk of further injury by improving your ability to control your movements and maintain proper alignment.
3. Strengthening Exercises: Strengthening exercises for the lower limb including isolated isometrics, compound movements and such as squats and lunges, can help build muscle strength around the knee joint and improve stability.

 

In order to achieve full function, it takes committed rehabilitation to be able to have the ability to participate in any running, jumping or chosen sport by the athlete. Gradually building strength, stability and challenging drills into their program to prevent most importantly re-injury. Our Kinematics Strength + Recovery facility also enables us to progress you into supervised small group classes, which provide ongoing tailored rehabilitation to ensure a full recovery from injury.

ACL injury and post-surgery exercises:

Range of motion: Terminal Knee Extension (TKE) 

This terminal knee extension (TKE) exercise is a great active way to restore end-range knee extension lost post injury +/or surgery.

Exercise cues: Stand with a power band around the knee and the knee in a flexed position. Squeeze and activate your quadriceps as you straighten your knee as much as possible. Hold each squeeze for up to 10 seconds and repeat 5 sets.
Proprioception: Single Leg Balance with Ball Catch

Regain your dynamic single-leg stability post injury +/or surgery with this challenging high-level balance exercise.

Exercise cues: Standing on one leg with a slightly bent knee, throw and catch a ball against the wall using your opposite hand. Aim for 10 throws in a row and repeat 3 sets on each leg.
Strength: Banded Glute Bridge March

This exercise is a great way to build up hip and hamstring strength, as well as develop early power to help regain normal walking as quickly as possible post ACL injury +/or surgery.

Exercise cues: Lift into a glute bridge with a power band across your hips fo resistance, march one knee to the chest as you hold strong for a couple of seconds. Then alternate sides. Aim for 8 marches each side, repeat 3 sets.

Why is ACL rehab important post injury and post surgery?

Exercise rehabilitation and early allied health intervention are essential components of ACL injury and post-operative recovery. A combination of hands on treatment and individualised exercises can help to restore range of motion and strength to the knee joint, reduce the risk of re-injury, improve balance and coordination, and improve overall physical fitness.

If you’re rehabilitating from an ACL injury +/or surgery, come in and see one of our experienced team for an individualised injury management plan. You can book an appointment here.

By Jules Lowther + Nick Pearse-Smith