ACL injuries are often feared by many athletes given the long-term rehabilitation that is required to recover fully.
However, the principal message is always that ACL rehabilitation is a step-by-step process that gives the athlete an opportunity to condition themselves back to a pre-injury level of performance or even better!
A comprehensive ACL rehabilitation programme should be designed to address strength, stability, mobility and functional movement.
It should also consist of different phases that focus on criteria-based progression as opposed to time-based progression.
This post will take you through an ideal rehab programme for athletes who have been injured during their sport as well as some example exercises that can be used along with the stages of your programme.
The Prehabilitation Phase
Ideally, rehab should begin prior to surgery and is also known as prehabilitation. This phase allows the initial swelling from the knee to go down and settle and for the injured patient to regain as much strength and function as possible prior to surgery.
This can be achieved through regular icing of the knee, and low-impact exercises such as cycling and strengthening exercises.
It’s important to note that during this phase it’s important to avoid aggressive direction changes and high-impact activities such as running and jumping as this could aggravate the injury.
Athletes should also be provided with education regarding the surgery, expected recovery times, and the importance of compliance with the ACL rehabilitation program.
Following surgery, the emphasis of early rehabilitation is focused on restoring the normal range of motion in the knee, particularly a full extension of the knee. Emphasis should also be put on reducing pain and swelling while minimising any muscle wasting that could have happened post-surgery.
Phase Two
Once the range of motion in the knee has been restored phase two can commence.
This typically involves progressive strength training initially implementing light load or body weight exercises which can be progressed as tolerated. Cycling and easy plyometric exercises can often be re-introduced around the 4-6 week mark.
The main goals of this phase are to regain the majority of leg muscle strength, balance and function. An ACL rehabilitation programme during this phase should be performed three to four times per week.
Here are some examples of exercises to do in this phase:
Phase Three
Phase three of an ACL rehabilitation programme should focus on increasing strength and volume by progressing exercises’ intensity, resistance and complexity to challenge the muscles and enhance functional movements.
This phase usually allows for the reintroduction of field-based straight-line running into the programme. However, athletes must meet certain single-leg and plyometric criteria prior to this.
Change of direction, agility and plyometric exercises may be further progressed as the athlete tolerates following a successful introduction of straight-line running.
Here are some examples of mid-stage ACL exercises to try:
Phase Four
The fourth phase of an ACL rehabilitation programme shifts to a power focus to include exercises such as box jumps, plyometric lunge jumps, countermovement jumps and bounds. Strength and field-based training should be continued throughout this phase and the exercises should be sports-specific to prepare the athlete for their return to play.
Athletes generally return to sport around 6-9 months into their recovery, however, timelines may vary between individuals. Prior to returning to play, athletes must pass a number of hopping, strength and agility tests to ensure they’re ready to return to full play. The athlete’s psychological readiness to return to play should also be considered an important factor to return to play.
Preventing Re-Injury
The final step in an ACL rehabilitation programme should be to prevent another ACL injury. It’s important for an athlete to incorporate injury-prevention exercises into their normal routine. The injury prevention exercises should consist of double and single leg strength and plyometric movements.
Are You Having Trouble With An ACL Injury?
Have you recently experienced an ACL injury during sport and you’re unsure how you can progress? Or are you in recovery and are having no success improving your performance and getting back to your best to get back into your sport?
Here at Pain and Performance Clinic, we’re passionate about getting you back to doing the activities you love without injuries getting in the way and stopping you from making the progress you strive for.
Right now, we’re offering you the chance to book a free knee pain telephone consultation where you can speak to one of our expert physiotherapists about your pain problems, ask your important questions and get clarity from the answers!
If you’ve had enough of knee pain ruining your favourite sports and activities arrange a free knee pain telephone consultation by calling our Lucan clinic at 086 787 6358.
Other Free Resources For Knee Pain
Read Our Blog – You’ve Injured Your ACL – Now What?
Read Our Blog – Patellofemoral Pain Syndrome
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