In most sports, a knee injury seems to be one of the most dreaded complaints that an athlete will face in their career. One of the common types of injury within the knee is a tear to the Anterior Cruciate Ligament, commonly known as the ACL. In most knee dislocations, the ACL tear is usually accompanied by a tear in one of the collateral ligament complexes, either the medial or lateral (MCL or LCL).
The role of the ACL is to help stabilize the knee joint during movement and to prevent the knee from straightening beyond its normal range of motion. Approximately 70 – 80% of ACL tears occur through non-contact mechanisms such as deceleration coupled with change of direction, for example, cutting, pivoting, side-stepping or awkward landings. When this injury occurs, the most common symptoms are pain, immediate swelling, the knee giving way or hearing a popping sound.
Such an injury can be very complex. Careful assessment is very important and requires a systematic approach to the initial evaluation and treatment. At BTF, a physical examination, x-rays and MRI are done to formulate the correct diagnosis, as well as determine if any fractures or damage to any other structures (MCL, LCL, meniscus) within the knee are evident. Once the diagnosis matches the evaluation, reconstructive surgery and bracing are done by an orthopedic surgeon to repair the tear. However, if there are no instability issues and the tear is considered a partial tear, nonsurgical rehabilitation treatment can be performed.
Rehabilitative therapy is imperative for this type of injury regardless of whether surgery has been performed or not. To begin this process, we typically start with soft tissue treatment of the knee and attachments to the hip above and ankle below. This soft tissue therapy softens and eliminates the fibrous adhesions usually created by scar tissue from the knee injury and/or surgical intervention; thus increasing the range of motion of the knee. Electrical stimulation (E-stim) and cryotherapy (ice massage) is also used to decrease pain and swelling. When the desired range of motion has been achieved, strengthening and flexibility exercises are done in order to restore muscle strength, muscle endurance and joint stability. An efficient ACL rehabilitation program will make sure the hamstring and gluteal muscles (butt muscles) are activating sufficiently. One exercise used at BTF to help achieve these goals is called a Core blaster (see video below).
To start, stand with your feet shoulder width apart and hold a light medicine ball over your head. As you squat down, bring the medicine ball down between your legs while keeping your chest upright. The goal is to be able to reach 90˚ of flexion in your hips and knees. Most of the time, this exercise can even be performed while wearing a knee stability brace. This is a great way to begin the process of strengthening the hamstring and gluteal muscles, core/trunk region and increasing the range of motion of the knee. If you have a knee complaint please contact our office at 310-534-1900 to schedule an evaluation with one of our doctors at BTF.