Physical Therapy for an ACL tear

Tearing your ACL and deciding whether to have it repaired is a huge decision.  One I often get asked.  And one where no one likes the answer because it depends is often my answer.  There are things that you must take into consideration when you are deciding whether to get their ACL repaired.  One of them is their activity level.  Do you play sports?  If so, then It might be a good idea to get it surgically repaired.  Does it hurt or stop you from doing things you enjoy?  If the answer is yes, then you might want to get surgery.   Whatever the decision it needs to be made with you and your surgeon and your family.

However, this is not the point of this blog.  This article is about what you could do if you chose not to the ACL surgery.  There are things that you need to do to help keep the knee joint strong and healthy despite not having a ligament.

It is important to understand the function of the ACL.  The ACL helps the bones in the legs not slide on one another.   Therefore, you must train the muscles and the other ligaments to perform the work of the ACL.

First you need to make sure that your muscles are not tight, that there are no knots in the muscles that are surrounding the knee.  It is important to check the hamstring, the calf and the quad and the IT Band.  If you have tight muscles, you are going to have a hard time training the muscles correctly to help assist with the fact that the ACL is gone.

The most effective way to get out the knots is to foam roll.  You can see a complete foam rolling program on our You Tube channel, Total Performance Physical Therapy.  You want to make sure that you foam roll every part of the leg.  You want to do it with a foam roll that has ridges or bumps to most effectively work out the knots.

After you roll out the knots you want to strengthen the muscles.  Most often times, a non-traumatic ACL tear (meaning an tear that happened where you didn’t have an accident like a fall down the steps but rather you were running and you went to change direction and you just heard a pop), happens because some muscles are strong and some muscles are weak.  This is called a muscle imbalance.  It is important that you correct these muscle imbalances.  You can do this by performing certain exercises.

Most of the muscle imbalances exist in the hips.  Usually the hips and the hamstrings (the muscle group in the back of the leg) are not strong enough to support the quads (the muscles in the front of the leg).  It is important before getting started that you identify exactly where all the muscle imbalances are and in what muscles.

In order to strength the hamstring one of the exercises that you do is a bridge.  This exercise can help to strengthen the hamstrings.  Start by laying on your back on a flat surface.  Bend you knees up and then place your feet flat on the floor.  Then putting all the weight in your heels push your butt off the ground.  You want to do 3 sets of 15.  Try not to rest all the way down in between each one.  If you find this exercise too easy then lift one leg off the ground and push your butt off the table.  Make sure to keep your hips level.

The next exercise you want to do is for your hips.  Most people have a weak gluteus medius which helps control the foot and the knee.  Stand with leg on the step and one leg off the step.  Do not bend the knee.  You want to keep the leg straight.  Drop your hip down and then raise it back up.  Repeat this 30 times on each side and do 3 on each side.  You will feel this in the leg on the steps.  You can watch this on the video below.

Another important thing to work on when you have a torn ACL is balance.  Retraining balance will help retrain the leg with the missing ligament.  You can do this by standing on one leg.  You can do this while brushing your teeth or washing dishes or just standing at the counter.  Start with just standing on one leg.  If you can do this for 30 seconds without holding onto anything then close your eyes.  If you can do it for 30 seconds standing on one leg without opening your eyes, then you can stand on a pillow and close your eyes and try to balance for 30 seconds.

It is important if you chose not to repair your ACL that you make sure that you properly rehabilitate your leg.   You could develop problems if you chose to not get it repaired and not rehabilitate the muscles, teaching them to be stronger and learning how to balance without the use of the ACL.

If you live in Montgomery or Bucks County PA and would like a FREE consultation for your ACL, call our office at 215-997-9898.


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