ACL rupture and prehabilitation

What is the ACL?

The anterior cruciate ligament (ACL) is one of the key ligaments that help stabilize your knee joint.The anterior cruciate ligament runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur, as well as provides rotational stability to the knee.

Common causes of rupture:

The anterior cruciate ligament can be injured in several ways:

  • Changing direction rapidly
  • Stopping suddenly
  • Slowing down while running
  • Landing from a jump incorrectly
  • Direct contact or collision, such as a football tackle


When you injure your anterior cruciate ligament, you might hear a “popping” noise and you may feel your knee give out from under you. Other typical symptoms include:

  • Pain with swelling. Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. However, if you attempt to return to sports, your knee will probably be unstable and you risk causing further damage to the cushioning cartilage (meniscus) of your knee.
  • Loss of full range of motion
  • Tenderness along the joint line
  • Discomfort while walking


How is the injury graded?

Injured ligaments are considered “sprains” and are graded on a severity scale.

Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable.

Grade 2 Sprains. A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament.

Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.


Prehabilitation for ACL rupture

A study published by Giesche et al., 2020, looked at Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-

81% of the ACL-reconstructed individuals included in the study returned to some kind of sports, 65% returned to their pre-injury level and 55% returned to competitive sport.

Clinically- this impacts us to educate the individual that prehab can assist with quicker recovery and return of strength, as well as get them back into sport with increased confidence 

  • Focus on keeping the individual as strong and functional as possible prior to surgery to reduce the postoperative strength and functional loss

Two years after surgery, individuals with preoperative strength deficits on the injured side above 20% still have abnormal muscular asymmetry. Hence, preoperative rehabilitation protocols should emphasise intensive quadriceps muscle strength training in order to improve side-to-side symmetry. 

From the study results, it was suggested that quadriceps muscle strength deficits of the injured limb should be less than 20% of the uninjured limb before ACL reconstruction to reduce the severity of long-lasting post- operative deficits.

So what this means for you?

Torn your ACL? Awaiting surgery?

Come in and see the team at PhyxYou today, to get you involved in a prehabilitation program which will improve outcomes postoperatively!


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