Physical Therapy After Trimming and Reconstruction Of Damaged ACL is essential to restore joint function, improve mobility, and promote healing. The type and intensity of physical therapy will depend on the extent of the cartilage damage, the surgical procedure, and the patient's individual progress. Here’s an outline of the typical stages of physical therapy after such a surgery:
𝟏. 𝐄𝐚𝐫𝐥𝐲 𝐏𝐡𝐚𝐬𝐞 (𝟎-𝟔 𝐖𝐞𝐞𝐤𝐬 𝐏𝐨𝐬𝐭-𝐒𝐮𝐫𝐠𝐞𝐫𝐲)
Goals: Reduce pain and swelling, protect the surgical site, and begin gentle range-of-motion (ROM) exercises.
𝑻𝒆𝒄𝒉𝒏𝒊𝒒𝒖𝒆𝒔:
- Passive range-of-motion exercises: Using a continuous passive motion (CPM) machine or therapist-assisted movements to gently bend and straighten the joint without muscle engagement.
- Edema control: Use of ice packs and elevation to manage swelling.
- Isometric exercises: Gentle contractions of the quadriceps and hamstrings without moving the knee (to prevent muscle atrophy while protecting the joint).
- Non-weight bearing activities: Crutches or a walker may be used to avoid placing weight on the joint.
𝟐. 𝐈𝐧𝐭𝐞𝐫𝐦𝐞𝐝𝐢𝐚𝐭𝐞 𝐏𝐡𝐚𝐬𝐞 (𝟔-𝟏𝟐 𝐖𝐞𝐞𝐤𝐬 𝐏𝐨𝐬𝐭-𝐒𝐮𝐫𝐠𝐞𝐫𝐲)
Goals: Improve joint mobility, increase strength, and begin partial weight-bearing.
𝑻𝒆𝒄𝒉𝒏𝒊𝒒𝒖𝒆𝒔:
- Active-assisted range-of-motion exercises: The patient actively moves the joint, with support from a therapist or equipment.
- Weight-bearing exercises: Gradual introduction of weight-bearing, starting with partial weight and progressing as tolerated.
- Stationary biking: Low-resistance cycling to improve mobility and circulation without placing undue stress on the knee.
- Strengthening exercises: Progression to strengthening the quadriceps, hamstrings, and calf muscles with light resistance bands or weights.
𝟑. 𝐀𝐝𝐯𝐚𝐧𝐜𝐞𝐝 𝐏𝐡𝐚𝐬𝐞 (𝟑-𝟔 𝐌𝐨𝐧𝐭𝐡𝐬 𝐏𝐨𝐬𝐭-𝐒𝐮𝐫𝐠𝐞𝐫𝐲)
Goals: Restore full range of motion, enhance strength, and improve balance.
𝑻𝒆𝒄𝒉𝒏𝒊𝒒𝒖𝒆𝒔:
- Full weight-bearing activities: Progressing to full weight-bearing as tolerated, ensuring proper walking mechanics.
- Functional exercises: Incorporating balance training, squats, and lunges to mimic daily activities and gradually improve knee function.
- Core and lower body strengthening: Focusing on hip, core, and lower leg muscles to improve stability and reduce strain on the knee joint.
- Proprioception exercises: Activities like standing on a wobble board to improve joint position sense and stability.
𝟒. 𝐑𝐞𝐭𝐮𝐫𝐧 𝐭𝐨 𝐒𝐩𝐨𝐫𝐭𝐬 𝐏𝐡𝐚𝐬𝐞 (𝟔-𝟏𝟐 𝐌𝐨𝐧𝐭𝐡𝐬 𝐏𝐨𝐬𝐭-𝐒𝐮𝐫𝐠𝐞𝐫𝐲)
Goals: Gradually return to sports and high-impact activities.
𝑻𝒆𝒄𝒉𝒏𝒊𝒒𝒖𝒆𝒔:
- Plyometric exercises: Gentle jumping and agility drills to prepare for high-impact movements.
- Sport-specific training: Tailoring exercises to the movements required in the patient’s sport or activity (e.g., cutting maneuvers for soccer players).
- Endurance training: Building overall stamina and cardiovascular fitness.
𝑲𝒆𝒚 𝑪𝒐𝒏𝒔𝒊𝒅𝒆𝒓𝒂𝒕𝒊𝒐𝒏𝒔:
- Patience: Recovery after cartilage surgery is slow, and overloading the joint too soon can damage the repair.
- Individualization: The rehab plan should be tailored to the individual’s surgery, condition, and progress.
- Consultation: Work closely with a physical therapist and surgeon to ensure exercises are safe and appropriate at each stage of recovery
Remember to always consult your healthcare professional before starting any new treatment or exercise regimen to ensure it's safe and appropriate for your specific condition.
References
American Academy of Orthopaedic Surgeons (AAOS)
ACL Injury Rehabilitation
https://orthoinfo.aaos.org/en/treatment/acl-injury-rehabilitation/
Cleveland Clinic
ACL Reconstruction Surgery and Rehabilitation
https://my.clevelandclinic.org/health/diseases/21786-acl-tear
Mayo Clinic
ACL Injury: Rehabilitation and Physical Therapy
https://www.mayoclinic.org/diseases-conditions/acl-injury/diagnosis-treatment/drc-20368282
Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Rehabilitation after ACL Reconstruction: A Systematic Review
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