ACL Rehabilitation – Patient Information

Hayden Morris & Christos Kondogiannis

Rehabilitation: Post ACL Reconstruction

  • The rehab is milestone based.
  • You need to complete the requirements of each phase before moving on to the next.
  • Approximate time frames are outlined.
  • At each post operative appointment, your progress will be assessed.
  • You will be referred to an appropriate physiotherapist (osteopath an alternative) who will guide you through this programme and outline details of specific exercises which you may perform yourself at the gym.
  • The physiotherapist will also give Mr. Morris feedback with regards to your progress
  • Not everyone attends a physiotherapist (eg lack of access). Please discuss with Mr.Morris

 

Recovery

Theme: Rest. Swelling, bruising control. Pain control

Week 0 – 2 (approximate)

  • The aim of this stage is to recover after surgery. You should spend the time at home resting. Stay mainly on the couch. Wear your tubigrip
  • Take pain killers as required. Stay well hydrated.
  • Icing: Ice your knee for 30mins: 5 or 6 times a day.
  • Use crutches but weight bear as tolerated
  • Try to lock your knee out straight and tighten the quadriceps
  • Pump the calf muscles every chance you get

 

Rehabilitation Phase 1

Theme: Range of Movement (ROM)

Week 2-6 (approximate)

  • The main aim here is to achieve a good ROM. Most importantly complete extension (knee out straight equal to the opposite healthy knee). Practice your knee extension locking exercise (most important), knee bending and prone hanging. Ask your physiotherapist or Mr. Morris for details
  • You should attempt to achieve a normal walking style
  • You may commence stationary cycling when comfortable
  • Resume normal daily activities
  • Continue icing the knee. Swelling MUST be minimised
  • This phase usually lasts about 6 weeks but may vary between 3 and 12 for example.
  • The simple thing is to do your best and don’t worry about your progress or lack of it. Each person has a unique road to recovery
  • Sometimes you will be told to slow down or speed up
  • You will have regular reviews with Mr. Morris and your physiotherapist.
  • GOALS: A good ROM, complete extension, no swelling
  • If you achieve all the desired goals you may move on to the next phase of rehabilitation.

 

Rehabilitation Phase 2

Theme: Strength, balance

Week 6 – 12 (approximate)

  • This phase usually lasts about 6 weeks, but may vary between 3 and 12 for example.
  • You should now be walking normally and performing normal activities of daily living
  • It is now time to commence a gym based programme emphasising strength of all muscle groups including quadriceps, hamstrings, calf, gluteals, core strength. Balance exercises are also important
  • Activities include walking, cycling, swimming (no breaststroke), rowing
  • Don’t over do it. Ice after activity
  • GOALS: Normal gait, swimming, cycling, one leg squat to 90º
  • If you achieve all the desired goals you may move on to the next phase of rehabilitation.

 

Rehabilitation Phase 3

Theme: Light agilities

Week 12 – 20

  • You may now commence jogging (if given the all clear)
  • Plyometrics begin – hopping, jumping, etc
  • Zig zag running
  • Don’t overdo it
  • Ice after activities

 

Rehabilitation Phase 4

Theme: More aggressive agility exercises

Week 20+

  • Sport specific exercises. Refer to Mr. Morris and your sport physiotherapist
  • Endurance. Fitness
  • Fifa “The 11 ExercisesThe prevention programme “The 11″ was developed by FIFA’s medical research centre (F-MARC) in cooperation with a group of international experts. “The 11″ is a simple, catchy and time-efficient preventive programme that comprises ten evidence-based or best-practice exercises and the promotion of Fair Play.

 

Download FIFA “The 11″ Injury Prevention Programme – Booklet

Download FIFA “The 11″ Injury Prevention Programme – Poster

 

  • Recommend the PEP programme. Refer to Video below:

 

 

 

Return To Sport Score

Once you have completed Phase 4 you have essentially completed your rehabilitation. We do however, need to know that you have achieved a state of recovery good enough to protect your “new” knee.

We have developed a score that accurately predicts whether or not you have attained a full recovery after your injury and surgery

  • The Australian ACL Return To Sport Score (AARTSS)

If you pass the test, you are ready to start training.

Once having completed full training, you may PLAY!