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  • Writer's picturezelechowski mathieu

From Injury to Recovery: A Comprehensive Guide to ACL Surgery and Rehabilitation

Updated: Jun 3, 2023


Mathieu Zelechowski physiotherapist osteopath from courchevel working on a broken acl knee

The anterior cruciate ligament (ACL) is one of the crucial ligaments that stabilize the knee joint. Unfortunately, it's also one of the most commonly injured, especially among athletes. A torn ACL can be a significant setback, but with advanced surgical procedures and dedicated rehabilitation, many can return to their previous levels of activity.

Immediate Phase: Injury and Diagnosis The journey begins with an unfortunate twist, bend, or sudden stop that tears the ACL. Initial symptoms usually include intense pain, swelling, and instability of the knee. After the injury, you'll consult with an orthopedic specialist who will conduct a physical examination and likely order imaging tests such as an MRI to confirm the ACL tear.

Weeks 1-2: Pre-operative Phase Before undergoing surgery, reducing inflammation, pain, and regaining as much range of motion as possible is crucial. This may involve physiotherapy exercises, icing, and using crutches to minimize weight-bearing.

Weeks 3-4: Surgical Intervention There are two primary types of ACL surgery: repair and reconstruction. Repair involves stitching the torn ligament back together. Reconstruction, the more common procedure, involves replacing the torn ACL with a graft from another part of your body (autograft) or from a donor (allograft). The surgery is typically performed arthroscopically, which is minimally invasive and reduces recovery time. An orthopedic surgeon will make small incisions around your knee and insert special instruments to remove the damaged ACL and replace it with the graft.

Weeks 4-6: Early Post-operative Phase The goal during the initial post-operative phase is to control pain and swelling, restore full range of motion, and to strengthen the muscles around the knee. Your knee will be initially immobilized with a brace, and you will most likely need crutches. Physiotherapy will begin soon after surgery. Exercises will initially be very gentle, focusing on gradually improving range of motion without putting excessive strain on the graft. Quadriceps strengthening exercises are also introduced.

Weeks 6-12: Intermediate Rehabilitation By this stage, most individuals will discontinue the use of crutches. The focus of rehabilitation shifts towards regaining strength, balance, and coordination. Physiotherapy exercises will increase in intensity and will begin to include weight-bearing activities, such as leg presses.

Months 3-6: Advanced Rehabilitation As strength and stability improve, the rehabilitation program will incorporate sport-specific or activity-specific exercises. This might include agility drills, running, and jumping exercises, depending on your activity level and goals.

Months 6-9: Return to Sport Phase This is the final phase of recovery, where the goal is to return to sport or pre-injury activity levels. It's important to note that the timeline can vary depending on the individual and the specific sport. Clearance to return to full unrestricted activities will typically be given when you have regained equal strength and mobility in both legs, and feel confident in your knee stability. The journey from an ACL injury through surgery and rehabilitation is not easy. It requires commitment, patience, and hard work. With the help of a dedicated medical team, personalized rehabilitation plan, and a positive mindset, it is certainly possible to overcome this challenge and return to the activities you love.

Please note: Every individual's recovery process will vary, and the timeline here is an approximate guide based on typical cases. Always consult with your healthcare provider for personalized advice.


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