In the past a torn ACL for a lot of athletes meant the end of a sports career, but because of a lot of research and innovation, the ACL is now an injury in which an athlete can come back from and be even stronger than before. The modernization of the ACL is due in large part to the discovery of the ACL healing better from complete reconstruction as opposed to a repair of the ligament. In the early 1970’s ACL surgeries were not performed very often1; if someone had been diagnosed with an ACL tear then they would usually go without surgery, but doctors later found out that people that did not get surgery suffered from knee deterioration, knee instability, and damage to the menisci and other ligaments.2 When doctors finally decided to start operating on knees they would either try to repair the torn ligament or they would replace it with synthetic material, which resulted in a very high rate of failure. Nowadays doctors do a minimally invasive surgery in which they completely replace the ACL with a tendon graft. This method has continued to evolve over time and has become a very successful way of treating ACL injuries.
The Rehab Process
Although the current method of surgery has proven to be much more effective than previous methods, the athlete still carries a lot of responsibility in making sure that he/she is ready to play. Having a successful surgery is just the first step in a long and arduous rehabilitation process. Usually an ACL recovery takes about 8-9 months to come back from and involves a lot of physical therapy.
The ACL process is broken down into three phases, prehabilitation, surgical recovery, and finally return to play. After an athlete is diagnosed with a torn ACL the first thing that they should do is ice their leg to bring the swelling down. It is also recommended that they isometrically contract their quad muscles and rock the pedals back and forth on a recumbent exercise bike to retain their range of motion and strength prior to their surgery. In the first three weeks after surgery the patient usually begins with basic therapeutic knee exercises such as quad sets, heel slides, straight leg raises, short arc quads, long arc quads, and hip abduction and adduction. They also eventually begin to do the bike and standing exercises such as mini squats and heel raises. At weeks 4-6 the patient begins to add isotonic weight machines to their rehab along with balance exercises and mini hurdles. In weeks 7-12 the patient intensifies the current exercises and should have full range of motion. From months 3-5 the patient begins a variety of lunging exercises, step ups, and step down exercises. From months 6-8 the patient begins to do jumping exercises, agility ladders, shuffling, and jogging. In the latter months the patient begins to do drills in their sports before they are eventually cleared to return to competition.3 If the patient is disciplined in their rehab and follows the orders of the doctor and their therapists, they should be able to return to sport with great success.
References:
1 Anterior Cruciate Ligament (ACL) Injuries – Then and Now. (n.d.). Retrieved February 07, 2016, from https://www.hss.edu/conditions_acl-injuries-then-and-now.asp
2 Murray, M. M., Vavken, P., & Fleming, B. (2013). The ACL Handbook Knee Biology, Mechanics, and Treatment. Retrieved from file:///C:/Users/btn11/Downloads/9781461407591-c1.pdf
3 ACL Rehabilitation Program. (n.d.). Retrieved February 07, 2016, from http://www.emoryhealthcare.org/acl-program/index.html
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