Hannah came in after injuring her knee when playing football last March. She suffered a lot of pain in her knee and the injury was so severe that she needed to have surgery on her ACL

"These guys have helped me so much with my ACL rehab! Couldn't recommend them more."

Hannah

What happened to the ACL?

Hannah came in after injuring her knee when playing football last March. She suffered a lot of pain in her knee and the injury was so severe that she needed to have ACL reconstruction surgery a few months later in September. Hannah got physiotherapy treatment for her knee to aid with recovery after the surgery but then moved to Sydney to begin her university studies.

Hannah decided to use Switch Physiotherapy in Sydney to continue with her rehabilitation and we’ve been helping her since February. Her ACL surgery rehab has progressed well and Hannah has returned to the gym and begin the process of strengthening her knee.

Hannah has the goal of returning to playing football and getting active again.

acl-reconstruction-illustration

Do many people in Australia suffer an ACL injury?

David Zbrojkiewicz, Christopher Vertullo and Jane E Grayson conducted research in 2018 that demonstrated an increasing incidence of ACL reconstructions in young Australians over 15 years between 2000 and 2015. They cited that individuals at greatest risk are men aged 20–24 years and women aged 15–19 years. 197 557 primary ACL reconstructions were performed during the study period; the annual incidence increased by 43% (from 54.0 to 77.4 per 100 000 population), and by 74% among those under 25 years of age (from 52.6 to 91.4 per 100 000 population)

The incidence of ACL reconstructions in Australia is regarded as the highest in the world where sports such as basketball, soccer, or Australian rules football that require pivoting, jumping and rapid deceleration are large contributors.

Every year there are so many people getting a torn ligament in the anterior cruciate ligament (ACL) and its most common among young athletes and knee´s with extra weight. The treatment depends on several factors but normally after surgery physiotherapy including physical therapy plays an important role.

What pain can an ACL knee injury cause?

A torn anterior cruciate ligament in the knee or ACL can be a very painful injury. The ACL is the tissue that connects the thighbone to the shinbone, at the knee. Most ACL injuries occur during sports such as rugby league, basketball, football, skiing or even tennis. For sports enthusiasts, you’ll often see headlines about famous sports players suffering ACL injuries, like Luke Keary or Brett Morris from the Sydney Roosters.

The symptoms include knee swelling, instability, and severe pain and treatment will depend on the individual’s circumstances but may include surgery and physiotherapy. From a day to day perspective you will feel a lack of range of motion and strength in your knee. It makes it hard to complete tasks day to day (walking or going up stairs) and when it comes to sport it is hard to run, change direction, jump, etc

When it comes to hurting important parts of our body that give us our mobility like feet, ankles, or knees there is also the fear associated with returning to doing normal things like sports or running. It becomes important to make sure you have a program in place to help with the rehabilitation after ACL surgery.

What things can cause an ACL injury?

ACL injuries can be caused by 

  • High impact sport (e.g. netball, soccer, rugby)

  • Fast changes of direction

  • Landing from a height w/ incorrect form

  • Direct contact from another player to the outside of the knee

 

We will normally ask questions such as

  • How did the injury occur?

  • What did the injury feel like?

  • Did you hear a pop/click when you injured your knee?

  • What are you currently unable to do?

How can Switch help you with plantar fasciitis pain?

  • Soft tissue release to reduce muscle tension and improve range of motion

 

  • Walking and running retraining

 

  • Gradual strength exercises to start activating and strengthening muscles around the area

 

  • Preparation and rehabilitation before/after surgery

What does a typical ACL rehab process look like

If you suffer an ACL injury there could be different choices for the treatment depending on whether surgery is required for the main treatment option. In any situation, it is best to get the right professional guidance to assist you. Each situation and every individual will require an evidence-based treatment plan that takes into consideration the severity of the issue, general health levels, age, etc but here is a rough guide and the time intervals will also vary based on how well each individual responds to the treatment plan created

 

FOLLOWING ACL SURGERY:

  • 4-6 weeks of prehab (aiming to regain 100% range of motion, and decrease swelling in knee)
  • 9 months of rehab to return to sport consisting of:
  • 3 months working on a range of motion, walking retraining, decreasing swelling, early strength training working towards running
  • 3 months of running retraining, working on acceleration/deceleration, change of direction, jumping and plyometric work
  • 3 months of sports specific training, returning to sport specific drills, starting to play small sided games, and then gradually returning to full contact competitive sport

 

CONSERVATIVE

  • Mostly similar will follow the 9-month protocol as similar to post-surgery
  • A good option for individuals who aren’t looking to return to sport
  • Will be trialed if the patient responds well to non-surgical treatment & then re-assessed

Common questions about ACL injuries

The anterior cruciate ligament (ACL) is one of the important ligaments that stabilise your knee. If you have torn (ruptured) this ligament, your knee can collapse or ‘give way’ when making twisting or turning movements.

An ACL rupture happens as a result of a twisting injury to your knee. The common causes are contact sports and skiing injuries.You can injure other parts of your knee at the same time such as tearing a cartilage (meniscus) or damaging the joint surface.

 

A physiotherapist can give you exercises to strengthen and improve the co-ordination of the quadriceps and hamstring muscles in your thigh. Wearing a knee brace can sometimes help if your knee only gives way while you are playing sports.

This will depend on the severity of the tear and how much pain or discomfort it is causing. Any type of tear should be assessed by a professional to ensure you are given the right information about possible treatment options. If it is a full ACL tear then surgery is typically the only solution to repair it. For slight tears it may be possible to receive medical or physiotherapy treatment depending on the situation.

You may still be able to walk with a torn ACL but will depend on the person, their general health, age and how severe the tear is. Once the initial pain or swelling subsides movement may be possible but we would advise having it assessed by a professional

Most people who tear their ACL feel sharp pain and a “pop” in their knee when the injury happens. Their knee usually gets swollen soon after the injury. After the swelling goes down, someone with an ACL tear may be able to walk depending on how bad it is but the knee may feel unstable and can give way easily.

When the ACL is torn and the loud “pop” is heard, intense pain follows and, within an hour, swelling occurs. Moderate-to-severe pain is very common. Initially, the pain is sharp and then becomes more of an ache or throbbing sensation as the knee swells depending on its severity

JAMES BECERRA

JAMES BECERRA

An experienced physiotherapist located in Sydney and the General Manager of the Switch Health Group in Sydney.