ACL Injury & Treatment 1

ACL Injury & Treatment

Background Information

The Anterior Cruciate Ligament, of ‘ACL’ is one of the major stabilising ligaments within the knee joint. ACL injury is one of the most common injuries seen in sporting populations – particularly in sports involving change-of-direction or pivoting maneuvers, such as soccer, netball, AFL and rugby. Following an ACL injury, athletes often report hearing a loud ‘pop’ or ‘crack’ within the knee. Usually, the player will be unable to continue playing, and will report immediate onset of pain and swelling around the joint.

Commonly, ACL injury occurs when an athlete ‘cuts’ or changes direction abruptly. This movement causes the knee to fall inwards, placing stress on the ACL. This type of injury indicates that the muscles that stabilise the knee (including the thigh and calf muscles) are not strong enough to support the knee and protect the ACL during rapid change of direction maneuvers. As such, the best way to rehabilitate an athlete after ACL injury, and to prevent injury recurrence, is to progressively strengthen the muscles around the knee. Additionally, it is important to also improve balance, control, and endurance of these muscles. Sometimes, in addition to physiotherapy rehab, surgery may be appropriate to increase the stability of the knee after ACL injury (however, this is not always necessary). 

Assessment

To gain a clear understanding of your injury, during your first assessment, your physiotherapist will ask you questions about your symptoms, how the injury occurred, and about your medical history and involvement with sporting and other physical activity. Your physio will then assess your knee joint, and surrounding structures. This assessment may involve:

  1. Feeling the knee joint to identify any swelling or tenderness
  2. Assessing the strength, endurance and control of the muscles around the knee
  3. Checking for any damage to the ligaments within the knee (including the ACL)
  4. Assessing strength, balance, and control of knee during activities such as walking, squatting, jogging, and jumping

Treatment

Based on the findings of the assessment, your physio will develop an individualised treatment plan and exercise program for you, to help you achieve your rehab goals (whether that’s to get back on the sporting field, or to get back to playing with your grandkids). Some key aspects of your treatment may include:

 

  • Early Management (0-2wks)

 

    • Soft tissue release, icing and compression, to reduce pain and swelling.
    • Restoration of joint range with gentle exercises.
    • Advice and education regarding load-management through your knee joint, and avoidance of non-optimal movement patterns.

 

  • Exercise Program Phase 1 (0-8wks)

 

    • Optimisation of the way your knee moves during activities such as walking, jogging, and squatting.
    • Low-level strengthening exercises for the muscles that stabilize the knee (calf, thigh, hip muscles)
    • Low-level balance and control exercises
    • Gentle jogging drills

 

  • Exercise Program Phase 2 (2-6mths)

 

    • Moderate-level strengthening exercises 
    • Moderate-level balance and control exercises
    • Increased volume of jogging drills
    • Begin jumping and landing exercises

 

  • Exercise Program Phase 3 (6-9mths)

 

    • High-level strengthening exercises
    • High-level balance and control exercises
    • Complex jumping and landing exercises
    • Change-of-direction and high-speed sports-specific drills
  • Return to Training/Sport (9-12mths)

Prognosis

Most patients will notice significant reductions in pain and discomfort over the first few weeks of rehab and will also demonstrate steady improvements in knee control and strength over the first 1-2 months after injury. Your physio will work closely with you along each stage of your rehab journey, to help you achieve your goals. With excellent compliance with physiotherapy and exercise programs, most people can return to doing the things they love, including high-level sports, within 9-12mths.

If you need help with pain or immobility to get you moving again, or need a tailored exercise program, book in for your treatment with one of our physios via 1300 012 273 or head to our website and book a session at your nearest clinic.