In addition to helping to keep the body stable, the knees are also subjected to extreme forces during pivotal movements. As a result, the knees are prone to injury. In fact, over the past decade, knee surgery has become a quite common practice. The anterior cruciate ligament, or ACL, is the most vulnerable to stress during pivotal movements, such as the cutting maneuvers that are required by athletes in a number of different sports. In order to get back into the game following ACL surgery, you must fully regain the ability to perform pivotal movements, such as running, jumping and changing directions at a high rate of speed.
A vigorous rehabilitation program following ACL surgery is crucial for the procedure to be a success. Rehab following the operation is somewhat of a lengthy process. It may be months before you are able to return to your chosen sport and resume your normal level of activity. Several variations of ACL rehabilitation are available, as specific rehabilitation must focus on the individual athlete, adhering to their own protocol. Your progression through rehab depends on the completion of each step before moving on to the next.
The First Few Days
In the first few days of rehab following ACL surgery, the primary goal is to keep the swelling at a minimum and remain as comfortable as possible. Some things you need to keep in mind during this phase of the healing process include:
• Remember to ice your knee frequently
• Keep the affected knee elevated as much as possible
• Use crutches to get around without the risk of further injury
In some cases, the surgeon may recommend that you use a brace following your ACL reconstruction. However, this is under some controversy, as a large number of surgeons believe that you should not use a brace. Equally controversial is the use of a motion machine, or CPM, following ACL surgery. Some surgeons recommend using a motion machine, although there is little to no evidence to support the fact that it aids recovery following ACL surgery.
The First Six Weeks
Immediately after your ACL surgery, you should be able to begin range of motion exercises. In the beginning, the focus should be on regaining full extension of the knee, which means being able to completely straighten out your knee. Generally, regaining the ability to bend your knee, or flexion, is much easier than extension.
You will need to work with a physical therapist on gait training, aerobic workouts and gentle strengthening exercises. Many physical therapists try to get their patients working out on a stationary bike as soon as possible following ACL surgery. The stationary bike aids in the improvement of aerobic activity, motion and strength.
As you continue to work with your physical therapist and your range of motion increases with great success, the focus of your rehabilitation will begin to shift toward strengthening your knee through balance and proprioceptive exercises.
Up To Three Months
After about seven weeks, you should be able to start back with simple activities, such as light jogging, working out in the pool and outdoor cycling. However, for the first three months, you should avoid sports that require pivotal and side-to-side movement, such as soccer, basketball and football. Around the tenth to twelfth week, some individuals will be able to begin lateral shuttles, shuttle runs and jumping rope.
The Final Four Months
During this phase of your rehabilitation, you will continue to progress with specific sports activities. It is important to note, however, that this stage of the healing process is often the most difficult. The reason for this is that the knee may feel normal, yet it is not quite ready to take on the stress of some activities.
The focus of rehab following ACL surgery should be on simulating the activities related to your particular sport. Most physical therapist have their patients do figure-eight drills and plyometrics during this phase, gradually adding sport drills as your progress with your rehabilitation.
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