ACL: The Rehabilitation Process

aclIn this fourth installment of our ACL Series, we will discuss keys and areas of focus during the early phases of rehabilitation following ACL surgery.
1) Protection and Controlling Pain and Inflammation- Following surgery, the main goal of therapy will be protecting the surgical site, managing any inflammation/edema, and facilitating the healing process. We want to make sure the surgical site is clean and doesn’t get infected. Also, managing swelling is extremely important, not only because it can cause pain/discomfort and limit range of motion, but also because it affects the quadricep muscles’ ability to contract.

2) Restoring and Maintaining Range of Motion- A potential complication following ACL surgery is loss of motion, with a lack of extension, or knee straight, more common than flexion or knee bent. Achieving range of motion to that of the uninvolved limb is of crucial importance to allow for proper function of the knee with every day activities like walking, stairs, and higher level activities like running and jumping. If you don’t properly restore motion in the knee you can run the risk of developing arthritis, as well as, causing various deviations and compensations with your movement.

3) Training – Retraining muscles not only for strength, but also proprioception, or your body’s sense of position in space, will be crucial during rehab. The initial focus will be on restoring the quadricep muscles’ ability to contract and strength in that muscle.

4) Normalizing Gait – Once adequate function of the quadricep muscles and knee extension range of motion is achieved, the pieces are put together to work on achieving normal walking. Exercises will focus on proper weight shifting from leg to leg, making sure the right muscles are firing, and any adjustments will be made based on observations by the Physical Therapist and feedback from the patient.

Everything mentioned and outlined above are important to ensure that the early phases of rehabilitation go well and to try and avoid complications down the road.
Our next and last post in our ACL Series, will discuss returning to sport. We will discuss what the later stage of rehabilitation will look like, talk about criteria we use to help determine whether an individual is ready to return to sport, and how to screen/assess in order to help avoid re-injury.

Posted in: Knee

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