ACL Tear

History

A 15 years old female Miss K who is a netballer presents with a right ACL reconstruction surgery one week ago. Her surgeon has referred her to do physiotherapy. What does she need to do in rehab?

Clinical examination

The patient is walking with two crutches. Her knee is moderately swollen. Her wound is covered by wound dressings. Her knee extension range is -5 degrees (meaning it’s in a slightly bended position) and her flexion range is about 20 degrees, both motions are limited by pain and stiffness.

Management

It is expected that ACL reconstruction rehabilitation to be a lengthy process. It generally takes at least six months to twelve months to return to sports. Most surgeons would provide the patient and the physiotherapist a rehabilitation protocol, but it is common to have variations which depend on the graft choice and individual factors.

Initial stage of ACL-recon for Miss K focuses on swelling control and restoring her loss of knee extension range. This is critical as it allows her to walk with normal gait as soon as possible and avoid the development of compensation strategies. Her treatment includes manual therapy, compression therapy, and inner range closed chain quadriceps exercises. 

In six weeks times, Miss K has recovered full knee extension and ninety per cent flexion range of motion.

Depends on the sports type, most patients can return to sports after six to twelve months. In between this six to twelve months, there is a variety of exercises need to be covered to allow successful return to sports. That includes improvement on proprioception, strength, balance, flexibility, agility, functional strength, plyometric ability and sports-specific skills.

As Miss K is very compliance to her rehabilitation program and keen to return to sports. She performs her exercises well and on schedule. She is able to return to low level netball in nine months.

If you have any questions regarding your post operative rehabilitation or are interested in seeing if we can help you, please give us a call at (02) 8411 2050. Here at Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.