Rehabilitation: Post ACL Reconstruction

• The rehab is milestone based.
• You need to complete the requirements of each phase before moving on to the next.
• Approximate time frames are outlined.
• At each post operative appointment, your progress will be assessed and you will be advised
• You will be referred to an appropriate physiotherapist (osteopath an alternative) who will guide you through this programme and outline details of specific exercises which you may perform yourself at the gym. Please discuss with Mr. Morris
• The physiotherapist will also give Mr. Morris feedback with regards to your progress
• Not everyone attends a physiotherapist (eg lack of access). Please discuss with Mr.Morris

Recovery

Theme: Rest. Swelling, bruising control. Pain control

Week 0 - 2 (approximate)

• The aim of this stage is to recover after surgery. You should spend the time at home resting. Stay mainly on the couch. Wear your tubigrip
• Take pain killers as required. Stay well hydrated.
• Icing: Ice your knee every 30mins 5 or 6 times a day.
• Use crutches but weight bear as tolerated
• Try to lock your knee out straight and tighten the quadriceps
• Pump the calf muscles every chance you get

Rehabilitation Phase 1

Theme: Range of Movement (ROM)

Week 2-6 (approximate)

• The main aim here is to achieve a good ROM. Most importantly complete extension (knee out straight equal to the opposite healthy knee). Practice your knee extension locking exercise (most important), knee bending and prone hanging. Ask your physiotherapist or Mr. Morris for details
• You should attempt to achieve a normal walking style
• You may commence stationary cycling when comfortable
• Resume normal daily activities
• Continue icing the knee. Swelling MUST be minimised
• If you achieve all the desired goals you may move on to the next phase of rehabilitation:
  • A good ROM, complete extension, no swelling
• This phase usually lasts about 6 weeks but may vary between 3 and 12 for example.
• The simple thing is to do your best and don’t worry about your progress or lack of it. Each person has a unique road to recovery
• Sometimes you will be told to slow down or speed up
• You will have regular reviews with Mr. Morris and your physiotherapist.

Rehabilitation Phase 2

Theme: Strength, balance

Week 6 - 12 (approximate)

• You should now be walking normally and performing normal activities of daily living
• It is now time to commence a gym based programme emphasising strength of all muscle groups including quadriceps, hamstrings, calf, gluteals, core strength. Balance exercises are also important
• Activities include walking, cycling, swimming (no breaststroke), rowing
• Don’t over do it. Ice after activity
• If you achieve all the desired goals you may move on to the next phase of rehabilitation:
  • Normal gait, swimming, cycling, one leg squat to 90º
• This phase usually lasts about 6 weeks, but may vary between 3 and 12 for example.

Rehabilitation Phase 3

Theme: Light agilities

Week 12 - 20

• You may now commence jogging (if given the all clear)
• Plyometrics begin - hopping, jumping, etc
• Zig zag running
• Don’t overdo it
• Ice after activities

Rehabilitation Phase 4

Theme: More aggressive agility exercises

Week 20+

• Sport specific exercises. Refer to Mr. Morris and your sport physiotherapist
• Endurance. Fitness
• Recommend the PEP programme.
• Fifa 11

Return To Sport Score

Once you have completed Phase 4 you have essentially completed your rehabilitation. We do however, need to know that you have achieved a state of recovery good enough to protect your “new” knee.

We have developed a score that accurately predicts whether or not you have attained a full recovery after your injury and surgery

• The Australian ACL Return To Sport Score (AARTSS)

If you pass the test, you are ready to start training.

Once having completed full training, you may PLAY!