What Happens During Physical Therapy for an ACL Injury?

Anterior cruciate ligament (ACL) knee injuries are common sports injuries especially prevalent among athletes who play basketball, football, gymnastics, downhill skiing, or soccer. ACL injuries include sprains, partial tears, or complete tears of the ligament. Any activity that involves sudden stops, pivots, or jumping and landing increases the risk of injuring the ACL.

Not all ACL injuries require surgery. However, whether or not your doctor recommends surgery, physical therapy is essential to help reduce pain and regain normal range of motion, strength, and functional mobility after an ACL injury. If surgery is necessary, studies have found physical therapy before and after surgery can lessen recovery time.

What is the ACL?

Your ACL is composed of four major ligaments in your knee that connect your shinbone (tibia) to your thigh bone (femur), helping to control and support movement in various directions. The major ligaments include:

• ACL (anterior cruciate ligament) which controls the rotation and forward movement of the shinbone
• PCL (posterior cruciate ligament), which is behind the knee and controls the backward movement of the shinbone
• MCL (medial collateral ligament), which stabilizes the inner knee
• LCL (lateral collateral ligament), which stabilizes the outer knee

Knee injuries occur when the knee extends beyond its normal range of motion or twists sharply while bearing weight. A severe injury may increase your risk of developing meniscal tears, knee instability, or osteoarthritis of the knee.

Signs of an ACL Injury.

Mayo Clinic experts say the first sign of an ACL injury may be a popping noise or sensation in your knee, followed by one or more of the following symptoms:

• Severe pain and inability to continue the activity
• Rapid swelling
• Loss of range of motion
• A feeling of instability or “giving way” when bearing weight

You may also experience warmth, redness, and tenderness around the knee joint, have trouble walking or climbing stairs, or your knee may feel numb.

If ligaments are severely damaged, you may need surgery to reconnect them. During the surgical procedure, your surgeon replaces tissue in the injured area with part of a tendon, usually taken from your hamstring or kneecap. If necessary, your surgeon uses tissue from a donor. However, the use of your own tissue decreases the risk of rejection.

What Happens During Physical Therapy for ACL Injury?

The goal of physical therapy after an ACL injury or surgery is to reduce pain and swelling, restore your knee’s full range of motion, and strengthen muscles. Before surgery, PT helps improve joint range of motion and leg strength for a better surgical outcome and faster recovery time.

Strong, balanced muscles and proper technique when executing movements reduce your risk of ACL and other injuries. If you are recovering from an ACL injury, your physical therapist will help you regain optimum function and teach you how to avoid future damage. Physical therapy goals include:

• Reduce pain and swelling
• Improve core strength, lower body strength, and overall physical condition
• Teach correct body posture during movements and landing after a jump
• Education on supportive footwear and appropriate sports gear

Pain reduction

Inflammation and swelling after an ACL injury or surgery can cause significant pain. Your physical therapist may use various modalities to reduce inflammation and relieve pain, including cold and hot therapy, compression, transcutaneous electrical nerve stimulation (TENS), ultrasound, low-level laser therapy, and other treatment approaches.

You can help speed the healing process by following physical therapy instructions at home, which often include rest, ice, compression, and elevation (RICE).

Strengthen core and lower body

Core muscles are those around your trunk and pelvis, including abdominals, obliques, diaphragm, pelvic floor muscles, hip flexors, and gluteal muscles. ACL and other injuries often occur when weak core muscles exert unnecessary stress on knee ligaments.

Core muscles control and support the pelvis and spine and coordinate with the legs and upper body. A strong core enables the body to maintain postures or perform movements without placing an undue load on the joints.

Exercises strengthening core muscles promote better balance and stability, helping you regain optimum function and lowering your risk of reinjuring your knee. PT for ACL rehabilitation also focuses on strengthening your leg and hip muscles to enable healthy coordination with core muscles and protect your knees.

PT treatment plan may include:

• Exercises to strengthen core, leg, and hip muscles and improve range of motion. Strong quadriceps and hamstrings are essential to help stabilize the knee.
• Exercises to improve balance and flexibility. Your PT may suggest a BAPS board to improve your sense of balance and movement.

Correct body posture

Correct posture means standing up straight with your weight centered over your feet, maintaining the natural curves in your spine. Maintaining good posture keeps your body balanced, decreases the risk of injury, and can improve sports performance.

PT treatment plan may include:

• Posture and gait training with or without assistive devices
• Proper technique for jumping and landing
• Pivoting techniques to decrease the risk of injury
• Sport-specific mobility drills

Good body posture relies on solid core muscles. Strong, balanced core muscles help stabilize your body when you have to change directions quickly or jump and land. If core muscles are weak, body posture is probably weak.

Your physical therapist may use plyometric exercises to improve your jumping and landing technique. Plyometrics helps strengthen the legs and increase your capacity for explosive power in your lower legs. You will also learn how to keep your knees from buckling inward.

Supportive footwear and protective gear

Supportive footwear and sports gear that fits well lowers your risk for an ACL or other injury. Your physical therapist will educate you on appropriate shoes and sports gear.

Athletic Physical Therapy Heals ACL Injuries Faster.

Depending on the severity of the ACL injury, recovery can take up to a year. Studies find working with a physical therapist is the fastest and safest way to restore function and stability to your knee and avoid reinjury.

The expert team at Athletic Physical Therapy specializes in sports medicine and orthopedic rehabilitation. Our proprietary physical therapy program, Active Rehabilitation Continuum (ARC), is proven to reduce inflammation and pain, increase flexibility and strength, and restore power and performance quickly so you can get back to the active lifestyle you love.