The anterior cruciate ligament (ACL) is one of four major ligaments that stabilize the knee joint. It prevents the shinbone (tibia) from sliding forward out of place in front of the thighbone (femur). An ACL injury is a tear or sprain of the ACL, and it is one of the most common sports injuries.
Physical therapy is an essential part of recovery from an ACL injury, regardless of whether or not surgery is required.
What is ACL injury?
ACL injury is tears or sprains of the anterior cruciate ligament (ACL), one of the four major ligaments in the knee joint. The ACL helps to stabilize the knee joint and prevent the shinbone from sliding out in front of the thighbone.
ACL injuries are common in sports that involve sudden stops and changes in direction, such as basketball, soccer, football, and skiing. They can also occur as a result of a fall or other accident.
ACL Injury Causes
The most common causes of ACL injuries are:
- Suddenly slowing down and changing direction (cutting): This is a common maneuver in many sports, such as basketball, soccer, and football. When you cut, you are putting a lot of stress on your ACL.
- Pivoting with your foot firmly planted: This can also put a lot of stress on your ACL.
- Landing awkwardly from a jump: If you land with your knee hyperextended (bent too far back) or with too much weight on one leg, you are at risk of an ACL injury.
- Stopping suddenly: This can also cause your ACL to overstretch and tear.
- Receiving a direct blow to the knee or having a collision: This is more common in contact sports, such as football and lacrosse.
Other factors that can increase your risk of an ACL injury include:
- Being female: Females are more likely than males to tear their ACL, especially during sports. This is thought to be due to a combination of factors, including hormonal differences, anatomy, and neuromuscular control.
- Participating in certain sports: Sports that involve sudden stops, changes in direction, and jumping are at high risk for ACL injuries. This includes basketball, soccer, football, lacrosse, and skiing.
- Poor conditioning: Weak muscles around the knee joint can increase your risk of an ACL injury.
- Using faulty movement patterns: This can include things like moving the knees inward during a squat.
- Wearing footwear that doesn’t fit properly: Improperly fitting shoes can increase your risk of an ACL injury by not providing enough support for the knee joint.
- Using poorly maintained sports equipment: This can include things like ski bindings that aren’t adjusted properly.
- Playing on artificial turf: Artificial turf has been shown to increase the risk of ACL injuries compared to natural grass.
Physical therapy helps with hand and wrist pain
ACL Injury Symptoms
Symptoms of an ACL injury include:
- A popping sound or sensation in the knee at the time of the injury
- Severe pain and swelling
- Loss of range of motion
- A feeling of instability or giving way in the knee
How can physical therapy help me recover from an ACL injury?
Physical therapy can help you recover from an ACL injury in a number of ways.
Reduce pain and swelling
One of the first goals of physical therapy is to reduce pain and swelling in the knee. This can be done through a variety of methods, such as ice, compression, and electrical stimulation.
Regain range of motion
Another important goal of physical therapy is to help you regain range of motion in your knee. This will allow you to move your knee more freely and without pain. Your physical therapist will teach you a variety of exercises to help you regain range of motion, such as gentle stretching and strengthening exercises.
Strengthen the muscles around the knee
Strong muscles around the knee are essential for providing stability and support to the joint. Your physical therapist will teach you exercises to strengthen the quadriceps, hamstrings, and other muscles around the knee.
Improve balance and coordination
Balance and coordination are also important for preventing ACL re-injury. Your physical therapist will teach you exercises to improve your balance and coordination, such as standing on one leg or balancing on a wobbleboard.
Return to sports and activities
Once you have regained your range of motion, strength, and balance, your physical therapist will work with you to develop a plan for returning to your desired activities. This may include gradually increasing the intensity of your workouts or participating in sports-specific training exercises.
Physical therapy is an important part of recovery from an ACL injury. It can help you to reduce pain and swelling, regain range of motion, strengthen the muscles around the knee, improve balance and coordination, and return to sports and activities.
Here are some specific examples of physical therapy exercises for ACL injuries:
- Quadriceps contraction: This exercise strengthens the quadriceps muscle, which is located on the front of the thigh. To do this exercise, sit on the edge of a table with your legs hanging down. Slowly straighten one leg and hold it straight for 5 seconds. Then, slowly bend your leg back to the starting position. Repeat 10 times with each leg.
