ACL REHAB –

Many people recovering from ACL ruptures and repairs, get to a point in their ACL rehab where they are feeling pretty good and able to do most things to an ‘alright’ level. In most cases, people then stop a lot of their rehab, as they feel they don’t need it anymore. However when questioned about how they would feel playing top level sport again or doing things exactly as they used to, they feel scared or uncertain of their knee performing. They feel their knee has recovered to a comfortable 80%, but getting that last 20% of recovery is the difference between getting back to top level performance or settling for the fact that they wont return to their best. At PhysioSteps we believe that the last 20% of rehab is the most critical, as it teaches the knee to react, perform and avoid injury, to the level that it once did.

Evidence suggests that most athletes tend to return to sport before they are 100%. At this point they still have one sided deficits when tested. This is part of the reason why the re-injury rate for ACLs is 2.3-13%! Which is far too high. The higher re-injury rates are in sports that require a lot of pivoting and change of direction such as netball and rugby. This is almost a 1 in 8 chance of re-injury if going back to a pivoting sport, but luckily this can be reduced with the right rehab.(1)

It should be realistic to have a 9 month return to sport goal, to allow all the functions mentioned below to develop. It is worth noting that at 12 months, only 50-60% of people will be back to top level sport. The time it takes for bone, tendon and muscle healing to occur needs to be taken into consideration, as well as the time it takes to build back to your original condition, if not better!

This last stage in your rehab involves building up the ability for your knee to respond to all sorts of different environments, by building a little thing called proprioception. This is the link between your brain and your knee, telling your brain where your knee is and what it is up to. Without this, there is a very high risk that you will re-injure your knee or something else. These specific exercises and training schedules are not only great for the recovering knee but they have been proven to be effective at preventing ACL injury in the opposite knee.

The sessions involve building you into a training program, involving jumping activities, stretching activities and strengthening that pushes your knee to the next level. The physio will work on these exercises with you, in the clinic to ensure you are doing everything correctly, and then set you up to do a program at home. As these exercises progress you will feel your confidence returning and the ability to return to top level sport will return. Progressions will start to focus on sports specific training, to ensure that you are only training for what you need to be training for!

Exercises include: 

• A good warm up with interval jogging, side stepping and backwards running
• Specific strengthening for the knee joint followed by jumping activities forward/back/sideways. This is progressed to single leg as able.
• And finally follow this with specific stretching.

It is important to have a physio work through these exercises with you, to ensure they are being performed correctly, as in most cases there is always something that needs correcting!