
ORTHOPEDICS/HIP & KNEE/ACL DAMAGE
When suffering an anterior cruciate ligament (ACL) tear and considering surgery, physical therapy trainings before surgery may be beneficial.
Preparing for surgery with physical therapist has been shown to improve a knee overall results with ACL repair.
To remind, an ACL sprain is the reason of a diversity of signs, and physical therapy can help regaining ideal function after a damage.
ACL sprain Signs may comprise: Knee pain, Knee inflammation, limited knee motion range, Loss of strength in quadriceps or hamstring muscles, unsteadiness feeling of around knee joint and Difficulty in performing basic duties like walking, running or climbing stairs.
Physical therapy before an ACL surgery has been shown to improve overall result.
PT Objectives prior to ACL surgery may include:
Normal knee restoration
Quadriceps and hamstring strength Improving
Hip strength and stability Improving
knee pain and inflammation Controlling
Hereunder an example of a workout schedule performed prior to ACL surgery.
1- Quad Sets and Short Arc Quads
After an ACL damage, patient may find that the quadriceps muscle on the front thigh is not functioning appropriately.
One of the primary objectives of pre-op ACL therapy is restoration normal function and strength to the quad muscle so that it handles the knee suitably.
Trainings that PT may improve quad function include:
Quad setting exercises: Lie on your back and put a small towel under your knee. Squeeze your quads by pressing the back of your knee into the towel. Hold for 5 seconds, and then relax.
Short arc quads (SAQ): Lie on your back and put a ball underneath your knee. Unbend your knee completely, maintaining the back of your knee against the ball.
Straight leg raises: Squeeze your quad muscle on the top of your thigh and then deliberately lift your straight leg up about 12 to 15 inches. Hold for 2 seconds, and then gradually lower your leg down.
Note that exercises should be performed in a pain-free motion; stop any quad exercises that may cause increasing pain in your knee.
2- Improving Knee Motion Range
Restoring knee motion range should be one of your primary objectives prior to ACL surgery.
Exercises that may be improve motion range include:
Heel slides: Lie on your back and gently bend your knee and slide your heel up towards your backsides.
Prone hang for knee extension: Lie on your stomach and hang your leg over the edge of a bed, tolerating your knee to hang in a completely straightened position.
Stationary bicycling: Use a bike at the gym or PT clinic to get slightly your knee curving and straightening.
3- Hamstring Strengthening
ACL helps stabilizing knee by preventing forward slippage of the shinbone underneath the thighbone.
By nature of their attachment points behind the thigh and knee, the hamstrings may also add stability to the knee joint.
Hamstring strengthening exercises may include:
Hamstring sets: Lie on your back with your knee fixed. Gently press your heel into the floor, shrinking your hamstring as you do so. Hold the position tight for 5 seconds, and then relax.
Prone knee bends: Lie on your stomach and gently curve your damaged knee up, using your hamstring on the back of your thigh.
Hamstrings strengthening should not cause any pain.
4- Hip Strengthening
Hips regulate the knees position when walking, running, and jumping. Keeping the hips strong maintains the knees in the best position possible while running and jumping.
Hip strengthening exercises may start with straight leg raises, with some other exercises program that may include:
Lateral band walks: Put an elastic band around your ankles and gently walk sideways across the room.
Hip hikers: Stand with one leg on a step and the other leg hanging liberally down, and then gradually lower your pelvis down, being sure the movements come from your knee.
Single leg bridges. Perform a bridge exercise with one knee curved and one knee out straight and lifted off the floor.
Maintaining hips strong prior to ACL surgery may maximize hip strength after surgery.
5- Neuromuscular Exercise
Neuromuscular exercise is performing explicit movements designed to improve how the body moves and responds to various powers that are placed upon it.
Exercises for neuromuscular exercise may include:
The drop jump exercise: Stand on a 12 to 18-inch seat, and jump down, landing with your knees curved. Then, directly jump back up as high as possible.
Learning to jump and land correctly: Practice jumping up and landing on your feet shoulder-width apart and your knees straight over your ankles. Land tenderly by curving your knees as you come down from your jump.
Single leg hopping: Stand on one foot and fly forward for three hops. Be sure to land with your knee marginally curved and straight over your ankle and foot.
7- Putting It All Together
An ACL sprain can be a shocking damage that sidelines with patient for months.
Choosing to have surgery can help restoring normal motion and function to the damaged knee.
The best way to understand what to do while preparing for an ACL surgery is to work closely on some overall exercises schedule that can maximize the chances of a complete and fast recovery after surgery.