Hurting your knee and damaging your ACL can make it hard to stand, walk, and complete your regular routines or enjoy your favorite activities. Yet, physical therapy can help ease the symptoms of ACL tears. If you have a knee injury, learning about ACL tear treatments offered by our physical therapists is helpful.
An anterior cruciate ligament (ACL) tear is a knee injury that often happens to athletes, including those who play soccer, basketball, skiing, or gymnastics. However, nonathletes can also have an ACL tear because of accidents or injuries. Approximately 70% of ACL tears in sports result from noncontact injuries, and 30% result from direct contact (player-to-player, player-to-object). Women have a higher chance of suffering from an ACL tear compared to men. Physical therapists are skilled in assisting those with ACL tears to ease pain and swelling, build strength and mobility, and get back to their favorite activities.
Physical therapists specialize in helping people move better. They enhance quality of life through personalized care, teaching, and recommended exercises. You can consult a physical therapist directly for an assessment.
What Is an ACL Tear?
The ACL is a primary ligament, a significant tissue band that links the thigh bone (femur) to the knee’s shin bone (tibia). It can rupture if you:
- Turn your knee while keeping your foot firmly on the ground.
- Come to an abrupt stop while running.
- Quickly move your weight from one leg to the opposite leg.
- Jump and come down on a straightened knee.
- Extend the knee beyond its normal range of motion.
- Get hit directly on the knee.
How Does It Feel?
There may be a sudden, sharp pain when the ACL tears, or you could even hear a loud “pop” or snapping sound. Walking on the injured leg might be difficult, as it can be too painful to bear weight through the knee. Typically, swelling in the knee begins almost immediately, and the knee may “give out” as you walk or apply pressure.
ACL Tear Treatments
Surgery
The majority of individuals who suffer an ACL tear will likely have surgery to fix it; however, a few may choose to avoid surgery by changing their physical activity to lessen stress on the knee joint. A small select group can return to intense physical activity after rehabilitation without requiring surgery.
Your physical therapist, along with your surgeon, can assist you in figuring out if non-operative treatment (rehabilitation without the need for surgery) is a suitable option for you. If you decide to proceed with surgery, your physical therapist will support you in preparing for surgery and in regaining your strength and mobility after surgery.
How Can a Physical Therapist Help?
Once an ACL tear has been confirmed and diagnosed, you will collaborate with your surgeon and physical therapist to determine whether you should proceed with surgery or can successfully recover without surgery. If you choose not to have surgery, your physical therapist will assist you in rebuilding your muscle strength, balance, and agility so you can return to your usual daily activities. Your physical therapist might teach you effective ways to adjust your physical activities to reduce stress on your knee. If you choose surgery, your physical therapist can support you both before and after.
Treatment Without Surgery
Current research has identified a certain group of patients (known as “copers”) who have the potential to heal without surgery after experiencing an ACL tear. These patients have only injured the ACL and have not had any episodes of the knee “giving out” since the initial injury occurred. You can find yourself in this category based on the tests your physical therapist will perform. Your therapist will create a personalized physical therapy treatment program for you. It may consist of gentle electrical stimulation to the quadriceps muscle, muscle strengthening exercises, and balance training techniques.
Treatment Before Surgery
If your orthopedic surgeon decides surgery is required, your physical therapist can work with you both before and after your surgical procedure. Certain orthopedic surgeons refer their patients to a physical therapist for a brief rehabilitation program before surgery. Your physical therapist will assist in reducing your swelling, improving the range of motion in your knee, and strengthening your thigh muscles, specifically the quadriceps.
Treatment Following a Surgery
Your orthopedic surgeon will give detailed post-surgery instructions to your physical therapist, who will then create a tailored treatment program designed specifically around your unique needs and personal goals. Your customized treatment program may include:
Bearing weight. After your surgery, you must use crutches to help you walk. The specific amount of weight you can place on your leg and the duration you use the crutches will depend on the specific type of reconstructive surgery you have undergone. Your physical therapist will produce a personalized treatment program to meet your unique needs and gently guide you toward achieving full weight bearing.
Icing and compression. Right after your surgery, your physical therapist will manage your swelling using a cold treatment, like an ice sleeve, that snugly fits around your knee and applies compression.
Bracing. Certain surgeons will provide you with a supportive brace to help limit your knee movement (range of motion) after surgery. Your skilled physical therapist will properly fit you with the brace and teach you how to use it correctly and safely. Some athletes will also be fitted for braces as they recover and gradually return to their sports activities.
Movement exercises. In the first week after your surgery, your physical therapist will assist you in starting to regain motion in your knee area and teach you some gentle exercises that you can easily do at home. The main goal will be to regain full movement in your knee joint. The initial exercises will help boost blood flow, which also helps reduce swelling.
Electrical stimulation. Your physical therapist might apply electrical stimulation to help you rebuild your thigh muscle strength and reach those final few degrees of knee motion.
Strengthening exercises. In the initial 4 weeks following your surgery, your physical therapist will assist you in boosting your power to bear weight on your knee through weight-bearing and non-weight-bearing exercises. The exercises will primarily target your thigh muscles (quadriceps and hamstrings) and may be restricted to a certain range of motion to safeguard the newly repaired ACL. In the following weeks, your physical therapist might raise the difficulty level of your exercises and include balance exercises in your rehabilitation program.
Balance exercises. Your physical therapist will assist you through various exercises on different surfaces to help restore your balance. At first, the exercises will help you slowly shift your weight onto the leg that had surgery. These activities will gradually progress to standing on the surgery leg on firm and unsteady surfaces to challenge your balance effectively.
Return to sports or activities. As athletes gradually regain their strength and balance, they might start performing activities such as running, jumping, hopping, and additional exercises specific to their sport. This phase can vary significantly from one individual to another. Physical therapists create personalized return-to-sport treatment programs tailored to each person’s needs and specific goals.
