ACL: The Road to Recovery
Hang on, an AC what? What is an ACL? The anterior cruciate ligament (ACL), or otherwise, as its name ‘cruciate’ suggests, the ligament that crosses the knee. It stabilises the knee but is commonly injured when the athlete is involved in a sport with a lot of twisting and turning. It can be managed with or without surgery.
What causes an ACL injury?
ACL injuries are one of the most common types of injuries we see in patients.
Three main mechanisms of injury include: (1) direct contact (2) indirect contact (3) non-contact.
- Direct contact
This occurs when a person or object strikes the knee directly. For example, in a rugby game, where an opponent tackles you directly at the knee level.
- Indirect contact
In this case, the injury happens when a force from either a person or an object strikes a part of the body other than the knee itself, causing the excess force to be transferred through the knee. For example, if someone suffers a direct blow to the thigh.
This last mechanism is the most common and accounts for about 70% of ACL injuries. It happens when there is a change of speed (deceleration/ acceleration) and direction (pivot), causing forces to be applied to the knee. This then causes the translation of the shin bone in relation to the thigh bone, which may result in ACL failure.
How do I know that I have torn my ACL?
Typically, when the ACL ruptures, a ‘pop’ or ‘snap’ is heard and a tearing sensation may be felt. Other symptoms may include:
Sudden onset of pain
Swelling may also be observed in the first 24 hours of injury
Difficulty moving your knee
A feeling of ‘instability’ may also be felt in the knee
Your Physiotherapist or your Orthopaedic surgeon will be able to determine if your ACL is torn. A MRI might also be done to determine the extent of the injury.
How long does it take to recover from an ACL injury?
The time taken to come back from an ACL injury depends on many factors, such as age and what was done during surgery. Typically, it will take at least 9-12 months before the athlete is able to return to sport.
To ensure that the athlete can return to sport safely, there are guidelines that we follow, in order to determine various milestones in his rehabilitation journey.
Previously, Physiotherapists followed a time-based guideline to guide their management of the patient. However, more recent research has hinted towards a criteria-based guideline, as the road to recovery is highly individualised and depends on factors such as compliance, motivation and the body’s capacity of healing.
Recovery can be split up into various phases:
- Phase 0: Prehab phase
- Phase 1: Recovery from surgery
- Phase 2: Strength and neuromuscular Control
- Phase 3: Running, agility, landing mechanism
- Phase 4: Return to sport
- Phase 5: Prevention of re-injury
Each phase has specific criteria based goals that the patient has to meet before they are able to progress through the phases. For example, before progressing on from Phase 1 to Phase 2, the patient must be able to straighten their knee and achieve a reasonable amount of knee bending.
Your Physiotherapist will conduct thorough assessments and formulate individualised plans for each patient, to ensure the best care is offered.
A torn ACL is not the end. It’s only the beginning to demonstrate what your limits are.
Book now or give us a call to schedule an appointment to see our Physiotherapist who will be able to partner you to recovery after your ACL reconstruction. Learn more about our post surgery care here.
DISCLAIMER: These advise and exercises should not replace the need for a consultation with a Physiotherapist especially if your condition doesn’t improve. Therapeutic exercise should be carefully selected to suit your condition.
- Brukner, P., Clarsen, B., Cook, J., Cools, A., Crossley, K., & Hutchinson, M. et al. (2018). Brukner & Khan’s clinical sports medicine. McGraw-Hill Education.
- Cooper, R. and Hughes, M., 2018. Melbourne ACL Rehabilitation Guide 2.0. [pdf] Available at: https://www.melbourneaclguide.com/brief
Filed under: Knee