Have You Suffered an ACL Injury?
Anterior Cruciate Ligament (ACL) injuries are an unfortunate, but somewhat common injury for the young and athletic sporting population. Furthermore, these injuries can have potential long term implications for lower limb function, return to sport capacity, post-traumatic osteoarthritis of the knee and general quality of life.
These injuries are most common in athletes who participate in sports involving pivoting and changes in direction, such as basketball, AFL and netball. These can occur in both contact and non-contact situations, however non-contact injuries are the most common. Non-contact ACL injuries generally occur when landing from a jump, decelerating from sprinting or rapidly changing directions.
The mechanism of an ACL injury occurs with a rapid externally rotating tibia (shin bone) on an internally rotating femur (thigh bone). It is common for athletes to hear an audible ‘pop’ as the ligament ruptures; which is often accompanied with significant swelling.
Our physiotherapists can provide an accurate diagnosis of the acute knee injury. When an acute ACL injury has been suspected, your physiotherapist can identify whether further investigations such as an MRI is required. They can also explain your rehabilitation scenarios, and what you can expect whether you choose a surgical or non-surgical recovery pathway.
At Move Physiotherapy, we follow a criterion based rehabilitation protocol. This is the gold standard of ACL rehabilitation protocols; regardless of whether you have chosen a surgical or conservative management pathway. The idea behind this progression of ACL rehabilitation, is that it requires an athlete to achieve certain steps of strength and control before they can progress their rehabilitation and eventually return to sport. It also allows the athlete to go through their rehabilitation at their own pace. Even if you choose a non-operative pathway, you may be able to return to your sport.
Furthermore, in the case of operative management, it prevents an athlete from returning to sport and potentially re-injuring their knee simply because it has been 12 months since their date of operation. Our protocol only permits an athlete to return to sport once they have satisfied our levels of strength and neuromuscular control that satisfies their sporting activity.
You can read more about this below.
ACL REHABILITATION PROTOCOL
Stage 1: Recovery From Surgery (If Applicable)
Your ACL operation is a traumatic event for your knee. Although at this stage, many athletes are rearing to commence their rehabilitation, it is best to let your knee settle for 1-2 weeks.
Your physiotherapist will set you simple range of movement exercises and muscle ‘setting’ exercises, however our primary aim is to allow the swelling to settle in your knee.
Stage 2: Regain Strength and Balance
In stage 2, we aim to rebuild strength in the muscles surrounding your knee, such as your quadriceps, gluteals and hamstring muscles. If you have undertaken a hamstring graft ACL replacement, regaining strength in your hamstrings is paramount in this stage.
We also aim to restore your balance. For example, most athletes between 15-30 years should be able to maintain single leg balance for 45 seconds and greater.
Stage 3: Running, Agility and Landing
Once you have passed the criteria of progression from stage 2, we can commence our running and agility drills.
At this stage, we examine your jumping and landing mechanics. For example, there is research that demonstrates that a quadriceps dominant jumping and landing style carries a greater risk of ACL injury compared with gluteal patterns of jumping.
We also progressively incorporate agility drills into your training, such as changes in direction, hopping and landing.
Stage 4: Sport Specific Training
At this stage, we will customise your ACL rehabilitation program to drills and exercises that are specific to your sport.
The demands of each sport vary considerably. For example, the requirements of playing netball and basketball are completely different to the demands of dancing!
At Move Physiotherapy we will work with you to ensure that you are confident and ready to return to sport and minimise the risk of re-injury.