Physiotherapy prior to undergoing ACL reconstructive surgery has been shown to be effective in improving strength and balance in an ACL deficient knee. These improvements may reduce the episodes of ‘giving way’ and decrease the chances of re-injury in an ACL deficient knee. Following an ACL injury the knee may incur deficits in terms of strength, proprioception (the ability to maintain balance), muscle timing and gait (walking patterns). Rehabilitation pre-operatively would aim to restore full range of motion, muscle strength and adequate neuro-muscular control.
Post operative Physiotherapy
The major goals of rehabilitation of the ACL-injured knee are:
To restore range of motion and stability to the knee, whilst protecting the reconstructed ligament.
Gain good functional stability
Repair muscle strength
Reach the best possible functional level
Decrease the risk for re-injury
The anterior cruciate ligament graft takes approximately 6 months to biologically heal, and this healing time must be respected. The final goal is to prevent knee instability and enable you to return to the level of physical activity that you enjoyed prior to your ACL injury.
Return to Sport
Strength and power deficits after surgery may be a risk factor for future injuries and may set athletes up for failure when they try to return to their prior performance levels. Researchers suggest that the surgically repaired leg should perform at least 90% as well as the uninjured leg before you return to sport ( J Orthop Sports Phys Ther 2011;41(6):388. doi:10.2519/jospt.2011.0504). Three hopping tests can be used as part of a comprehensive physical and functional examination to help ensure not just a speedy, but a safe return to sport after ACL reconstruction. These 3 tests are sensitive enough to measure side-to-side differences and can be used during more advanced recovery phases after surgery to help ensure that the athlete’s exercise program is successful in returning the injured leg at least to the level of the uninjured leg. J Orthop Sports Phys Ther 2011;41(6):388. doi:10.2519/jospt.2011.0504)
About the author:
Dr Jan Naughton received her PhD at Sydney University where she was lecturing in Sports Medicine and undergraduate physiotherapy. She specialises in shoulder injuries and has a sports physiotherapy practice in Wahroonga on Sydney's upper north shore working with two other specialist colleagues.