Nhs trust acl reconstruction physiotherapy advice for patients. The acl reconstruction protocol is intended to provide the treating clinician with a guideline for. A graft that stretches or ruptures during this time period is not repairable. This video should not be used as a substitute for regular. Quadriceps isometrics exercises, straight leg raises, and range of motion exercises should be started immediately. Acl reconstruction rehab protocol general guidelines brace will remain locked until patient demonstrates good quadriceps control two to four weeks with weight bearing activities. Protect graft and graft fixation with use of brace and specific exercises. Anterior cruciate ligament reconstruction this protocol is designed to assist you with your preparation for surgery and should be followed under the direction. The physiotherapist must exercise their best professional judgment to determine how to integrate this protocol into an appropriate treatment plan.
Stationary bike can be increased to 2030 min as tolerated. The goal of these videos is to help maximize your recovery following acl reconstruction surgery. What is a current technique of an acl reconstruction and what is its rationale. Mathes during the surgery, a lighted telescopic lens called an arthroscope is inserted directly into the knee joint to. Intensity of exercise increases and therefore recuperation time is necessary so home program is reduced to 3 daysweek stationary bike swimming with flutter kick stair climbing machine. Basic gentle exercises, regular application of ice and elevation of the knee are bene.
This article will outline the importance of earlystage acl rehab, and the role that stretching and strengthening. For acl reconstruction performed with meniscal repair or transplant, defer to rom. What are possible technical complications associated with the reconstruction. Rehabilitation guidelines for acl reconstruction in the adult athlete skeletally mature anterior cruciate ligament acl injuries affect men and women across a wide age range and at all levels of athletics. It is no means intended to be a substitute for ones clinical decision making. Surgery to reconstruct the acl ligament can be done arthroscopically through small incisions and is done on an outpatient basis avoiding a hospital stay and allowing the patient to recover in the comfort of their own home. Anterior cruciate ligament acl reconstruction protocol please see the important note for stretching knee extension on page 5 the intent of this protocol is to provide a general framework for acl rehabilitation. Phase i maximum protection weeks 0 to 2 brace six weeks.
Full extension is obtained by doing the following exercises. The guide to rehabilitation of anterior cruciate ligament. Pdf exercises following anterior cruciate ligament. The guide to rehabilitation of anterior cruciate ligament acl reconstruction introduction anterior cruciate ligament surgery and rehabilitation have undergone dramatic changes over the past decade, due to extensive clinical experience, improved surgical technique and better understanding of rehabilitation. Get explanations of 8 simple rehabilitation exercises for acl injuries to help strengthen muscles and improve the knees function. Rehabilitation guidelines for acl reconstruction in the. These exercises can begin immediately after an acl injury. This is helps retain your muscle strength around the acl, range of motion and control swelling. Supine wall slides, heel slides and knee to chest to improve knee flexion as needed.
Early stretch and strengthen after acl reconstruction. Physiotherapy acl protocol rehabilitation following anterior cruciate ligament reconstruction aclr is an essential part of a full recovery. Acl reconstruction protocol1 northwestern medical center. Rehabilitation following anterior cruciate ligament reconstruction aclr is an essential part of a full recovery. See acl rehabilitation program for an overview of when each. You will return to see your surgeon at the following intervals after surgery. This protocol must be followed to prevent injury to the acl graft. Brace will remain locked until patient demonstrates good quadriceps control two to four weeks. May use of rom brace locked out at zero degrees extension for ambulation for six weeks no running for four months after surgery no biodex or kt testing for foursix months after surgery no resisted open chain knee extension exercises 02 weeks. Finally, we provide some recommendations for rehabilitation specialists regarding the application of exercise after acl ligament reconstruction, plus some future.
Frequency of exercises 34 times per day, unless otherwise indicated. Be sure to follow the more conservative protocol with regards to range of motion, weight bearing, and rehab progression when there are concomitant injuries i. Each patient and injury will be different so always take the advice of your medical professional or surgeon. Acl exercises mobility and strengthening for torn acl. Loss of knee extension has been shown to result in a limp, quadriceps muscle weakness, and anterior knee pain. Acl hamstring tendon autograft reconstruction protocol the intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a patient that has undergone an acl hamstring tendon autograft reconstruction. Rehabilitation following acl reconstruction for dr. Acl strain and tensile forces for weight bearing and non. Intensive research into the biomechanics of the injured and the operated knee have led to a movement away from the techniques of the early 1980s characterized by post operative casting, delayed weight bearing and limitation of rom, to the current early rehabilitation program with immediate training of rom and weight. Acl rehabilitation has undergone considerable changes over the past decade. Please give a copy of this acl rehabilitation protocol to your therapist. Keenan 2009 information on acl ruptures the knee is the largest joint in the body.
