The anterior cruciate ligament (ACL) is one of the main ligaments that provides stability to the knee. Anterior cruciate ligament injury commonly occurs during non-contact sports movements that involve aggressive interruption, cutting, or lane change. ACL injury is typically signaled by pain, a "bubbling" sound and swelling of the knee. In most cases, surgery is recommended to reconstruct the injured ACL to avoid instability and further damage to the knee.
The most common problem after surgery to reconstruct the anterior cruciate ligament is knee stiffness or loss of movement, especially extension. When this occurs, it can lead to an imbalance of the flaccid muscle, and to a deficient function of the painful knee.
Many studies have shown that the timing of ACL surgery is crucial to having a good result. In particular, if the surgery is performed to reconstruct the anterior cruciate ligament of the knee when it is swollen and with a poor range of motion, then there is a high incidence of stiffness in the knee after surgery. These complications can be significantly reduced if surgery is delayed until the acute injury phase has resolved and movement and normal walking have returned.
Rehabilitation after ACL injury or pre-habilitation before ACL surgery has three main objectives: to control inflammation, restore range of motion and improve quadriceps muscle strength for restore normal running.
After an ACL injury occurs it is common to immobilize the knee and use crutches until the pain is gone and the muscle control has returned enough to walk without falling. However, you must be careful with immobilization. Remember that the goal is to regain function and prolonged use of a knee immobilizer can lead to a worsening of stiffness and muscle loss. If you dare to use the knee, put weight gradually on it and move it as much as pain allows.
Self-care and home therapy
Here are some simple steps to improve knee function and ultimately to improve results after surgery. First to control pain and swelling. Placing ice and raising the knee is a great therapy at first.You must place an ice pack on the knee with a thin protective barrier for 15 to 20 minutes for a moment 2 to 3 times per day. In addition, over-the-counter anti-inflammatory medications such as Advil, Motrin or Aleve are useful to help control pain and inflammation during the first week (or the first two weeks) after the injury.
Next you must do everything possible to restore the range of movement as quickly as possible. To recover the extension you must prop the heel in a rolled towel to move it away from the earth, relax it and let the gravity take the leg to its full extension. Hanging upside down is also very effective. This is done face down on a table with the legs dangling over the edge from the edge again allowing gravity to bring the knee to full extension. The toe of the healthy leg can also be used to push on the heel of the injured leg to push the knee straight.
Heel gliders are very useful for recovering flexion. This is done by resting on your back and sliding the heel up to the buttocks. In later stages you can grab the leg with both hands and pull the heel toward you to gain more flex.
These exercises should be done 3 to 4 times a day for 15 to 20 minutes each time. Once you have recovered the movement of the knee, begin to strengthen the quadriceps muscle. Lifting the leg straight is a good way to start and then you can gradually move on to the stationary bike, swimming and elliptical training machines.
These activities should continue until you can walk normally without limping and have a similar movement restored to the uninjured side. As always, you should consult your orthopedic surgeon to help you and guide you through this process.