This ligament can rupture during deceleration, sports contact, improper landing, changing direction, or from the knee collapsing inward. There is usually a ‘pop’ sound with immediate swelling and a feeling of instability. If the ACL has been ruptured the medial collateral ligament (MCL) and medial meniscus may also be damaged.
How long does it take to get better?
The ACL can be repaired with surgery OR it can be managed without surgery. This depends on several factors (https://imovephysio.com.au/acl-surgery-do-you-need-one/). It is important to discuss with your physiotherapist and healthcare providers the option that would best suit you.
If you are going to undergo ACL surgery, a pre-surgical therapy program should be undertaken first. Delaying surgery by 5 weeks and completing an intensive exercise program prior to surgery resulted in better outcomes 5 years after ACL surgery (Filbay et al 2017).
After surgery, 9 months is the minimum time frame for the tissue to heal as well as allow enough time to complete return to sports rehabilitation (Beischer S et al 2020). The time to get back to walking and other activities is earlier than this, but a comprehensive rehabilitation program needs to be in place before going back to contact sports that require cutting, changing directions, and landing.
Here is a useful guide to give an outline of the rehabilitation process:
Melbourne ACL Rehabilitation Guide 2.0
Preoperatively the goals will be:
Reduce swelling, regain range of motion, regain 90% strength in the quads and hamstring compared to the other side, single-leg hop 90% compared to the other side
Phase 1: Recovery from surgery
Get the knee straight
Reduce swelling with ice and compression
Activating the quadriceps
Phase 2: Strength, balance, and control
Begins with bodyweight exercises and progresses into gym-based
Regain single leg balance
Regain muscle strength
Single leg squat control
Phase 3: Running, agility, landings
Full strength and balance
Phase 4: Return to sport
An athlete is comfortable, confident, and eager to return to sport
ACL injury prevention program
Score a 95+ on Melbourne return to sport score
Phase 5: Prevention
Includes plyometric, balance and strength exercises
Performed more than once per week for at least 6 weeks
Popular programs include:
The fifa 11+ warm up
The PEP program
The KNEE program – netball Australia
The footyfirst program – AFL
Progression to each of these phases depends on how quickly you respond to each of the exercises.
If you have any questions about ACL injuries and rehabilitation send us a message or book in to one of our clinics.