ACL STRAIN

• Commonly in Sports related injuries
• side impact injury
• Twist your knee while keeping your foot planted on the ground.
• Stop suddenly while running.
• Suddenly shift your weight from one leg to the other.
• Jump and land on an extended (straightened) knee.
• Stretch the knee farther than its usual range of movement.
• Experience a direct hit to the knee

• ACL tear can be partial(incomplete) or complete depending upon the severity of trauma.
• ACL injury can lead to sudden increase in pain and swelling over the knee and in long term can cause instability or feeling of giving away while walking

Once an ACL tear has been diagnosed, you will work with your orthopaedic and physical therapist to decide if you should have surgery, or if you can recover without surgery.

GOALS OF PHYSIOTHERAPY

 If you don’t have surgery, your physical therapist will work with you to restore your. 

muscle strength

agility

balance

return to your regular activities. 

PHASE OF TREATMENT

The physiotherapy intervention could be divided in phases:

• Acute Stage
• Pre-surgical Stage or Conservative Treatment
• Post-surgical Stage
• Return to sport

ACUTE STAGE

After an ACL injury physiotherapy management focuses on

regaining range of movement

strength

proprioception and stability.

In the acute stage PRICE should be used in order to reduce swelling and pain, to attempt full range of motion and to decrease joint effusion. 

KINESIOLOGY TAPING

Kinesio tape (KT) is an elastic therapeutic tape, which is proposed to be beneficial:-

• in the prevention and treatment of sports injury
• by decreasing pain and increasing proprioception
• muscle activity and active ROM

TREATMENT BEFORE SURGERY

Your physical therapist will help :-

• decrease your swelling
• increase the range of movement of your knee
• strengthen your thigh muscles (quadriceps).

TREATMENT BEFORE SURGERY

Your physical therapist will help :-

• decrease your swelling
• increase the range of movement of your knee
• strengthen your thigh muscles (quadriceps).
• program to meet your needs and gently guide you toward full weight bearing.
  • Icing and compression.
  • Immediately following surgery,
  • control  swelling with a cold application,
  • such as an ice sleeve, that fits around your knee and compresses it.
  • Some surgeons will give you a brace to limit your knee movement .

Movement exercises. 

1^st week

• begin to regain motion in the knee area
• teach you gentle exercises you can do at home.
• The focus will be on regaining full movement of your knee.
• The early exercises help with increasing blood flow
• helps reduce swelling.

Movement exercises. 

1^st week

• begin to regain motion in the knee area
• teach you gentle exercises you can do at home.
• The focus will be on regaining full movement of your knee.
• The early exercises help with increasing blood flow
• helps reduce swelling.

Strengthening exercises.

In the first 4 weeks after surgery,

• increase your ability to put weight on your knee,
• combination of weight-bearing
• non-weight-bearing exercises.
• focus on your thigh muscles (quadriceps and hamstrings)
• range of motion to protect the new ACL.
• During subsequent weeks :- increase the intensity of your exercises and add balance exercises to your program.

Balance exercises. 

• exercises on varied surfaces to help restore your balance.
• Initially, the exercises will help you gently shift your weight on to the surgery leg.
• progress to standing on the surgery leg
• on firm and unsteady surfaces to challenge your balance.

MONTH 3

• After 3 months the patient can move on to functional exercises such as
• running and jumping.
• As proprioceptive and coordination exercises become more intense
• faster changes in direction are possible.

MONTH 4-5

• The final goal is to maximize endurance and strength of the knee stabilizers, optimize neuromuscular control with plyometric exercises and to add the sport-specific exercises.
• Acceleration and deceleration, variations in running and turning and cutting manoeuvres

RETURN TO SPORT OR ACTIVITIES.

• As athletes regain strength and balance
• they may begin running, jumping, hopping, and other exercises specific to their individual sport.
• This phase varies greatly from person-to-person.
• Physical therapists design return-to-sport treatment programs to fit individual needs and goals.