The anterior cruciate ligament (ACL) is a ligament in the centre of the knee that prevents the shin bone (tibia) from moving forward on the thigh bone (femur).

Injuries to the ACL can range from mild (small tear/sprain) to severe (complete tear of the ligaments). When the ACL has been completely torn, and there are signs of instability, reconstructive surgery is required.
 

Mechanism of Injury
The most common mechanism of injury of the ACL is as a result of sudden pivoting or changing direction, twisting on a bent knee, or landing awkwardly from a jump.  

A physiotherapist can perform a series of special tests and examinations to identify an ACL tear, however the gold standard for diagnosis will be Magnetic Resonance Imaging (MRI).

ACL Reconstruction Surgery
ACL reconstruction surgery uses a graft to replace the ligament. Typically, the graft is taken from your own body, such as the tendon of the knee cap (patella) or of the hamstrings or quadriceps. The ligament can also be taken from a decreased donor.  

How Can Physiotherapy Help?
Rehabilitation begins immediately after surgery. A knee brace may be required to limit certain ranges of motion to optimize healing.
 

Rehabilitation can be broken into 3 phases:

Early Phase (Weeks 0-9)

•  Decrease pain
•  Reduce swelling
•  Increase knee range of motion (as recommended)
•  Maintain range of motion of hip and ankle on surgical side
•  Activation of quadriceps muscle (thigh muscle)

Intermediate Phase (Weeks 9-16)

•  Achieve full knee range of motion
•  Strengthen quadriceps and lower leg
•  Balance/Proprioceptive training 

Late Phase (Weeks 16-24)

•  Continue strengthening of lower leg
•  Sport specific strengthening
•  Plyometric activities (explosive resistance exercises)
•  Non-contact sport drills
•  Continue balance/proprioceptive training 

As everyone’s situation is unique always consult a registered health professional to help create a management plan that’s effective and safe for you!

-K