Full Answer
Should you strengthen your quadriceps during ACL rehabilitation?
Dec 04, 2017 · The most important muscle after ACL surgery. The quadriceps (while technically four muscles, for this post we’ll view them as one) get the most attention after reconstructive anterior cruciate ligament surgery. And the quads do need work.
What are the keys to ACL rehabilitation?
Aug 26, 2003 · These muscles include the quadriceps muscles ("quads") in the front of your leg and the hamstrings ("hams") in the back part of your thigh. Strengthening these muscles will help you gradually extend your range of motion so your knee doesn't "freeze." 2 These exercises can be done at home, ideally with the input of your doctor or physical therapist.
Which muscle is most important after ACL surgery?
Jun 03, 2021 · Quadriceps strength after ACL reconstruction is very important to the restoration of function and return to sport. A recent study showed a significantly strong correlation between quadriceps strength at 12-weeks follow ACL surgery with ultimate quadriceps strength at the time to return to sport.
Is NMES a part of ACL rehabilitation?
You begin the second phase of your ACL rehabilitation when your physical therapist, athletic trainer or physician evaluates you and determines: You can extend your knee to within five degrees of fully straight even while active. You can bend your knee (flexion) to at least 110 degrees. Your quadriceps muscle is contracting with strength.
What muscles work with the ACL?
So when you land, your core, glutes, quadriceps, and hamstrings are working together to provide stability and keep the ACL from bearing the full brunt of the force.Mar 26, 2021
Which muscle is used for ACL reconstruction?
Hamstring tendons are widely used for anterior cruciate ligament (ACL) reconstruction of the knee.Jan 21, 2013
What does ACL rehab include?
When rehabbing from ACL surgery, your physical therapist will include drills at each phase of recovery that will help: Strengthen your injured leg. Achieve full range of motion in your knee. Increase flexibility, coordination, and agility.
Do hamstrings regrow after ACL surgery?
Many patients often wonder about the outcome of a hamstring tendon, if it is used as a graft to replace the ACL. Many studies have shown that the hamstring tendon will regenerate within a year after ACL reconstruction after using the hamstring tendon as an autograft.May 19, 2016
Which is better autograft or allograft?
Which is better? Both of these are often successful options for a graft delivery procedure. While autografts have a higher success rate, allografts result in a quicker recovery time. Depending on the injury, your doctor will be able to make the right call for the type of graft to use.Aug 6, 2018
What should be avoided during ACL rehab?
Even if you don't experience significant discomfort or can push through the pain, try to avoid these exercises while recovering from an ACL injury:Excessive weight-bearing before your body is ready. ... Walking without support too early. ... Full-range open-chain knee extension.
What happens at 6 weeks after ACL surgery?
Week 6-12: Patients will begin working on more activity-specific strengthening and weight bearing exercises, such as squats, ascending and descending stairs, and balancing. They can also begin biking with resistance. The muscles begin to recover their normal function and gait becomes more normalized.Nov 22, 2019
Why can't you bend your knee after ACL surgery?
The most common complication and cause for poorer outcomes following ACL reconstruction is motion loss, particularly loss of full knee extension. The inability to fully extend the knee results in abnormal joint motions, scar tissue formation in the front of the knee joint, and subtle changes in normal knee mobility.
Diminish Pain and Inflammation
The first key to ACL Rehabilitation is simple, diminish the pain and inflammation associated with the surgery. While this is a no-brainer, it is wo...
Restore Full Knee Extension Motion
Restoring full knee extension range of motion could be the #1 key to rehabilitation following ACL reconstruction surgery, however I chose to list i...
Gradually Progress Knee Flexion Motion
Although loss of knee flexion doesn’t tend to be as common as knee extension, it does happen and you don’t want to neglect working on flexion. Ther...
Maintain Patellar Mobility
Sometimes one of the reasons that range of motion is reduced is because patellar mobility is lost. Full patella mobility is required for knee flexi...
