1. ACL Rehab Phase 4

    ACL Rehabilitation Phase 4

    The fourth phase of rehabilitation from twelve weeks to six months involves the gradual re-introduction of sports specific exercises aimed at improving agility and reaction times and increasing total leg strength.

    ACL Strength Exercises:

    • Leg press
    • Squats
    • Leg extensions

    Keeping Your ACL Healthy and Strong:

    During this phase you will work on building your strength back while allowing the ligament to heal into the bone tunnels in your femur and tibia. Most physical therapists prescribe closed chain kinetic exercises during this phase. In this type of exercise your foot is planted on the floor and it is not free to move about. Squats are an example of a closed chain kinetic exercise whereas quadriceps extension exercises on a weight training machine are an open chain exercise.

    Most surgeons prefer to wait until at least three months have passed before allowing their patients to return to agility training exercises. When to return to competitive or recreational sports after an ACL reconstruction is a difficult decision. The timing of your return will depend upon how well you have done with your rehabilitation, how solid your knee feels to you, and what you and your surgeon decide is reasonable for you. Even after you return, it is important that you pay special attention to keeping your quadriceps and hamstrings in good shape, as this is considered an essential part of protecting the ACL.

    An elite athlete who has had a technically well performed early reconstruction of the anterior cruciate ligament followed by an adequate and successful rehabilitation program, should be able to return to the field of his chosen sport between six and nine months. This has been achieved in my previous football (soccer) and rugby professional athletes that I have helped in the past.

    Note: I am a certified personal trainer with lots of experience and knowledge, I am not a Physiotherapist.

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  2. ACL Rehab Phase 3

    ACL Rehabilitation Phase 3

    During the third stage, from six to twelve weeks, emphasis is placed on improved muscular control and general muscular strengthening. Rehabilitation will progress from static to dynamic techniques including balance exercises. The patient should have a full range of motion during this stage and gentle resistance work should be added.

    ACL Exercises:

    During this phase you can start using an exercise bicycle and a stair-stepper, as long as you are comfortable and your knee does not hurt or swell significantly after exercise. By the end of this period the patient should be able to cycle normally, swim with a straight leg kick and be able to jog freely.

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  3. ACL Rehab Phase 2

    ACL Rehabilitation Phase 2:

    During the second phase, from two to six weeks, the emphasis is on increasing the range of motion, increasing weight bearing and gaining hamstring and quadriceps control. The patient is usually out of the brace by the fourth week. During this phase gait re-education and static exercises. This may include balancing on the affected leg and pool work to maintain conditioning and range of motion.

    ACL Exercises:

    Knee extensions — This exercise helps you to restore range of motion. Place your heel on object like a telephone book so that your heel and calf are not touching the bed. Remain in this position for five to ten minutes.

    Quad sets — This exercise helps you to maintain your strength and your range of motion. Keep your heel elevated as in the knee extension exercise. Begin by tightening the quadriceps muscle and holding it for ten seconds. Repeat ten times.

    Straight leg raise –This exercise helps you maintain your quadriceps strength. Start with your leg flat on the bed. Begin by tightening your quadriceps, as in the quad sets exercise. Then lift your leg off the bed until your heel is approximately eighteen inches off of the bed. Lower your leg back down and relax for five seconds.

    Heel slides — This exercise is for range of motion (ROM). Begin with your with knee flat on the on the ground and slowly bend your knee until it is just slightly uncomfortable. Hold your knee in this position for 10 seconds to 20 seconds, and then relax by straightening your leg, rest for ten seconds. Repeat ten times.

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  4. ACL Rehab Phase 1

    ACL Rehabilitation:

    After your operation is over, the hard work really begins. The goals of physical therapy and rehabilitation after ACL surgery are to rebuild your strength and to get your motion back. This whole process requires a lot of work and patience on your part, but it is the most important aspect to getting you back on the playing field. In the past, rehabilitation after an ACL injury was primarily concerned with protecting the new ligament and the surgical fixation. For that reason, full extension of the knee and active quadriceps exercises were avoided. Unfortunately, it has been discovered that this type of rehabilitation can cause problems with stiffness and may result in a limited range of motion.

    ACL Rehabilitation Phase 1:

    Our NoLimit2Fitness rehabilitation program is divided into four phases. In the first phase; one to two weeks the aims of therapy are to decrease pain and swelling, and increase the range of motion (ROM) of the knee. A post-operative brace is ranged from 30 to 90° and is used until there is adequate quadriceps control. Crutch -walking with partial weight bearing is allowed and the usual modalities are used to reduce pain and swelling.

    ACL Exercises:

    Heel Slides– For this next exercise, start with you injured leg stretched out. Then, while keeping your heel on the floor, gradually bend your knee and slide your heel towards your buttock. Bend your knee until it becomes just slightly uncomfortable and you can feel a bit of pressure inside your knee. Hold it in this position for ten seconds. Then straighten your knee out again and relax for ten seconds. Repeat this exercise ten times as well. This exercise will help you to maintain range of motion (ROM).

    Straight leg raise –This exercise helps you maintain your quadriceps strength. Start with your leg flat on the bed. Begin by tightening your quadriceps, as in the quad sets exercise. Then lift your leg off the bed until your heel is approximately eighteen inches off of the bed. Lower your leg back down and relax for ten seconds

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  5. ACL Rehab

    Rehabilitation begins immediately after the injury.

    Initial rehab should include ice, gentle knee motion, quad setting, straight leg raise, and protected weight bearing. The worst thing that can be done is to not move or use the knee. When the ACL ruptures, the knee fills with blood, becomes stiff and painful. Gentle motion will help to move the blood out of the joint to improve pain and function. When the knee is not moved the blood in the joint becomes clotted. When this occurs, motion becomes more painful and the removal of the blood takes longer. Rupture of the ACL causes significant short term and long term disability.

    The major goals of rehabilitation following ACL surgery are:

    Restoration of joint anatomy; is a provision of static and dynamic stability maintenance of the aerobic conditioning and psychological well being; and early return to work and sport.

    These have required the development of an intensive rehabilitation program in which the patient has to take an active involvement.

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