What Is ACL Rehab Physiotherapy?
If you play sports, you’ve likely heard of other players or professional athletes suffering from a ‘torn ACL’. A torn ACL is a relatively common, severe knee injury. While common in sports like basketball, football, skiing, and tennis, a torn ACL often means a long, frustrating rehabilitation process. So, what’s involved in ACL rehab physiotherapy?
NQ Physio Solutions are Townsville's leading sports and general physiotherapists and have treated hundreds (if not thousands) of torn ACL’s over the years. Within this blog article, NQ Physio are here to provide a full outline of the physiotherapeutic recovery process after a torn ACL, including torn ACL symptoms, causes, treatment, and recovery stages.
What is the ACL?
The Anterior Cruciate Ligament (ACL) is a ligament in the knee joint. It is considered one of the strongest ligaments in the body and is made up of two fibres along each side of the knee, and connects the femur (thigh bone) to the tibia (shin bone). The ACL ligament is responsible for the stability of the lower legs and prevents abnormal twisting movement like twisting too far forward, backward, or sideways.
An ACL ligament will become injured or torn when these motions occur and one or both of the two ligaments on each side of the knee are put under extreme pressure. ACL injuries often occur when there are abrupt changes in direction and speed, or there is too much force on the bent knee. A torn ACL is most common in activities like basketball, tennis, rugby, netball, and football.
What Are the Symptoms of a Torn ACL?
If you’ve ever had a knee or ACL injury, you know how uncomfortable and painful the condition can be. Generally, a torn ACL means that the knee loses most or all stability, and will not function as normal.
Although ACL Injuries can range from mild to severe, every ACL injury will often come with similar symptoms:
- When an ACL tears, the injured person will often feel a popping sensation. It can sound like something being ripped.
- Often there will be a sensation of the bones in the knee shifting
- The moment an ACL is torn, you may feel anything from mild discomfort to sudden intense pain
- The knee can feel very unstable after a torn ACL. It feels like it's about to give way.
- A torn ACL can make walking and getting around extremely uncomfortable. The movement of walking can be painful, unstable, and weak.
- A torn ACL results in a loss of range of motion in the knee. It's harder to bend or stretch the lower leg with knee movements.
- The in some cases knee will begin to swell within one to four hours after the injury.
What Is ACL Rehab Physiotherapy?
ACL rehab physiotherapy is a type of physiotherapy specifically designed to help patients recovering from an ACL injury, either as the only treatment or as part of the rehabilitation following surgery.
The focus of ACL physiotherapy is to restore strength, stability, and mobility in the injured knee joint. ACL rehab physio will help patients to get back into performing daily activities again, such as walking, running, jumping, or crouching down.
To regain those movements and improve mobility, physiotherapists will rely on various techniques and exercises taken from both general and sports physiotherapy practices. These may include stretching, remedial massage, strengthening exercises, and proprioceptive drills. Your physio will also offer ongoing professional and clinical advice, providing a treatment plan, at-home stretches and exercises, and ongoing strengthening to reduce the risk of knee injury in the future.
How long is the ACL rehab physio process?
The length of ACL physiotherapy and rehab will vary depending on the nature of your tear, the cause of the injury, and your range of motion after the injury.
When it comes to an ACL tear, there are different levels of severity. Therefore, every ACL injury will require a different treatment method timeframe, and number of physio sessions. Your recovery progress, overall health situation, and the intensity of the symptoms will also determine how long you’ll need to see a physio for.
Generally speaking, ACL rehab physiotherapy will require anywhere from a few weeks for a less severe injury up to several months to a year for more severe injuries and those involving surgery. Typically, if you have an ACL tear, you’ll need to see your physiotherapist once or twice a week for six weeks before the physio sessions can be lessened to fortnightly and eventually monthly sessions.
Will I require Surgery?
Not every ACL injury will require surgery. Even if you completely rupture your ACL the decision may be made to continue along a non-surgical pathway. Your Physiotherapist can assist you with choosing the right path of treatment and this will involve discussions with your GP and an Orthopaedic Specialist.
The Six Stages of Post-operative ACL Physiotherapy
The physiotherapy and rehabilitation process following an ACL reconstruction can be broken up into stages. There is an excellent guide called the Melbourne ACL Rehabilitation Guide. This Guide is based on goals rather than time frames and is tailored for those who wish to return to higher level sports as well as normal daily activities.
Injury Recovery and readiness for Surgery
In this stage it is important to allow the knee to settle from the injury and regain a good level of strength and function before surgery (if required). The important goals of this phase are to eliminate swelling, regain full range of motion and strength of the quads and hamstrings. This will allow for good preparation for surgery and allow our physios to determine your readiness to return to activity.
Recovery from Surgery
Surgery is traumatic to the knee and a period of rest and recovery is required following the operation. 1-2 weeks of basic range of motion exercises, quad setting and continued ice and compression will help allow the knee to settle.
The main goal following this phase is to get the knee straight, settle the post-surgical swelling and get the quad muscle to fire again.
Strength and Neuromuscular control
This phase is all about regaining more movement, muscle strength and starts to look at balance and basic co-ordination. Exercises in this phase will start out with body weight and progress into a gym-based program that will be prescribed by our physio’s based on your goals. This may include a mixture of resistance, balance and co-ordination exercises and drills. Typical exercises you might be required to perform are; lunges, squats, calf raises and non-impact aerobics such as cycling and swimming.
Listening to the knee is very important during this phase as pain and swelling may be indications that the knee is not tolerating the workload. The end goal for this phase is to regain most of your single leg balance, strength and perform a decent single leg squat with correct form.
Running, Agility and Landings
A return to running, jumping and agility is seen during this phase, as well as continued progression of your strength and neuromuscular control program. At this point the knee should be free of pain and swelling and emphasis on correct technique is pushed especially in landing and deceleration drills.
Activities such as shuttle runs, ladder drills, hopping and jumping will be performed with supervision from your physio to attain excellent hopping performance and to complete successfully modified gameplay in preparation for returning to sport.
By the end of this phase full strength and balance should be achieved.
Return to Sport
Training activities and exercises that a usual for your sport are integrated into the regime during this phase. The focus now turns to getting your knee ready to return to sport, but also the whole person. The knee needs to be stable and strong with great neuromuscular control. Furthermore, the athlete must be confident in their ability and match play situations to be ready and able to return to the game.
Your previous exercise program will be continued with added focus on progressive training from restricted play to unrestricted.
Prevent Re-injury
Finally, an injury prevention program will be established including plyometric, strength and balance exercises. Evidence shows that this program should be performed 10-15 minutes before all trainings and games and is ongoing to have the best change a preventing a re-injury. Your physio will ensure that the program is right for your sport and individualised to suit your needs.
Conclusion
If you’ve torn your ACL, rehabilitation can be a long, steep process. However, with the right support, physiotherapy can ensure that you make a full recovery and your knee is ready to get back into the sports and activities that you love.
NQ Physio Solutions are Townsville's leading sports and general physiotherapists. If you‘re dealing with an injured, partially torn, or completely torn ACL, get in touch with our expert team of physios to book in and begin your rehab.