ACL Tear Reconstruction Rehab

You are about to go up for a header, so you don’t see the fast-moving opposing player coming at you. Your knees collide with hers at high speed, you feel a flash of pain, and then a kind of popping sound.

You know right away it doesn’t sound good, and it isn’t. Your trainer suspects a torn anterior cruciate ligament, known as an ACL tear, an injury to a critical ligament in the knee. The next day an MRI confirms it. You are out for the season.

But almost certainly not out for good. “I am back running, biking, and hiking thanks to her service,“ patient Robert A. tells us about his Park Sports therapist after completing physical therapy for ACL reconstruction. Dozens of athletes have suffered ACL tears and recovered, like legendary quarterback Tom Brady and NBA All-Star Derrick Rose. 

On this page, we describe:

  • Who are recipients of ACL reconstruction?
  • What is ACL reconstruction?
  • Physical Therapy for ACL Reconstruction: What might it look like?
  • Stages of treatment: what to expect
  • Treatment for non-athletes
  • Treatment for athletes
  • ACL reconstruction FAQ

Who are recipients of ACL reconstruction?

The primary recipients of ACL reconstruction surgery are people at ages 10-29; the injury is most common in the sports world, especially players in football, baseball, soccer, lacrosse, gymnastics, basketball and skiing. Women athletes are disproportionately affected, with a injury rate up to six times that of male athletes.

People not in the sports world also undergo ACL reconstruction and will find their rehabilitation process tailored to fit their different needs. 

What is ACL reconstruction?

If you are one of the fortunate few, you are a “coper“ in medical slang, and won’t need surgical repair, but more probably you will need ACL reconstruction. In this common, if serious, procedure, torn ligament is removed and replaced with tendon from another part of your knee or with that of a donor’s. 

The good news is that ACL reconstruction has an 80-90% success rate, and where it is unsuccessful, a lack of Physical Therapy is usually the culprit. Knowledgeable sports-specific Physical Therapy, will almost certainly get you back on the field. 

Physical Therapy for ACL Reconstruction: What might it look like? 

Given the demographics of ACL reconstruction patients, the primary goal of Physical Therapy  will be to safely return patients to their sport. That is why we at Park Sports Physical Therapy value a holistic approach, fully customizing rehabilitation plans by understanding your needs and working with your surgical team.

We may incorporate various methods of therapy to fit your needs: manual therapy, kinesiology taping, state-of-the-art equipment, and yoga therapy, amongst many others.  We aim always to ensure that you are getting the best treatment for your individual bodily and psychological needs.

 Stages of treatment: what to expect

Treatment plans for ACL reconstruction consist of multiple stages over the 2-9 months. These plans can be altered depending on your needs, but generally follows this description, based on the clinical literature: 

ACL reconstruction treatment: Weeks 0-2:

Initially, you will be on crutches and the operative leg will not be allowed to bear weight. Use of  crutches generally lasts for up to four weeks. For the first two, your therapist will guide you through passive range-of-motion exercises, such as assisted leg-curls and leg-extensions on the side of a bed. During these, the operative leg must remain elevated.

ACL reconstruction treatment: Weeks 2-4: 

Typically at this stage, doctors allow the patient to begin to put some weight on the leg–allowing for exercises like partial squats and toe raises.  You are fit with a knee brace that must be worn for up to six weeks. Movement like walking can begin to resume during this time, which will help jump-start the process of restrengthening your leg.

ACL reconstruction treatment: Physical therapy begins (2-6 months): 

This large range in rehab times is dependent on your normal activity levels and lifestyle to which you will return. If you are normally sedentary or lightly active, recovery may take closer to 2 months. If you are an athlete or are very active, recovery will take closer to 6 months. 

Treatment for non-athletes

Generally speaking, for the former group, gradual increases in strength, balance, symmetry, and range of motion in the lower extremities and core will characterize your recovery plan. This will mean a slow easing back into walking, sitting, and doing normal daily activities like shopping or cleaning, pain-free. 

Treatment for athletes

For athletes, rehab is considerably longer. An athletic baseline in terms of strength and range-of-motion is far more extensive than non-athletes, hence, more work to regain. According to clinical data, athletes are recovered and can safely return to their sport only when they meet the following metrics:

  • Quadriceps strength at least 80% of normal 
  • Hamstring strength at least 80% of normal
  • Full motion
  • No swelling 
  • Good stability 
  • Ability to complete a running program 

These stringent tests are necessary because athletes will experience strong rotational movement, pivoting, lateral movement, jumping, and high energy impact on landing. The risk of re-injury is relatively high. 

So when returning it is the job of both the therapist and the patient that the athlete follows proper technique from the very beginning of the return. 

Our team of therapists consists of former athletes who are highly educated in the domain of sports medicine, having extensive experience in treating sport-related knee injuries, and in turn, are readily understanding of athletes’ needs. 

Want more information? Making an appointment? Call 718-230-1180  or Contact us on line .

ACL reconstruction FAQ

How common are ACL tears?

More than 200,000 ACL tears occur annually, and are increasingly common, especially among athletes today, having doubled in recent years. 

Why are women more susceptible to ACL injury?

The injury is anywhere from 2 to 6 times more prevalent in women, which might help explain the increased overall incidence, given the much wider opportunities recently for women in professional and college sports and at all levels. 

It is thought that women biomechanics are more susceptible to the injury when pivoting, causing greater rotational force against their knee.

What about long-term effects of ACL tear? Can physical therapy mitigate those?

An ACL tear risks future onset of osteoarthritis in the region, with or without ACL reconstruction. But Physical Therapy exercises, according to the Arthritis Foundation, may be very effective in reducing rates of osteoarthritis in people who have had ACL reconstruction. For example, people rehabbing from ACL may benefit from reducing wear and tear on the knee with low impact exercises. 

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