Anterior cruciate ligament (ACL) tears are a significant injury often seen in sports. Unlike common sprains, ACL tears are more severe, with athletes often describing hearing a “pop” followed by intense pain. When an ACL tear occurs, it’s a major blow to an athlete, and in some severe cases, surgery may be required. However, the road to recovery doesn’t end with surgery; rehabilitation plays a crucial role. OneEssential’s physical therapists have extensive experience treating athletes, and today, we’ll walk you through the complete recovery process, from surgery to post-surgery physical therapy.
How is ACL Tear Diagnosed?
MRI (Magnetic Resonance Imaging) and X-ray are the primary methods used to diagnose ACL tears. MRI is the gold standard for diagnosing ACL tears, as it provides clear images of ligament damage. X-rays are used mainly to rule out fractures or other bony injuries in the knee. These diagnostic tools are typically used after symptoms of ACL tears appear. However, to assess the health of the ACL before any injury, you can perform an initial self-check using the Anterior Drawer Test as follows:
- Have the patient lie down with the hips bent at a 45-degree angle and knees bent at 90 degrees, with the feet flat on the floor.
- The examiner should sit on the patient’s foot to stabilize it, then hold the upper part of the lower leg and try to pull the shin forward.
- If there’s noticeable forward movement of the tibia, it could indicate an ACL injury.
If you suspect an ACL issue and aren’t sure how to perform this test correctly, it’s best to consult a professional physical therapist. OneEssential’s physical therapists offer 1-on-1 consultations and detailed evaluations to precisely determine the health of your ACL. If a tear is confirmed, we can plan an effective rehabilitation program to get you back to your active lifestyle safely.
When is Surgery Necessary for an ACL Tear?
Treatment for an ACL tear depends on the severity of the injury. If the ligament is partially torn but not completely ruptured, surgery is not typically required. However, if the ACL is completely torn or if there is damage to the meniscus, surgery may be necessary for reconstruction. Some patients may opt not to undergo surgery, and the decision depends on individual considerations, so it’s important to consult with your doctor and physical therapist for the best course of action.
Primary Treatments for ACL Tears
Treatment for ACL tears typically involves a combination of surgery, physical therapy, and medication. Regardless of the treatment chosen, physical therapy is crucial in the recovery process. Below is a detailed explanation of physical therapy for ACL rehabilitation:
ACL Physical Therapy
Physical therapy for ACL recovery includes a series of strengthening and stability exercises for the knee joint, designed to restore function and alleviate pain. The therapy process includes building muscle strength, improving joint range of motion, and enhancing balance and coordination. Based on the severity of the injury and individual needs, therapists will create a customized rehabilitation plan, gradually increasing the intensity of exercises to help the knee regain full function. Below are the grades of ACL injuries and corresponding physical therapy guidelines:
- Grade I Injury: This is the mildest injury where the ligament experiences a partial tear or stretch. Although the ligament remains largely intact, patients may feel slight pain and instability. While knee function is usually preserved, treatment is still recommended. In this case, the focus will be on managing inflammation using techniques like acupuncture and laser therapy, followed by stretching and strengthening exercises.
- Grade II Injury: In this stage, the ACL experiences a more significant tear, and the ligament is partially torn. Patients will feel instability in the knee, especially when walking, and may experience a feeling of the knee giving out or swelling. Treatment plans for this stage are tailored to individual symptoms and fitness goals, with a focus on preventing re-injury and managing swelling. A knee brace may be recommended, along with shockwave therapy to speed up deep tissue recovery, followed by stretching and strengthening exercises.
- Grade III Injury: This is the most severe injury, where the ACL is completely torn. Patients will experience severe instability, making it almost impossible to bear weight on the knee, along with intense pain and swelling. Physical therapy is tailored to the patient’s symptoms and goals, with a longer recovery time and rehabilitation period. After surgery, the recovery process can take around 9 months or more.
ACL Reconstruction Surgery
For patients with a complete ACL tear, particularly professional athletes concerned about long-term impacts on their performance, ACL reconstruction surgery is usually the most effective and commonly chosen treatment option. The surgery involves reconstructing the damaged ACL, typically using tissue from the patient’s own body (e.g., patellar tendon or hamstring tendon) to replace the torn ligament.
There are two main types of ACL reconstruction surgery: traditional surgery and minimally invasive surgery. Traditional surgery requires a larger incision, while minimally invasive surgery (currently the preferred method) involves smaller incisions, leading to a quicker recovery time, less pain, and minimal scarring. The recovery period after ACL reconstruction surgery generally takes 6 to 12 months, and physical therapy is necessary to restore knee strength and range of motion.
An ACL tear is a dreaded injury for anyone who loves sports or relies on physical activity. With the advancements in modern medicine, proper physical therapy can significantly shorten recovery times, allowing athletes to return to their sports quicker and more safely. If you’re facing similar challenges, contact OneEssential’s physical therapists today, and let us help you design a personalized treatment plan based on your specific condition!