Question

POST KNEE SURGERY: Design a post Physical Therapy rehab program for a someone who is recovering from ACL surgery. Consult local resources and therapy textbooks for the most updated information?

Answer 1

Anterior cruciate ligament of knee is one of the ligament that hold three bones of the joint together.   

After ACL surger proper treatment including physical care should be given to the patient for full functional recovery.

Main goals of rehabilitation include

▪ good functional stability

▪ providing muscle strength

▪ decrease the risk of reoccurance of injuary.

Physical therapy focus on rangs of motion, strength, propioception and stability. This include 4 phases.

□In phase 1( weel 1_2) : -help to bend and strengthen knee.

Exercises: knee extension, static squad, heel slides

□Phase 2 ( week 2-6) -have full range of motion

Exercises : Quads strengthening, hamstring strengthening , hamstring catches and streches calf stregthening and streches , propioception.

□Phase 3 ( week 6_ 12) -in this phase have full range of motion, no swelling, balance.

Exercises :Single knee extension single leg squats , jogging running, jumping

□Phase 4( after 3 months ) - safe return to normal function of knee.

Exercises:High level balànce and polymetric exercises.

Week 1

▪ initial post operative weeks focus on learning to walk with the help of crutches.

▪ Regular use of ice help to control swelling.

▪ use of neuromuscular electrical stimulation for improving contracting ability of quard and perform range of motion exercises ( 90 degree bent).

Week 2

▪ exercises to control quard and hamastring muscles in the back of your legs.

▪ patient should try to walk by using one crutches.

Week 3

Advanced hip exercises ans start to use light weight during straight leg exercise.

Week 4to 6

▪ propioception and cordination exercises to improve balance, squats, stegthens quards and glutes along with straight leg exercise and advanced hip stegthening.

▪ no longer need NMES.

Week 7 to 8

Besides doing exercises integrity of ACL is tested.

Week 9 to 10

Forward, backward and lateral dynamic movement and isokinetic exercises helping in stability and strength.

After 3 months

After 3 month patient can do functional exercises like jogging, walking, jumping

Final goal is to maximize endurance and strength of knee stabilizers , neuromuacular control with pylometric exercises and to add spor specefic exercises.