ACL Injury Physiotherapy | Move Physiotherapy Fremantle
Have you or a loved one recently suffered an ACL Injury? Perhaps you have tweaked your knee and are unsure whether you have sustained an ACL injury? Move Physiotherapy Fremantle are your experts in acute knee injury diagnosis and rehabilitation.
Our physiotherapists can provide an accurate diagnosis of your knee pain pathology often without the need for further investigations. When an acute ACL injury has been suspected, your physiotherapist can identify whether further investigations such as an MRI is required.
Your physiotherapist is integral in your ACL rehabilitation protocol, regardless of whether you elect for a surgical repair of your torn ACL, or choose to simply rehabilitate your knee conservatively. At Move Physiotherapy we are equipped with an onsite 200m2 semi-private gymnasium which can be fully utilised to return you to the activities you love the most.
MECHANISM OF ACL INJURY
ACL injuries are most common in athletes who participate in sports involving pivoting and changes in direction, such as basketball, Australian Rules Football and netball. They can range from mild injuries where the ligament is only partially torn through to complete ruptures of the ligament.
ACL injuries can occur in both contact and non-contact situations, however non-contact injuries are most common. Non-contact injuries most commonly occur when landing from a jump, decelerating from sprinting or rapidly changing directions. The mechanism of injury involves an excessively outwardly rotating tibia on an inwardly rotating femur. It is common for the athlete to report hearing an audible ‘pop’ as the ligament ruptures.
A full rupture of the ligament is often less painful than partial tears. However, both injuries are often accompanied with a significant amount of swelling. Appropriate first aid management of knee injuries – such as rest, ice, compression and elevation – is highly important when suspecting an ACL injury. In the event of acute locking and giving way of the knee joint, it may also indicate that other structures have been damaged. An ACL injury can often occur in conjunction with injury to the medial meniscus and medial collateral ligament, in what is termed an ‘unhappy triad.’
ACL REHABILITATION PROTOCOL
At Move Physiotherapy, we follow a criterion based rehabilitation protocol. 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.
Quite simply, 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.
Stage 1: Recovery From Surgery
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.