What is an ACL Injury

ACL stands for anterior cruciate ligament and is located in the middle of the knee. Its primary function is to prevent the shin bone from sliding out in front of the thigh bone. An ACL injury occurs most commonly in contact sports where there is a sudden change in direction for example in football, rugby etc. Often an ACL tear does not happen in isolation and other structures of the knee may be damaged, such as the cartilage and collateral ligaments.

An ACL tear usually occurs as a result of either a twisting force being applied to the knee while the foot is firmly planted on the ground or twisting of the knee when landing from a jump. They can also occur from contact situation such as a direct blow from the outside of the knee causing the knee to buckle inwards. The ACL can be partially or completely torn. If you suspect an injury to your ACL you should seek medical guidance as soon as possible. Your physiotherapist will be able to assess the integrity of you ACL and recommend further medical treatment should it be required.

What is the Treatment for an ACL injury

Following an ACL tear most people opt for surgical reconstruction. However, it must be clear that surgery is not always necessary and some people complete intensive physiotherapy rehabilitation and function day to day very well without surgery. The overall decision on whether to operate depends on a number of factors such as the athlete’s age, their occupation, their lifestyle and the degree of instability within the knee, and an orthopaedic surgeon will be able to advise on which treatment approach is preferable. Before opting for surgery you must be aware that you will need some time off work in the initial recovery period. Moreover, you will also have to dedicate a lot of time and effort to your rehabilitation to make the best recovery possible.

ACL Rehabilitation

After diagnosis of an ACL tear and the initial acute management phase, the first stage of recovery is to restore full range of movement through mobility exercises. Prior to surgery the surgeon will want the swelling to be reduced and normal knee movement to be restored, as research has shown that this results in better outcomes after surgery.

Each patient and injury will be different so it is important to see guidance from a trained physiotherapist to guide you through your rehabilitation. Below are some of the keys areas that your rehabilitation will focus on.

• Mobility – Knee mobility exercises are of upmost importance after surgery and should begin as soon as possible to allow for correct healing of the reconstructed ACL and return to normal function.
• Strengthening – Strengthening exercises will also begin very soon after the surgery as pain allows. Static and active strengthening exercises will be prescribed with gradual increase in intensity and load.
• Proprioception – Proprioception is your body’s awareness of where a joint or limb is in space. Proprioception exercises re-establish this natural instinct in the body and facilitate the surrounding muscles of the knee to react quickly enough to control movement and prevent further injury. Similar to mobility and strengthening exercises these exercises will be performed progressively throughout the rehabilitation process.
• Functional and plyometric exercises – Plyometric exercises are dynamic exercises that often have an explosive element to them. The idea of these exercises are to bridge the gap between regaining normal strength and translating this into full training and return to competition. Sport specific drills and exercises will help you build your confidence and fitness levels prior to returning to your sport.

Here at Ballsbridge Physiotherapy Clinic our physiotherapist are trained in ACL rehabilitation. Two of our therapists, David Richards and Olive Mc Cafferty have a masters in Sports and Exercise Medicine and work with sports teams. Contact the clinic today to book an appointment. We have both early morning and evening appointments.