Updated: Dec 7, 2021
An ACL injury has the potential to be a devastating sports/knee injury. The ACL or anterior cruciate ligament is the most commonly injured ligament of the knee. The ACL is one of the four major ligaments of the knee that helps to stabilize the knee during everyday activities and especially during sporting type activities (cutting, jumping, running, fast-paced movements). The ACL's job is to prevent your shin bone (tibia) from translating forward on your thigh bone (femur).
There are two options after an ACL injury: surgery or conservative management depending on the severity of the injury. Currently, most injured athletes choose surgical reconstruction. Options should be discussed with your orthopedic surgeon and depending upon your injury, the surgeon will give you their recommendation. Depending on your decision, the surgeon will then discuss different graft options to repair your ACL. There is much variability in the research and your surgeon's personal preference/experience will contribute to their recommendations.
ACL rehabilitation can be a challenging process taking anywhere from 12-18 months for a full recovery. Research shows that even after 12-18 months, only around 60% of athletes with ACL tears return to their previous sports level following surgery.
The first step of rehab is to get your knee straight (in full extension). Early motion is essential for a good outcome. Recovery of full knee extension reduces pain, stimulates cartilage, improves gait, and prevents scar and/or knee capsule issues. Just as important as knee straightening is restoring knee bending.
After that, a period of general strengthening will be performed focusing on restoring muscle strength and control to the quadriceps, glutes, hamstrings, and calves. After an appropriate amount of time and your level of progression, your medical team will decide whether you are ready to begin running, jumping, landing and eventual return to sports training. A huge emphasis during this phase will be on deceleration training or "eccentric training." Furthermore, you will need to be exposed on practicing changing direction and multidirectional agility training to promote the confidence of movement control specific to your sport activities.
So, what steps can be taken to ensure you don't fall into the 40% of athletes/individuals that do not recover fully? Having an individualized, patient-specific rehabilitation plan is an essential first step. While there are common steps between all protocols, receiving one-on-one care to ensure that you are meeting all goals and progressing according to the plan is a great way to avoid falling behind. Most programs do a great job of focusing on restoring full range of motion and strength.
The research shows the biggest deficit in the rehabilitation process is in not focusing on neuromuscular control and reactive training enough to meet desired level of sports skills. Here at Columbia PT InMotion, we utilize the latest research, best technology and techniques to ensure that patients are ready for their return to sport/activity. You can see a patient recovering from an ACL tear utilizing the FITLIGHT TRAINER to work on their reactive training during their rehabilitation process.
The rehabilitation from an ACL tear can seem like a daunting process. It is essential to have an expert rehab team that you trust to help guide you through your process. Here at Columbia PT InMotion all our practitioners have post-doctoral certification and training in the functional rehabilitation/sports medicine of orthopedic/sport-related injuries. Allow us to help you on your path back to the field!