Acl hamstring tendon autograft reconstruction protocol. Acl in practice is a tutorial that examines human resources records and credit card transactions at a fictional company, metaphor corporation. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. Gait exercises continue with 12 passes 20ft up and back daily. Rehabilitation protocol for acl reconstruction this protocol is intended to guide clinicians and patients through the postoperative course of an acl reconstruction. Acl rehab protocol is an outline of an anterior cruciate ligament sprain rehabilitation program. It consists of initial first aid, mobility, strength, balance, fitness and agility exercises both before and after reconstructive knee surgery. Anterior cruciate ligament acl reconstruction protocol. Acl reconstruction protocol hamstring graft week one week two initial evaluation evaluate range of motion joint hemarthrosis ability to contract quadvmo gait generally wbat in brace patella mobility inspect for infectionsigns of dvt assess rtw and sport expectations range of motion.
The majority of acl surgery patients will be prescribed a specific exercise program that focuses on regaining range of motion and gradually bearing weight on the knee. Stationary bicycle, swimming, low impact exercise machines such as an elliptical crosstrainer, leg press machine, leg curl machine. However, if youre struggling for ideas, ive compiled a few of my favorite exercises into a video in no particular order to get the knee going during different phases of rehab following acl reconstruction. Physiotherapy following acl reconstruction protocol rehabilitation following anterior cruciate ligament reconstruction aclr is an essential part of a full recovery. Acl reconstruction protocol allograft week one week two initial evaluation evaluate range of motion joint hemarthrosis ability to contract quadvmo gait generally wbat in brace patella mobility inspect for infectionsigns of dvt assess rtw and sport expectations range of motion.
The following acl advanced strengthening and coordination exercises, which are demonstrated in this video, should be conducted during phase 4 of your acl reconstruction rehab. When you finish, you will be able to apply the power of acl to your. Facts transformation of the graft into a strong and durable ligament requires four months. The therapist must modify the program appropriately depending on the individuals goals for activity following reconstruction. Physical therapy may be necessary prior to surgery. The grafted acl sees minimal force with normal daily activities and immediate weight. The goal of the initial rehabilitation phase is to gain full flexion and extension of the knee joint and then build balance and strength. Time frames for brace or crutches may be extended by dr. Victoria v8z 09 tel 250 940 4444 fax 250 385 9600 page 2 april 2015 v1s. If suspect an acl sprain, we strongly advise you seek professional medical advice as soon as possible.
Acl reconstruction postoperative protocol rosenberg. Recovery after acl reconstruction requires a thorough rehabilitation programme to ensure both optimal function of the knee and prevention of further injury. In the acute period after acl reconstruction the knee needs some time to recover from the acute trauma of surgery. Anterior cruciate ligament acl rehabilitation physiopedia.
What is the history of acl reconstruction and its evolution. Gsss patients guide to anterior cruciate ligament reconstruction colin walker frcs frank gilroy bsc mcsp 2nd edition 2016 based on previous programme written for gsss written and produced by c. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports. The exercises will help to strengthen the muscles around the knee and help you to regain full range of movement.
Anterior cruciate ligament acl and how do todays reconstruction techniques attempt to recreate it. Acl rehabilitation protocol mark clatworthy, orthopaedic surgeon, knee specialist this guideline has been prepared to help guide you through your recovery following your anterior cruciate ligament reconstruction. In the early weeks post op it is crucial to control the swelling, restore full joint movement and. Acl reconstruction rehabilitation protocol sports medicine north. Anterior cruciate ligament reconstruction terminology and education phase 1 acute management, early motion and basic movement retraining phase 2 basic strength and proprioception phase 3 dynamic neuromotor strength, endurance and coordination phase 4 athletic enhancement and return to activity phase 5 rehabilitation of athletic movement and. Rehabilitation protocol for anterior cruciate ligament. Emphasis is placed on early physical therapy and home exercises. The exercises will help to strengthen the muscles around the. A large number of clinical trials continue to assess aspects of this rehabilitation process. With in this framework there are specific guidelines for activity progression which. Rehabilitation after anterior cruciate ligament reconstruction. Add wall slides see figure 3 and hand assisted heel drags to increase your range of motion. If you have suffered an acute acl injury and surgery is planned, the time between injury and surgery should be used to regain knee motion, decrease swelling, and maintain muscle tone. Remember to ice for 1015 minutes following exercise sessions to prevent inflammation pain and swelling phase 3 exercises.
Acl tear and reconstruction connecticut orthopaedics. It contains detailed exercises appropriate for the different phases of rehabilitation. These functions are vital to prepare an injured athlete for acl surgery. Rigorous rehabilitation after anterior cruciate ligament acl reconstruction is necessary for a successful surgical outcome. Guide to acl reconstruction rehabilitation welcome to our acl reconstruction rehabilitation video series. Nhs trust acl reconstruction physiotherapy advice for. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Crushed ice or an aircast knee cryocuff along with nonsteroidal antiinflammatory medications such as advil, nuprin, motrin, ibuprofen, aleve 2 tablets twice a day are used to help control pain and swelling. About the anterior cruciate ligament acl there are four main ligaments that stabilize the knee.
Doing the exercises ankle pumps below, using aspirin and at times compressive. Acl exercises form part of acl rehab protocol following an anterior cruciate ligament sprain. Anterior cruciate ligament acl reconstruction protocol following surgical reconstruction of the acl, it is important to follow rehabilitative and postoperative instructions to facilitate recovery and avoid injury to the new graft tissue. Rehabilitation protocol for acl reconstruction massachusetts.