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ACL Injury – Anterior cruciate ligament (ACL) injuries are one of the most common knee injuries, and are typically seen in sports that involve change in direction or landing from a jump. The mechanism is often in a noncontact situation when the athlete feels that the give way or collapse, sometimes hearing a pop. Contact injuries usually occur when the foot is planted at an external force is suddenly applied to the knee. Swelling usually appears within a couple of hours.

Diagnosis

Clinical tests in experienced hands have a high accuracy in diagnosing an ACL rupture. An MRI can be useful in confirming the diagnosis, and also assessing for associated injuries.

Initial Management

Crutches can be used initially to help you get around, but generally we encouraged patients to achieve a normal gait as soon as possible. Early weight bearing will help maintain muscle control. Quads and gluteal activation and strength exercises are also needed to maintain muscle function.

Ice and compression are used to reduce swelling and pain. Gentle but regular range of motion exercises to assist in regaining your movement. Once you have enough range a stationary bike is an excellent way of reducing stiffness and improving quads strength.

Rehabilitation

it is important to begin functional lower limb strengthening such as squatting or step ups as soon your knee allows. The number of repetitions and load will be dependent on symptoms and effusion (swelling). Balance exercises and neuromuscular control are important to regain the dynamic stability of your knee.

You should avoid impact activities or weighted gym exercises until cleared by your physiotherapist or specialist.

Surgical opinion

When your goal is to return to higher demand sporting activities surgical opinion is recommended. It is important to remember that ACL reconstruction does not need to happen straightaway, and in fact evidence shows that operating on a knee with good range of motion, no swelling, and good quad strength leads to improved outcomes post surgery.

Conservative management?

For people with low activity demands on their knee, generally sticking to straight line activities or controlled exercise such as swimming and the gym, conservative rehabilitation is a viable option. Rehabilitation will be progressed over 3 to 6 months, and a successful outcome is dependent on regaining full function and confidence in the knee.

Injury Prevention

Randomised controlled trials have shown that a compilation of strength, balance, plyometric exercises can reduce the incidence of noncontact ACL injuries particularly in female athletes. At Zone 34 we will guide you through your rehabilitation and provide you with the knowledge you need to be able to continue with an injury prevention program independently in the long term.

David Hillard

David Hillard

SPORTS + EXERCISE PHYSIOTHERAPIST

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