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ACL Recovery With Physical Therapy

Our bodies are designed to move and should move in a specific way, but how do you know if you are moving correctly to prevent injuries? In order to prevent injury to our knees, we need to be cognizant of our body’s movement and positioning. If not, we put ourselves at risk for injuries that may put us out of commision for an extended period of time. One of the most common and debilitating injuries can occur when we tear our ACL. This sort of injury may be preventable if we take care our knees while playing sports and during everyday activities.

What Causes ACL Tears?

Over time we develop ways of moving our bodies through space that allow us to accomplish a task. Sometimes we learn the incorrect way to move which puts us at risk for injury. You can get away with that movement, until you can’t. Eventually, your body will break down overtime or you’ll move with enough force to create an injury. This may occur due to exercising or playing a sport, but could also be as simple as picking something up while having your knee torqued a strange way.

Tips for Preventing ACL and Knee Injuries

Fundamentally, preventing knee injuries boils down to making sure you move your body the way it is designed, not the way your environment is allowing you to. For example, you can get away with moving incorrectly at the knee until enough force tears a ligament, or breaks down your meniscus/cartilage, or a tendon starts to degenerate.

Avoid the position of no return. Eliminate torque in your knees by keeping your knees from going inward past your ankles, keeping an arch in your feet, and not letting your hips rotate inward. Use your hips and ankles to control your knees. Because your knees are primarily a hinge joint they move mostly in a single plane, therefore much of the rotational control comes from the hip and foot/ankle. When moving, try to put most of your weight/force through the muscles in your hips as much as the muscles around your knee. This will help you avoid becoming quad dominate and putting extra stress on your knees. It is common for many people to avoid using their hips to take pressure off their knees. Visually inspect yourself. Stand in front of a mirror and do a squat or sit down to a chair. Your knee should track over your foot, not inside. If your knees come together during either of these movements it may be a sign of a larger issue. Additionally, your knee should not progress forward over your toes during a squat, which increases the force in your knee. If this happens place more weight through your heels and stick your hips back more.

How Physical Therapy Helps With ACL Recovery?

Seek out a physician immediately after an injury occurs to put you on track for a speedy recovery. As you are waiting for medical attention, perform RICE (rest, ice, compression and elevation) to alleviate swelling and pain. If surgery is required, you will need to reduce swelling, regain range of motion (if you have lost any), and get your muscles to reactivate. It is recommended that you see a physical therapist prior to surgery so that you don’t lose quadriceps function as your wait for surgery, to educate you on the process, provide you with a home exercise program and even teach you on how to properly and safely use crutches. At Therapydia, our physical therapists are dedicated to connecting with their patients one-on-one to provide unique care and education on their injury/recovery. Building this relationship is an invaluable part to your recovery as each injury is unique to you and your lifestyle.

Rehab is an important part of regaining range of motion and strength in your knee. Re-tears are fairly common, but physical therapy is linked with lower rates of recurring injuries. During recovery, your physical therapist will follow an evidence based rehabilitation protocol, but also formulate a plan based on your independent needs.

They may also include treatment techniques such as:

  • Manual therapy: skilled, hands-on techniques performed on the surface of the knee joint and the surrounding muscles to reduce inflammation and address common post-surgery complications like stiffness and loss of range of motion.
  • Balance training: incorporating one-legged activities to improve your body’s movement, building up strength and full flexibility.
  • Custom exercises: to target areas surrounding the knee, such as the hips and core, to strengthen weakened muscles and to reduce the risk of ACL reinjury.

Post-ACL Surgery Recovery Timeline

Because re-tearing the ACL is fairly common, your physical therapist will design a treatment plan designed to ward off future injury and address your individual needs. The pain and swelling will typically subside after 3-6 months but it can take up to a year or more for the knee to completely heal. Your physical therapist will take you through multiple tests to ensure that you’re in full control of your knees under high-stress circumstances like when you are fatigued or conducting high-impact activities like running or jumping.

Physical therapy is an essential part of your recovery plan to ensure that you don’t experience long term damage and that you can return to your peak performance as soon as possible. Although the timeline for recovery varies depending on your specific injury, you should expect 4-6 months of one-on-one treatment with your physical therapist. A typical timeline for ACL recovery may go something like this:

Treatment before surgery: “Prehab” is a form of physical therapy that begins prior to surgery and focuses on increasing strength and flexibility of muscles. It also educates you on proper movements during recovery post-surgery. The surgery will fix the tear but it will also cause the muscles in the knee to become weak and stiff. Going through prehab treatment is an effective way to speed up your recovery post-surgery.

  • 0-4 weeks: The main priorities of treatment during this stage of recovery are reducing inflammation, regaining range of motion of the knee, and beginning to slowly withstand bearing weight. Your physical therapist may incorporate manual therapy and exercises targeted toward strengthening the quadricep.
  • 4-10 weeks: At this point, the goal is to start getting your natural walking pattern back and to control your movements while doing so. Your physical therapist may incorporate balance training into your plan of care to put decrease pressure on your healing ACL and to strengthen muscles surrounding your hips and knee.
  • 12-16 weeks: The swelling will likely subside by the 3 month mark and you should have full range of motion in your knee, meaning you can extend and bend the leg without restriction. Your personal ACL treatment program will continue building strength in your core and lower body muscles. More advanced balance training may be incorporated along with endurance training on a stationary bike, elliptical, or treadmill. You may begin lightly running, jumping, or getting back into physical activities that you used to do.
  • 4 months+: Time to get back in the game. Although the severity of your ACL tear will affect your recovery time, there’s a range of what patients with a healing ACL injury may be able to do around the 4 month mark. Without halting any progress by over-exerting the knee, your treatment program will focus on building up the body’s strength and flexibility in ways that prevent future ACL tears. Your one-on-one treatments will incorporate your favorite physical activities to steadily get you back to 100%

Physical therapists can provide the necessary tools to treat a torn ACL and help you to make sure that you aren’t at risk for future injury, allowing you to return to your favorite activities pain-free and stronger than ever. To learn more about how to prevent ACL injuries or to eliminate any current discomfort, book a physical therapy assessment today.


Jessica Jones

Physical Therapist

Jessica recently moved to Seattle from Boston, MA and is excited to join the Therapydia team. Her treatment experience includes orthopedics, sports medicine, pediatrics, and vestibular therapy. Jessica received her Doctorate in Physical Therapy from Northeastern University in Boston, MA in 2016. She has completed the Pediatric Physical Therapy Residency at Boston Children’s Hospital and is in the process of completing a Comprehensive Vestibular Rehabilitation certification. Jessica believes in empowering and inspiring patients to take control of their health through education, movement, and exercise. She enjoys treating patients of all ages and levels while utilizing soft tissue techniques, neuromuscular re-education, balance training as well as therapeutic exercise. In her free time, Jessica enjoys yoga, dancing, kayaking, and hiking with her dog!


Move Better with Physical Therapy

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