Whether it is our favorite athlete on TV, family member or friend, most of us have all heard of or have seen someone suffer an ACL injury. The ACL is clinically defined as; the anterior cruciate ligament. The ACL is the ligament in the knee that connects and stabilizes the Femur or long thigh bone to the Tibia the lower leg bone. The ACL prevents the shin bone from traveling too far forward and away from the thigh bone. The ACL is integral during twisting and planting type motions of the leg when it is on the ground. Females are at a particularly increased risk due to the alignment of the knee and hips. However, young athletes, seasoned professionals and weekend warriors alike are all susceptible.
Not all repairs and rehabilitation are the same
Recently in the clinic, I have seen an increase of both pre and post-operative ACL tears. Not all ACL repairs and rehabilitation programs are created equal! In the past few years, surgical procedures have advanced to the point that accelerated and aggressive rehab programs can get you out of the brace, off crutches, and walking normally in as little as 6 weeks…not the 4-6 months that we have seen in the past. Full return to high-level athletic activities will still vary from case to case. Rehabilitation can vary based on the severity of damage to the other knee structures. The correct rehabilitation from a Doctor of Physical Therapy is paramount in getting you back in the game of life quickly and efficiently!
Dependent on surgeon and therapist preference, recent rehabilitation protocols have focused on early weight bearing, early full range of motion, and return to function quickly.
ACL rehab is broken down into 4 primary phases:
- Acute swelling management, early range of motion and retraining of daily activities. 1-2 weeks
- Basic strengthening and balance activities. 2-4 weeks
- Dynamic strength and endurance activities. 6-12 weeks
- Return to previous athletic activity. Target date is 6 months
Common Repair Types
Patellar Tendon grafts; Long considered the gold standard in ACL reconstructions favored for the strength and durability. These types of grafts while strong can often lead to front knee pain, tendonitis, and stiffness.
Hamstring grafts; The semitendinosus and in some cases the gracilis tendon are harvested at the time of surgery and used to create the new ACL. Outcomes in strength are very similar to the patellar tendon graft and are preferred due to less frontal knee pain.
Quadriceps tendon graft; Recent research has shown favorable outcomes to the use of this type of repair in which a thin portion of the tendon above the knee is harvested and used to construct the “new” ACL. I personally prefer this repair for the quick return to function and progressive rehabilitation.
Prevention is key!
The best way to avoid ACL surgery and rehabilitation is to prevent it. A comprehensive core, hip and knee strengthening and flexibility regimen under the supervision of a licensed Athletic Trainer or a Doctor of Physical Therapy can greatly reduce the risk and incidence of ACL tears.
Spooner & Hayward Physical Therapy & Wellness conduct an evidence-based ACL injury prevention program that is accessible to anyone at anytime. Do not hesitate to call today to prevent your ACL injury!