Restore Volitional Quad Control
As previously mentioned, there is a reflexive inhibition of muscle control around the knee after surgery due to the pain, inflammation, and swellin...
Restore Independent Ambulation
Now that we have addressed the pain and swelling, started to restore motion and patellar mobility, and can now turn on the quads, we put it all tog...
What is the ACL injury?
An ACL injury is caused by overstretching or tearing the ligament, either partially or completely. 1 . ONY59 / Getty Images.
What happens if you tear your ACL?
An injury to the ACL affects the very stability of your knee, resulting in a loss of leg strength and a restriction in the knee's range of motion. Severe tears or ruptures will often require surgery and extensive rehabilitation to fully restore your mobility. 1 .
What muscles do you use to prevent knee compression?
Instead, you would focus on strengthening muscles surrounding the knee—the quadriceps ("quads") and hamstrings ("hams") —while gradually extending your range of motion so that your knee doesn't "freeze.". 2 .
How to do isometric contractions?
Isometric contractions of the quads are also done seated: Sit on the floor with your injured leg extended and your other leg bent. Slowly contract the quadriceps of the injured knee without moving the leg. Hold for 10 seconds. Relax. Repeat 10 times.
How to do knee extension?
Knee extensions require either a TheraBand or a length of an exercise band: To begin, loop one end of Theraband around the leg of the table and the other around the ankle of your injured leg. (Alternately, tie both ends of the exercise band around the table leg and insert the ankle of your injured leg into the looped end.)
How to do a half squat?
Half squats are done standing while holding a sturdy table with both hands: Placing your feet a shoulder’s width apart, slowly bend your knees and lower your hips into a half squat. Hold for 10 seconds and then slowly return to a standing position. Repeat 10 times.
How to stretch out hamstrings?
Place the chairs facing each other at a distance slightly shorter than the length of your leg: Sit in one chair and place your heel on the seat of the other . Relax your leg and allow your knee to straighten. Rest in this position 1 to 2 minutes several times a day to gradually stretch out the hamstrings.
What is the first key to ACL rehabilitation?
The first key to ACL Rehabilitation is simple, diminish the pain and swelling associated with the surgery. While this is a no-brainer, it is worth reviewing why this is so important.
How to fix ACL?
Really, the following list of keys to ACL rehabilitation is all going to be difficult to achieve without addressing the pain and swelling. Here are just a handful of important things to consider: 1 Pain and swelling have been shown in numerous studies to essentially shut down your muscles around your knee, specifically your quadriceps. Even a small amount of fluid in the joint has been shown to decrease your ability to contract your quad. 2 Without a quad, it is hard to function, and you tend to walk around with a bent and stiff knee. This actually fatigues out your quadriceps muscle even more, making gains in strength very difficult. 3 Pain and swelling will limit your range of motion progression. This again may limit your return of strength.
What is NMES in quads?
Lynn Snyder-Mackler, at the University of Delaware, has produced dozens of articles on the use of neuromuscular electrical stimulation (NMES) on the quad follow ACL surgery. Essentially, NMES helps restore quad strength and function faster that just exercises without NMES.
Why is range of motion reduced?
Sometimes one of the reasons that range of motion is reduced is because patellar mobility is lost. If patellar mobility is neglected, the chances of losing range of motion go up significantly. Full patella mobility is required for knee flexion and extension.
How long does it take to strengthen quadriceps after ACL surgery?
A recent study showed a significantly strong correlation between quadriceps strength at 12-weeks follow ACL surgery with ultimate quadriceps strength at the time to return to sport. This stresses the importance of getting ahead of quadriceps strengthening during the early phases of ACL rehabilitation.
What happens if you have an ACL surgery?
One of the more common complications following ACL surgery is loss of motion, with loss of extension being more troublesome than flexion. When pain and swelling are present, it is just more comfortable to hold your knee in a slightly bent position.
