1. ACL Injuries Are Common
The anterior cruciate ligament prevents your tibia, or shin bone, from shifting ahead of the femur, or thigh bone, keeps the tibia at the correct angle relative to the femur and prevents excess tibial rotation. ACL tears, which occur when you plant your foot and turn too quickly or sharply, are one of the most common injuries to the knee, especially if you participate in high-impact sports. But they can also be work-related or due to trauma; even something like missing a step when climbing down from a ladder.
Symptoms are a sudden feeling that your knee is giving out, often accompanied by a "popping" sound, immediate swelling around your knee and pain. ACL injuries are not emergencies, so you have time to think about treatment options. Whether you choose surgery or a more conservative non-surgical approach depends on your lifestyle, your occupation, your age, the degree of damage or instability to your knee, whether the ACL was torn or ruptured and how you approach rehab.
2. Rehab for Non-Surgical Interventions
Rehabilitation after an ACL injury starts with reducing swelling while maintaining range of motion. You generally start with quad sets, heel slides, prone knee flexion and passive hamstring stretches. As you are able to bear more weight with fewer symptoms, you can progress to more intensive exercises, such as mini-squats, bridges and heel raises. When your strength and endurance improves, your therapist will add weight training and eventually balance and stability exercises. After formal physical therapy, you may continue rehab through fitness club programs with weight machines, exercise bicycles or treadmills. Non-weight bearing activities like swimming and cycling are great for building muscle around your knees.
3. Rehab After Surgery
Rehab following surgical repair of your ACL injury begins with a physical therapy visit to teach you some exercises you can do after you leave the hospital. You will be on crutches for a few weeks and may wear a brace at least part of the time. Rehab after ACL reconstruction surgery is similar to that for non-surgical treatment but proceeds somewhat more slowly. Initially, you will go to physical therapy frequently. Your exercises will focus on reducing swelling and maintaining range of motion. After 6 to 8 weeks, you will have fewer PT visits, but the exercise regimen will include more strengthening, balance and stability exercises. Your therapist may recommend additional exercises to be done at a fitness center. Your rehab may continue for several months, concluding with activities specific to your sport or activity.
More than 90 percent of people who have ACL reconstruction are able to regain their previous lifestyle. If you keep up with your rehab program, you can usually return to your normal activities about 6 to 7 months after surgery. While it's generally not required, you may feel more secure if you continue to use your knee brace for higher risk activities.
