At Ground Up Physiotherapy, we’ve seen an increased amount of ACL (Anterior Cruciate Ligament) injuries over the last couple of years. And the common trend we hear is what is it, and should I do surgery or not?
It generally depends on what state your ACL is in upon injury and whether there are other structures involved too. However, both generally require the same amount of grit and determination during your rehabilitation as it’s a 12 month journey.
What is an ACL and how does it occur?
The ACL plays a critical role in stabilising the knee, preventing excessive forward movement and ensuring rotational stability.
Positioned within the knee's notch, it connects the thigh bone (femur) and shine bone (tibia), illustrated through models to highlight its function. Alongside its counterpart, the posterior cruciate ligament (PCL), the ACL is pivotal in maintaining knee stability during directional changes. ACL sprains or tears, often caused by excessive knee stress, can lead to instability and potential tibia displacement.
These injuries frequently arise from non-contact situations, like abrupt stops or shifts in direction during activities like running or jumping.
Signs and Symptoms of ACL Injury
Symptoms of an ACL injury typically include:
- Popping sensation at the time of injury
- Swelling of the knee joint
- Difficulty bearing weight on affected leg
Diagnosis of an ACL injury usually involves a physical examination by a healthcare professional, followed by imaging tests such as MRI to confirm the extent of the damage.
Treatment Options for ACL Injury
When it comes to treating ACL injuries, several factors need to be considered, including:
- Severity of the injury
- Patient's activity level, and
- their overall health
Treatment options include:
Surgical Intervention:
In ACL reconstruction surgery, the torn ACL is commonly replaced with a new ligament crafted from the patient's own tissue.
The patient's own tissue can be harvested from various areas including the iliotibial band, hamstring, quadriceps, or patellar tendon.
The surgery is typically performed arthroscopically, utilising small incisions and specialised instruments. While a slightly larger incision is necessary to obtain the tissue graft, the procedure is usually done on an outpatient basis, allowing patients to return home the same day.
Non-Surgical Management:
Non-surgical treatment for ACL injuries offers a credible alternative to surgery, as supported by new recent research.
The Cross-bracing protocol, developed by Dr. Mervyn Cross and Dr. Tom Cross in 2014, is a procedure that involves immobilising the knee at 90d of flexion after ACL rupture in an attempt to facilitate bridging of the tissue and healing between the ruptured ACL remnants.
Keep in mind, there is a strict criteria and protocol that must be met for eligibility.
Exercises for ACL
Injury Rehabilitation:
Early Stage Rehab: The primary focus lies in:
- Restoring the range of motion in the knee and
- Establishing natural walking patterns.
Mid Stage Rehab:
The approach encompasses muscle strengthening, movement training, and fitness reconditioning, with a particular emphasis on exercises aimed at strengthening the lower limb whilst preparing the injured client for a return to running.
End Stage Rehab:
This is when we start to integrate on-field running, change of direction as well as sports-specific movements to prepare the athlete to return to their respective sport.
ACL rehabilitation can be quite demanding physically and emotionally as the process can take up to 12 months. If you suspect you may have an ACL injury, contact us on 0481 873 288 or book online for a consultation to get you returning to sport in a timely manner. Ground Up Physiotherapy is located inside a well-equipped gym that can accelerate your rehabilitation strength.
