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Knee ACL Injury and its Rehabilitation

Knee ACL Injury rehabilitation:

Knee ACL Injury are rarely isolated events. The existence and severity of additional ailments may influence how the ACL damage is handled. The method of injury can indeed cause damage to the Medial Collateral Ligament (MCL) or the meniscus. Microfractures or bone contusions, with or without chondral injuries, might also be related injuries.

The primary aims of rehabilitation are:

  • Gain full ROM of the knee
  • Repair muscle strength and proprioception
  • Gain in good functional stability
  • Reach the best possible functional level (walking, running, jumping…)
  • Decrease the risk for re-injury
  • Return to sport

ACL rehabilitation can have 4 different stages such as Acute stage, pre-surgical stage or conservative treatment, post-surgical stage, and return to sport.

There are various concerns in the acute care period to safeguard the surgical repair and enable healing without affecting ROM.. such as

  • During rehabilitation, the patient can move freely, either actively or passively, across the available range of motion while remaining pain-free.
  • Bracing can use to prevent re-injury during the acute period.
  • Partial weight-bearing to protect against scarring, enable healing, and restore joint homeostasis as soon as feasible.
  • On day 10, or if 110° knee ROM reach, a stationary bike can introduce.
  • To minimize scar hypertrophy and stiffness, resistance weight-bearing strength training should avoide until 6 weeks after surgery.

Physiotherapy Rehabilitation of Knee ACL Injury:

First and foremost, early ROM restoration is initiated in order to limit the danger of arthrofibrosis. Active-assisted knee flexion off the side of the bed can be progress to wall slides, active-assisted sitting, and a half-circle movement on a stationary cycle.

Gradually increase weight-bearing exercises: weight-bearing exercises can start from 1st-day post-surgery if there is only the ACL injury. In another case where ACL injury is accompanied by injury of other structures such as meniscus, and cartilage, their weight-bearing can start after the 6th week.

The third rehab program includes building muscle endurance and this can be achieve by: training with low resistance and greater repetitions exercises.

Then, Strengthening exercises can be initiate from the 19th week which includes: strengthening of the upper and lower body, some exercises are leg press, single leg bridge, Romanian deadlift, squat, single-leg squat, and nordic hamstring curl, etc.

Regaining muscle power: physiotherapists design a special exercise program to regain muscle power.

Building running tolerance: start with treadmill running then progress to pool running exercise in addition to cardio exercises.

Speed and agility training: Starts at week 32. And physiotherapists introduce uni-directional drill training for a week then progress to multi-directional training.

Then finally, return to play in which athletes train to perform their respective sports at their best.

Along with all the above treatments physiotherapists also use electrotherapy to achieve all the rehabilitation goals such as Extracorporeal shock wave therapy, Wireless professional, combo therapy, cryo therapy, high-intensity class 4 laser therapy, etc.

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