Accelerated anterior cruciate ligament, or ACL, rehabilitation involves putting your injured knee in motion immediately after surgery. Traditional rehabilitation limited your knee's movements; you had to wear a brace for up to eight weeks and were encouraged to keep weight off the leg to protect the graph. After the late 1980s, a more accelerated exercise program became popular. This method can speed your participation in exercise and may help you return to "normal" life more quickly.
Traditional Rehabilitation
In 1982, your knee's range-of-motion, or ROM, weight-bearing activity and exercise after surgery was limited. Doctors typically recommended you wear a brace that kept your knee at 30 degrees of flexion, to protect the graft. You could not walk without a brace for six to eight weeks nor could you participate in sports for almost a year. These conservative methods led to high rates of postoperative complications like permanent knee stiffness, knee pain and low return to high-level sports.
Range-of-Motion
One of the biggest differences between traditional and accelerated rehab techniques is the emphasis on ROM directly after surgery. Doctors noticed noncompliant patients of traditional therapies fared better after surgery than compliant patients. They began ROM exercises earlier, and saw positive results. In 1992 the "Journal of Orthopaedic and Sports Physical Therapy" published an early study on accelerated rehab procedures. The study found patients that followed accelerated programs saw active and passive ROM return more quickly and fully than patients in traditional programs. As of time of publication, most doctors recommend using a CPM, or continuous passive motion, machine -- starting immediately after surgery -- to enhance your ROM recovery.
Return to Activity
Following an accelerated rehabilitation program, you can potentially return to your regular activities and sports more quickly. With traditional recommendations, you could not go back to playing sports for a year; in contrast, accelerating your therapy can get you back to sport-specific training in six to eight weeks. Competing at your full capacity typically happens within six months to a year. "The American Journal of Sports Medicine" featured a study in November of 1997 that found that the average time it took for accelerated rehab patients to return to sport-specific activity was 6.2 weeks. The mean time it took to regain full competitive capacity was 6.2 months.
Quality of Life
Putting weight on your leg, using crutches without a brace and exercising can help you feel more normal during recovery. Keeping your leg in a brace that locks it in a certain position and having limited ability to move around can hinder your working life as well as your personal life. Accelerated strategies allow patients to participate in daily activities and exercise programs more quickly; exercise is important for boosting mood and reducing stress, according to MayoClinic.com. Exercising stimulates brain chemicals that may leave you feeling happier and more relaxed. A lighter mood can enhance your self-esteem and help you avoid depression.
References
- Chester Knee Clinic: Accelerated ACL Rehabilitation
- "Journal of Orthopaedic Sports and Physical Therapy"; Traditional versus Accelerated Rehabilitation following ACL Reconstruction: A One-Year Follow-Up; M.S. DeCarlo et al; 1992
- "American Journal of Sports Medicine"; Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation. A two- to nine-year followup; K.D. Shelbourne KD and T. Gray; November 1997
- MayoClinic.com: 7 Benefits of Exercise
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