ACL Solutions - Treatment Options

The first phase of treatment: restoring motion, maintaining strength, and walking normally

The goal of immediate treatment after an ACL injury is to restore the normal motion of the knee as much as possible. This is the beginning of the recovery process for everyone who sustains an ACL injury, whether or not they are going to have a surgical reconstruction. For those who elect to have surgery, it is an important procedure because full motion can often be very difficult to regain if it is lost for a significant period of time. For this reason, it is generally important that the patient goes into surgery with as much motion as possible, as this will tend to make rehabilitation much easier. While it is always best to follow your doctor's advise carefully, you should make a special point of doing so with respect to those measures designed to maximize your preoperative mobility.

After you have injured your ACL, the largest muscle in your thigh, the quadriceps muscle, begins to weaken very quickly. This is because an injured knee sends a signal to your body that stops the quadriceps muscle from working normally, causing it to shrink. "Quad atrophy" can happen very quickly and it can make it difficult to get your strength back whether you have surgery or not. Exercises that maintain the tone in your quadriceps are an important part of the first phase of treatment. Motion is restored in the knee by helping the swelling to go down, and by gradually stretching the knee. Rest, and time off from any training activities is the first step. You should ice and elevate your knee as much as possible, and you should use a soft compression wrap with an ace bandage in order to speed up the process of removing the swelling. A physical therapist can be very helpful in teaching you a series of stretching exercises to restore the motion to you knee.

After a knee injury, it is normal to limp for a while. If your knee is hurt badly enough that you are limping then you should probably be using a pair of crutches to get around. At the same time, once you can walk normally, without a limp, it is usually not necessary to use crutches anymore. Removing the swelling in your knee and keeping your quadriceps strong will help you to walk without a limp faster.

Here are some common exercises that many ACL patient may be able to work on in order to both try to help the swelling in their knee go away and to maintain strength in their quadriceps. Each of these exercises should be done gently and gradually. You should not push yourself to the point where you are in a significant amount of pain. Before stating this or any other exercise program, however, check with your doctor.

Exercises:

Knee extensions -- this exercise helps you to restore range of motion (ROM). Start with your leg stretched on a bed, then place your heel on object like a telephone book so that your heel and calf are not touching the bed. Remain in this position for five to ten minutes.

Quad sets -- this exercise helps you to maintain your strength and your range of motion (ROM). Keep your heel elevated just like the knee extension exercise. Begin by tightening the quadriceps muscle and holding it for ten seconds. Repeat ten times.

Straight leg raise --this exercise helps you to maintain your quadriceps strength. Start with your leg flat on the bed. Begin by tightening your quadriceps, as in the quad sets exercise. Lift your leg off the bed until your heel is approximately eighteen inches above the bed. Lower your leg back down and relax for five seconds.

Heel slides -- this exercise is for ROM. Begin with your knee flat on the bed and slowly bend your knee up until it is just slightly uncomfortable. Hold your knee in this position for ten seconds, and then relax by straightening your leg. Rest for ten seconds and then repeat ten times.

If you perform these exercises daily you will recover the motion in your knee quite quickly. You should reach a point where you have nearly normal range of motion within a few weeks.