- Hamstring stretch: This exercise stretches the hamstring muscles, which are located on the back of the thigh. To do this exercise, sit on the floor with your legs extended in front of you. Reach forward and try to touch your toes. Hold the stretch for 10 seconds. Repeat 3 times.
- Calf raises: This exercise strengthens the calf muscles, which are located on the back of the lower leg. To do this exercise, stand with your feet shoulder-width apart. Raise your heels off the ground and hold the position for 5 seconds. Then, slowly lower your heels back to the starting position. Repeat 10 times.
- Balance exercises: There are many different balance exercises that can be done to improve balance and coordination after an ACL injury. Some examples include standing on one leg, balancing on a wobbleboard, or walking on a balance beam.
Your physical therapist will develop a personalized exercise program for you based on your individual needs and goals.
What are the two benefits of doing physiotherapy prior to ACL surgery?
There are two main benefits of doing physiotherapy prior to ACL surgery:
- Reduce muscle atrophy: ACL surgery is a major surgery, and it is important to maintain as much muscle mass as possible before the surgery. Physiotherapy can help to reduce muscle atrophy by providing exercises to strengthen the muscles around the knee.
- Improve range of motion: ACL surgery can cause stiffness in the knee joint. Physiotherapy can help to improve the range of motion by providing exercises to stretch and strengthen the muscles and ligaments around the knee.
What is a safe exercise for ACL injury?
The most important thing when choosing exercises for an ACL injury is to listen to your body and avoid activities that cause pain or discomfort.
Here are some general guidelines for safe exercise after an ACL injury:
- Start slowly and gradually increase the intensity and duration of your workouts.
- Focus on low-impact exercises that are easy on your joints.
- Avoid exercises that put a lot of stress on your knees, such as running, jumping, and pivoting.
- Wear supportive shoes or braces when exercising.
- Warm up before exercising and cool down afterward.
Here are some specific examples of safe exercises for an ACL injury:
- Swimming: Swimming is a great low-impact exercise that can help to improve the range of motion and strength in the knee.
- Biking: Biking is another good low-impact exercise that can help to improve the range of motion and strength in the knee.
- Elliptical training: Elliptical training is a low-impact exercise that can help to improve cardiovascular health and strengthen the muscles around the knee.
- Strength training: Strength training exercises can help to strengthen the muscles around the knee and improve stability. Some examples of safe strength training exercises for an ACL injury include quadriceps sets, hamstring curls, and calf raises.
- Stretching: Stretching exercises can help to improve the range of motion and reduce the risk of re-injury. Some examples of safe stretching exercises for an ACL injury include hamstring stretches, quadriceps stretches, and calf stretches.
It is important to note that this is just a general overview of safe exercises for an ACL injury. Your individual needs may vary. Be sure to talk to your doctor or physical therapist before starting any new exercise program.
How can I heal my ACL at home?
There is no way to completely heal an ACL tear at home. The ACL is a ligament, and ligaments do not have the same ability to heal as muscles. However, you can do some things at home to help manage your symptoms and prevent further injury.
Here are some tips for healing an ACL tear at home:
- Rest: Avoid activities that put weight on your knee, such as walking and running.
- Ice: Apply ice to your knee for 20 minutes at a time, several times a day. This will help to reduce pain and inflammation.
- Compression: Wrap your knee in an elastic bandage to help reduce swelling.
- Elevation: Prop your knee up on pillows when you are sitting or lying down. This will also help to reduce swelling.
You can also do some gentle exercises at home to help improve the range of motion and strength in your knee.
How long is physical therapy after ACL surgery?
The length of physical therapy after ACL surgery varies depending on the individual’s recovery and goals. Most patients will need at least 6-9 months of physical therapy to fully recover from ACL surgery. Some patients may need more or less time, depending on the severity of their injury and their individual healing process.
Can ACL tears heal with physical therapy?
An ACL tear cannot heal completely with physical therapy alone. The ACL is a ligament, and ligaments do not have the same ability to heal as muscles.
Do tennis players tear their ACLs?
Yes, tennis players can tear their ACL. In fact, ACL tears are a relatively common injury in tennis, accounting for about 2% of all tennis injuries.
Physical therapy is an essential part of recovery from an ACL injury. It can help to reduce pain and inflammation, improve range of motion, strengthen the muscles around the knee, improve balance and coordination, and reduce the risk of re-injury.
Physical therapy can help people with ACL injuries to return to their desired activities, such as sports and work. It is important to follow your physical therapist’s instructions and listen to your body.
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