3. Definition
ACL TEAR
• ACL, one of two ligaments that cross in the
middle of the knee, connects your
thighbone (femur) to your shinbone (tibia)
and helps stabilize your knee joint.
• ACL injuries most commonly occur during
sports that involve sudden stops, jumping
or changes in direction — such as football,
tennis, downhill skiing and gymnastics.
• feel a "pop" in the knee when an ACL injury
occurs.
4.
5. Symptoms
ACL TEAR
• A loud "pop" or a "popping" sensation
in the knee
• Severe pain and inability to continue
activity
• Swelling that begins within a few
hours
• Loss of range of motion
• A feeling of instability or "giving
way" with weight bearing
6. causes
ACL TEAR
• Suddenly slowing down and
changing direction (cutting)
• Pivoting with your foot firmly
planted
• Landing from a jump incorrectly
• Stopping suddenly
• Receiving a direct blow to the knee
or collision, such as a football tackle
7. Complications
ACL TEAR
• People who experience an ACL
injury are at higher risk of
developing knee osteoarthritis.
• in which joint cartilage deteriorates
and its smooth surface roughens.
• Arthritis may occur even if you have
surgery to reconstruct the ligament.
9. Initial treatment
• Rest. General rest is necessary for healing and limits weight bearing
on your knee.
• Ice. When you're awake, try to ice your knee at least every two hours
for 20 minutes at a time.
• Compression. Wrap an elastic bandage or compression wrap around
your knee.
• Elevation. Lie down with your knee propped up on pillows.
10. Surgery
ACL TEAR
• ACL reconstruction
• the surgeon removes the damaged
ligament and replaces it with a
segment of tendon.
11. Physiotherapy for ACL tear
Preoperative Rehabilitation Phase :
• full range of motion for knee flexion and extension
• Full extension is obtained by doing the following
exercises:
1) Passive knee extension.
2) 2) Heel Props: Do this 3-4 times a day for 10 - 15
minutes at a time
3) 3) Prone hang exercise.
12. Physiotherapy for ACL tear
Preoperative Rehabilitation Phase :
• Develop muscle strength
• 1) Stationary Bicycle. Use a stationary bicycle two times a day for
10 - 20 minutes to help increase muscular strength, endurance,
and maintain range of motion.
• 2) Swimming is also another exercise that can be done during this
phase to develop muscle strength and maintain your range of
motion.
• 3) Low impact exercise machines such as an elliptical cross-
trainer, leg press machine, leg curl machine, and treadmill can
also be used.
13. Physiotherapy for ACL tear
Post-operative Rehabilitation Phase :
• Weight bearing status- This applies to all ACL reconstruction
unless otherwise specified.
• Day 1-7 = 50% body weight (2 crutches)
• Day 8-14 = 50-75% body weight (1 crutch)
• End of week 2 = full weight bearing
14. Physiotherapy for ACL tear
Postoperative Rehabilitation Phase 1-7 days :
Goals:
• Control pain and swelling
• Care for the knee and dressing
• Early range of motion exercises: knee 90° flexion
• Achieve and maintain full passive extension
• Prevent shutdown of the quadriceps muscles
• Gait training
15. Physiotherapy for ACL tear
Post-operative Rehabilitation Phase 1-7 days :
Exercising Quadriceps:
1) Quadriceps isometric contractions,
2) SLR.
3 sets of 10 repetitions 3 times a day.
16. Physiotherapy for ACL tear
Post-operative Rehabilitation Phase 1-7 days :
Exercising Hamstrings:
• If patellar graft taken hamstring muscles are exercised by pulling your heel back
producing a hamstring contraction.
• If hamstring graft avoid excessive stretching of the hamstring muscles during the
first 6 weeks after surgery.
• To avoid re-injuring the hamstring muscles, bend your knee during the activities,
thus relaxing the hamstring muscles.
17. Physiotherapy for ACL tear
Postoperative Rehabilitation Phase 8-10 days :
Goals:
• Physical Therapy and Full Extension: Continue doing the
quadriceps isometrics, SLR, active flexion, and active-assisted
extension exercises.
18. Physiotherapy for ACL tear
Postoperative Rehabilitation Phase week 2:
Goals:
• Maintain full extension
• Achieve 100 - 120 degrees of flexion
• Develop enough muscular control to wean off knee
immobilizer:
1) Start Partial Squats.
2) Start Toe Raises.
19. Physiotherapy for ACL tear
Postoperative Rehabilitation Phase weeks 3-4:
Goals:
• Knee Flexion 100-120 degree
• Strength through exercise
21. Physiotherapy for ACL tear
Postoperative Rehabilitation Phase weeks 6-12:
Goals:
• Knee Flexion 135 degree
• continue strength exercise: Hamstring graft patient in safe
side now.
• Introduce treadmill
22. Physiotherapy for ACL tear
Postoperative Rehabilitation Phase weeks 12-20:
Goals:
• Continued strength
• Introduce jogging and light running
• Introduce agility drills
23. Physiotherapy for ACL tear
24 Weeks Postoperative (6 months)
Goals:
• Return to sports
To return to sports you should have:
• Quadriceps strength at least 80% of the normal leg
• Hamstring strength at least 80% of the normal leg
• Full motion
• No swelling
• Good stability
• Ability to complete a running program
