Whether you are a fan of football, baseball, basketball, or any other recreational activity you have at one time or another heard of an ACL injury. Maybe your favorite athlete was sidelined for months with a tear to their ACL, or possibly it was you that had to watch from the sidelines for a few months. The Anterior Cruciate Ligament (ACL) is in fact a common major injury to the knee. Luckily for us with a good surgeon and physical therapist, an ACL injury is not career threatening. Read more about ACL injuries and what to expect during the rehab process.
Anatomy of the Anterior Cruciate Ligament (ACL)
Each one of our knees contains a number of ligaments that help stabilize its movements. Of the four major ligaments contained within the knee capsule, the ACL is considered by many to be the most important because it provides the majority of the knee's stability. The ACL's main objective is to stabilize the knee during planting and twisting motions, as well as prevent forward movement of the lower leg from the upper leg. It is able to do this by attaching to our upper leg at the front of the femur and crosses the knee to attach to the lower leg at the back of the tibia. When an injury to the ACL occurs it is either a partial or full tear of the ligament. The joint responds as it would to any other soft tissue injury by swelling. Some people hear a pop while others just notice an extreme lack of stability and a sense of the knee giving out when weight is shifted on to that leg. Depending on the extent of the injury a patient may or may not have surgery to repair a partial tear of the ACL. As previously mentioned it is not just athletes that experience tears of their ACL. Women tend to be more prone to an ACL injury, an unfortunate problem attributed to a number of factors. Anatomical factors that can contribute to one's likelihood of injury include: strength imbalances between the hamstrings and quadriceps, joint laxity, and a large Q-angle.
Typical Rehabilitation Actions
Surgical and non-surgical rehabilitation protocols are very similar, if not the same in many cases. Once the surgical wounds have healed a patient will then schedule their first appointment with a physical therapist. The physical therapist will develop a plan of action for the patient's treatment. The most important objective early on is to reduce swelling and work to prevent scar tissue buildup. The next objective is to regain full range of motion, while simultaneously strengthening the muscles that support the knee joint. With full of range of motion and increasing strengths, eventually a physical therapist will finish their rehab treatment with a phase of neuromuscular control activities and functional movements that correspond with the patient's everyday needs.
It is wise to follow the acronym PRICE during the early stages of recovery from an ACL tear. PRICE stands for protection, rest, ice, compression, and elevation. By following these five steps each day a patient will effectively decrease their pain and swelling and better prepare their joint for the recovery process. About one or two weeks following surgery the patient will begin physical therapy. The physical therapist will perform an initial evaluation consisting of background questions, and visual and physical inspection of the knee itself. With this information a physical therapist will develop a detailed plan specific to each patient's rehabilitation needs.
Rehabilitation Timetable & Expectations
As with any injury the expected time of recovery is based on numerous factors, such as: age, extent of injury, success and type of surgery, work ethic during rehab, physical therapist technique and care to detail, and overall health and fitness of the patient. An average patient, who had a traditional ACL surgery, will begin light jogging about four months post-surgery with full strength and mobility not being full restored until about six to nine months after surgery. Most doctors will advise a patient to not return to more aggressive physical activities until their recovering leg has gained at least 90% of the strength of the healthy leg. There are more advanced surgeries that can put an athlete on the playing field in about six months. This option is intended for serious athletes only and a physician should be consulted before investigating this alternative.
Any type of major injury can be a setback in an athletic career, or quite a struggle to deal with in day-to-day life, and an ACL tear is no different. Surgery and rehabilitation techniques are improving each day and are therefore making the recovery from such an injury less painful. A patient who is dedicated to their complete recovery will have a much better experience throughout the process and give themselves a great opportunity to continue their life, be it as an athlete or not.
Robert Tendick is a student preparing himself to earn a Doctor of Physical Therapy. Through his degree in Kinesiology and experiences as an athlete, Robert has become familiar with injuries to the ACL and common expectations for ACL surgery recovery. He has also had the opportunity as a physical therapy aide to help heal a number of Los Angeles physical therapy patients through the use of cutting edge injury rehabilitation techniques.
