ACL Injury

ACL Injuries

What is an ACL tear?

The anterior cruciate ligament (ACL) is located in the knee and can be injured or torn when it is harshly twisted or the knee collapses inward.  ACL tears are especially common in athletes who participate in sports such as basketball, gymnastics, football, soccer, tennis, volleyball,  lacrosse, or downhill skiing. Most of these sports require sudden stops and changes in direction or landing from a jump, making the risk higher for twisting or collapsing of the knee and sustaining an ACL injury.  Most ACL injuries occur without contact with another athlete!  Female athletes are 3-8x as likely to tear their ACL than their male counterparts.

An ACL injury is painful and debilitating. Those suffering from this type of injury typically experience severe pain, swelling, limited range of motion, and instability when trying to bear weight.  There is also a significant psychological impact when one is relegated to the sidelines for 10-14 months after the injury. Muscles around the knee start to atrophy immediately following the injury.  Most of these injuries require surgery to allow for a return to sport.  Rehabilitation takes 10-12 months after surgery before the athlete can step back on the field.  

Why does it take so long to recover and return to sport after an ACL tear?

One of the biggest problems surrounding this knee injury is the extended period of inactivity that occurs after the injury.  It often takes a few weeks to see an orthopedic surgeon.  An MRI typically follows and one must wait for a period to get the MRI…followed by a wait to see the physician for follow-up.  Surgery is scheduled usually a few weeks or months after that depending on the physician’s schedule and knee joint swelling.  During this period of weeks and months, the body is breaking down muscle and bone that will take months to restore.  The longer it took to get started on PT, the longer it takes for the muscles to return to their pre-injury level.  Many of the top sports medicine Docs will refer patients to PT prior to surgery, but by then 1 month might have passed.  In an ideal world, an athlete with this injury would be in our office exercising within 3 days of the injury.  

The healing timeline after ACL reconstruction also dictates a return to sport and activity.  ACL grafts are typically taken from your patellar tendon (the tendon below your knee), your hamstring tendon(the tight cord behind your knee and upper leg), or from the tissue of a cadaver. The process that the body undergoes to reorganize and incorporate this new graft takes upwards of 1 year if the tissue is taken from your own body and significantly longer if taken from a cadaver.  Research shows that returning to sport prior to 9 months post-op increases your risk of another ACL injury by over 20%.  At Balance Physical Therapy we create an environment that places the proper stresses on the graft and surrounding muscles to maximize the speed of recovery, but we cannot speed up the healing timeline.  We must respect it.  

How are the therapists at Balance Physical Therapy working to CHANGE THE OUTCOME?

Balance Physical Therapy, we are looking to change the outcome of ACL injuries.  Our first line of defense is PREVENTION and when we have not been able to prevent it, we are determined to get our injured athletes into PT quickly and carefully push them to be quicker, faster,  stronger, and to move better than before their injury.  Teaching athletes, especially female athletes, to move better by retraining movement patterns is the cornerstone of prevention and is built into our rehabilitation process.  Numerous studies have now shown that teaching proper movement with jumping and landing, with the change of direction, and with deceleration can reduce knee injury and ACL injury by 50%-75% or better.

Our prevention and rehab programs are based on the best science and research available.  Below are links to research that has been shown to reduce ACL and knee injury from which we have developed our program, ACL BE FASTER.

https://link.springer.com/content/pdf/10.1007%2Fs11999-017-5342-5.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759702/

http://www.oliverfinlay.com/assets/pdf/mandelbaum%20et%20al%20(2005)%20effectiveness%20of%20a%20neuromuscular%20&%20proprioceptive%20training%20program%20in%20preventing%20anterior%20cruciate%20ligament%20injuries%20in%20female%20athletes.%20%202-year%20follow-up.pdf

In addition to getting you rehabbing sooner after injury and training movement mechanics, we have tools that will thwart the body’s tendency to break tissue down.  Personalized Blood Flow Restriction Therapy (BFR) (LINK) can reverse the catabolic cascade that occurs after injury and surgery.  Using a tourniquet to restrict blood flow to the limb while exercising at low resistance will speed up muscle building, bone building, and regeneration of blood vessels (link).  

At Balance Physical Therapy, we are dedicated not only to helping you recover from your ACL injury and return to your sport(s), but we are also able to help you prevent further injuries from occurring in the future. 

Our Goffstown & Windham, NH physical therapists, trained for this specific rehabilitation process, will cater therapy to your specific needs, your speed of recovery, and your specific sports. They will re-tune your whole body so that you’re quicker, faster, stronger, more resilient, and move better than you did before this injury.

Get started on your recovery today!

If you are suffering from an ACL injury, contact Balance Physical Therapy today to schedule your initial appointment.  Please don’t wait.  We will do our best to start you back on the road to recovery and an active lifestyle ASAP.