Anterior cruciate ligament (ACL) rupture is a debilitating injury which we often hear about happening to professional sports people, however we are seeing more and more of these injuries at our Auckland Physio clinic in everyday athletes. The ACL is a ligament inside your knee joint that attaches to your tibia (shin bone) and femur (thigh bone). Its purpose is to create stability in the knee preventing anterior (forwards) translation of the tibia and protecting against rotational forces.
The majority of ACL injuries occur in the younger more active population and are usually the result of slowing down or deceleration, landing, or a pivoting injury. Some may describe a popping sensation or sound and have a loss of range of motion at the knee, however the key sign is an instant large swelling at the knee. Bruising may also develop, and most people will find it hard to put weight though the injured leg and it may feel unstable.
Treating an ACL rupture will depend on an individual’s age and their activity levels. Roughly 80% of those who rupture their ACL will eventually undergo surgical reconstruction. This is usually the case for younger people and those that are hoping to return to their chosen sport or leisure activity. For some patients who enjoy low impact activities such as walking, they can function perfectly fine day to day without ACL reconstruction surgery, however a supervised rehabilitation programme should be implemented to improve strength and control of the knee.
Physiotherapy plays a huge role in the pre- and post-operative management for patients to ensure the best chance of full recovery from an ACL rupture. One of the main predictors of a successful ACL rupture rehabilitation is prehabilitation. Research shows that patients who undertake a quality prehab programme to regain full knee range of motion, remove swelling and regain 90% in the strength of your quad muscles compared to the opposite limb have a significantly improved outcome post-surgery than those who don’t.
On the flip side, research has also shown that approximately 40% of males under the age of 25 who undergo ACL reconstruction surgery will re-rupture the same ACL within two years. This is believed to be due to poor rehabilitation quality, poor compliance to ongoing strengthening and balance exercises and the individual returning to high level activity too soon.
At our Auckland physio clinic, we treat a number of patients with ACL injuries. We provide a quality prehab programme which include a number of treatment options including exercises to help regain a full range of motion, compression to help control swelling around the injured knee and where appropriate we use acupuncture to help alleviate pain and swelling. On top of this we provide targeted exercises to help strengthen your entire lower limb and we work on the control of your knee with balance exercises.
Recovery and rehabilitation of an ACL injury is not a short process. Although rehab is based on functional ability rather than time, six months of rehab is normally required before a patient should returning to running and 12 months before contemplating returning to sport.
An ACL rupture not only has a significant impact on an athletes’ playing career but can also have impact later in life with increased risks of osteoarthritis of the injured knee. Not all is lost though as many people who sustain ACL injuries and complete a quality rehabilitation programme can regain full function of their knee and not have it bother them again. Contact us to today at Cairnhill Physiotherapy and we can help give you the best chance of recovery for your ACL injury.