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ACL rehab for active adults

One of the most common injuries among athletes is rupture of the Anterior Cruciate Ligament, one of the four main ligaments in the knee. It binds the back of the thigh bone (femur) to the front of the shin bone (tibia), and prevents the knee from moving excessively in relation to the femur. An injury to this type of ligament has the potential to disable you for a couple of months, at least.

The average patient with this type of injury is a very active or athletic male, who wants to return to playing sport as soon as possible. Fortunately, even though rest is required, the modern approach to ACL rehab is to begin immediately, preferably 24 hours following surgery. This has the advantage of maintaining nutrition to the articular cartilage (where the bones meet) and retaining bone mineralisation, essential for its hardness and strength.

During the first two weeks, rehab focuses on pain and oedema (swelling) management and increasing the range of motion of the knee. The Continuous Passive Motion (CPM) device is very helpful in this regard. While passively ranging the joint, the CPM helps to move synovial fluid and nutrition to the joint and move blood and waste matter out. This greatly reduces oedema, stiffness and pain. Use of crutches is advised at this time, and your physiotherapist will teach you how to follow weight-bearing precautions.

From two to six weeks, therapy will involve exercises to strengthen the joint. Weight-bearing is increased during ambulation, and gait and balance training will begin at this time. If you previously wore a brace, this will be removed so you can perform aquatic therapy to condition and strengthen the knee. By twelve weeks you should have achieved full range of motion and adequate muscle strength. Resistance training is done at this stage, as well as cycling, swimming and jogging. With proper rehabilitation, you should be able to return to active sport in six to nine months.


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