The anterior cruciate ligament, or ACL, is one of the four main ligaments that stabilize your knee joint. A torn ACL is quite a common knee injury, especially in sportspeople, and is usually caused by a direct blow to the knee or by twisting your knee while your foot is planted on the ground or when landing. Surgery is often used to treat a torn ACL, but your doctor will make the decision based on your age and degree of physical activity.
About The ACL
The ACL's job is to stop your tibia, or lower leg bone, from moving forward out of your knee joint. One end of the ligament attaches to the bottom of your thigh bone at the back of your knee and the other end attaches to the top of your tibia at the front of your knee. The most common signs of a tear are a cracking sound at the point of injury, followed by extreme pain and difficulty moving and straightening your knee. Rest, ice, compression and elevation form the initial treatment; however, surgery is usually recommended if you are young, fit and healthy and physically active.
Rehabilitation Methods
Two main rehabilitation methods are typically employed after surgery for a torn ACL. Accelerated rehabilitation aims to restore you to full range of movement in six months, while the slower method takes nine months. Accelerated rehabilitation has been found to be more effective and patients who achieve a full range of motion early in their recovery have better long-term results and overall knee stability. However, you should always discuss your rehabilitation with your surgeon and/or physiotherapist.
Before Surgery and Early Rehabilitation
Regardless of whether you choose a fast or slow rehab program, your doctor or physiotherapist is likely to recommend gentle range of motion exercises to help reduce swelling in your injured knee and mobilize the joint. To help improve your ability to bend and straighten your knee, heel slides are a useful exercise. Lie on your back with your knees bent and your feet flat on the floor. Draw the foot of the injured leg up to your buttocks and out again, keeping your foot firmly on the floor at all times. Mild discomfort is common, but you should stop immediately if you feel any pain.
After Surgery
As with the preoperative/early rehabilitation stage, exercises immediately after ACL surgery are designed to reduce swelling, improve strength and restore range of motion. It is also important to regularly apply ice to the injured area. Static thigh contractions are recommended at this stage. Sit on the floor with your injured leg straight and the other leg bent. Place your fingers on the vastus medialis muscle above and to the inner side of your knee cap, then tighten your quadriceps and hold for five seconds. You should feel the muscle contract under your fingertips. Relax and repeat up to 20 times. Do this exercise regularly throughout the day.
Late Rehab and Ongoing Care
Once you can walk normally and manage going up and down stairs, your physiotherapist is likely to prescribe more advanced range of motion exercises, such as using the stationary bike and step machine. Once your injured knee is functioning at about 90 percent of your healthy knee, you are ready to move onto sport-specific drills -- such as ball skills -- if you are an athlete, or exercises for ongoing care if you are not. You should gradually increase the intensity and duration of these exercises as your knee fitness improves. For example, start by jogging 100 yards then walking for 50 yards and repeating six times. The next day, jog 150 yards and walk 50 yards, and so on until you are jogging a mile or more and not walking at all.
