ACL Rehabilitation: Early Focus on Range of Motion and Strength

ACL reconstruction (ACLR) outcomes can be challenging, with only 80% of recreational athletes returning to sport, and just 65% reaching pre-injury levels. Early-stage ACL rehabilitation plays a crucial role in improving these outcomes and reducing the risk of ACL re-injury.

Key Takeaways:

  • Range of Motion (ROM): Achieving full knee extension early post ACL surgery is vital. This helps reduce swelling, improve pain, and prevent complications like the “cyclops” lesion. Flexion should reach 110-120° by 4-6 weeks to allow for stationary cycling and other functional exercises post ACL Surgery.
  • Quadriceps Strength: Quadriceps strength and muscle activation are significant challenges after ACL Reconstruction. Early resistance training, including isometrics and open-chain exercises, is recommended to rebuild muscle strength and activation. Strategies like neuromuscular electrical stimulation (NMES) or blood flow restriction (BFR) can aid in restoring strength.
  • Fitness Preservation: Maintaining overall physical fitness during the early phase is crucial. Engaging in safe strength training for the uninjured limbs, core, and upper body helps athletes stay conditioned while recovering after ACL surgery.

What Physiotherapists Can Do: By focusing on ROM exercises, carefully planned strength training, and cardiovascular fitness, we can help athletes regain mobility and strength more effectively, ultimately improving their chances of returning to sport at a high level. Early, individualised rehab protocols are key to long-term success.

If you have had a recent ACL reconstruction surgery or awaiting ACL surgery, book in with one of our consultants to create a plan to improve range of motion, strength and prevent complications post ACL Surgery. We can assist you returning safely back to your sport or activity

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ACL Surgery Return to Sport and Risk of Re-Injury

Returning to sport after ACL reconstruction is a significant milestone, but rushing back too soon from ACL surgery may increase the risk of ACL re-injury. A systematic review explored whether time to return to sport (RTS) is a key factor in second ACL injuries.

Key Takeaways:

  • Athletes who suffered a second ACL injury returned to sport about 25 days earlier after ACL surgery than those who returned to sport later.
  • The evidence linking earlier return to sport after ACL injury with a higher risk of re-injury is low in certainty, because timing alone may not fully explain re-injury risks. There are many factors involved but it’s an important fact to keep in mind when returning to sport after ACL surgery.

What This Means for Athletes: While the study suggests a slight increase in risk for athletes returning to sport after ACL surgery sooner, it highlights that ACL re-injury is influenced by multiple factors, not just timing. This emphasises the importance of using both time and functional performance as criteria for safe return to sport.

Physiotherapists’ Role: Physiotherapists should guide ACL patients through a balanced recovery, focusing on both time post ACL surgery and rehabilitation progress including strength, control, power, confidence etc. It is crucial to have collaborative decision-making between clinicians and patients, using individual progress and functional tests, ensures safer return to sport and lowers the risk of ACL re-injury.

Remember, taking the time for proper healing and recovery is key to long-term success in preventing ACL re-injury. At the physio crew we create individual plans to ensure you are confident and safe when returning to sport after ACL surgery.

To book with our clinicians, call our friendly staff on 9116 8691 or book online.

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