Why is there a reflexive inhibition of muscle control around the knee after surgery?
As previously mentioned, there is a reflexive inhibition of muscle control around the knee after surgery due to the pain, inflammation, and swelling. In addition, to address these factors, there are techniques that can be performed to help restore volitional control of the quadriceps muscle.
How many degrees can you bend your knee in ACL rehabilitation?
You can bend your knee (flexion) to at least 110 degrees.
How to exercise after knee surgery?
You’ll need an exercise band and stable item or partner to hold the band. This exercise is recommended for after surgery and is unnecessary before. Attach the band to a stable item or have a partner hold the band securely . Begin with your knee slightly bent.
How to get a knee cap to move?
Start on your back or sitting with your legs out straight. Next, tighten the top of your thigh so you are pushing your knee flat against the surface. This tightening should cause your knee cap to move toward your hip. Focus on the quadriceps, not your gluteal (butt) muscle or hamstrings.
How to get your knee out of a chair?
Seated in a chair place the foot of your nonoperative leg under the knee surgery leg behind the foot. Gently use your good leg to lift your surgical leg out as straight as possible while keeping your surgical leg relaxed. Return to the starting position. Repeat 10–20 times two to three times each day.
How long after knee surgery can you do straight leg raises?
Your quadriceps muscle is contracting with strength. For example, you can do 20 straight leg raises without difficulty. This will be normally about two to three weeks after surgery. However, function, not time, is what matters! Keeping full extension of your knee continues to be critical to your rehabilitation.
What is the goal of phase 2 of knee rehabilitation?
Phase 2 Goals. Progress your knee to full range of motion. Continue to improve muscle strength with increasing resistance in your exercises. Begin to resume your normal daily living activities.
How to improve hip strength?
Add a resistance band as your strength improves with the approval of your physician, physical therapist or athletic trainer. Do this exercise with smooth and controlled movement. PRIMARY Side-Lying Hip Abduction. Side-lying hip abductions improve muscle strength in the side and the back of your hip.
What are the phases of ACL rehab?
In Phases 1 and 2, you built a base of function and strength. Your body is now ready to regain much of your pre-tear functionality. This includes agility, reaction time, power, flexibility, endurance and more. Some people complete Phase 3 ACL rehabilitation and return to normal activities: they can walk, use stairs and do their jobs.
What happens after phase 3 of rehabilitation?
However, for most people stopping rehabilitation after Phase 3 means giving up aggressive running and jumping. If your goal is to return to your sport, your rehabilitation program will continue beyond Phase 3 with physical therapy and athletic training combined with group and on-your-own workouts.
How to get your knee out of a chair?
Seated in a chair place the foot of your nonoperative leg under the knee surgery leg behind the foot. Gently use your good leg to lift your surgical leg out as straight as possible while keeping your surgical leg relaxed. Return to the starting position. Repeat 10–20 times two to three times each day.
How to get rid of a swollen thigh?
Stand tall and tighten the front thigh (quadriceps) muscle of the leg in the band, straightening and locking the knee. Holding your quadriceps tight, lift the leg in the band slightly and kick forward slowly . Return to the starting position slowly. Complete the movement 12 times.
How to increase resistance in strength exercises?
You’re ready to increase resistance in your strength exercises through weights and bands. You can do a double leg squat down to at least 60 degrees at the knee with equal weight on both legs with proper mechanics. Your self-assessment score is 7 or higher on IKDC question 10 ( see self-assessment below ).
What is the goal of phase 3?
Phase 3 Goals. By the end of Phase 3, you want to be able to: Maintain full range of motion equal to your other leg with minimal to no swelling or pain. Being able to bend your reconstructed knee the same amount as the non-surgical knee is critical.
How to improve your calves?
This exercise improves the strength of your calves. This improves your ability to walk, jump and later in your rehabilitation , run. Stand with your hands on a solid surface and your feet shoulder-width apart. Lift and keep the foot of your non-surgical leg off the ground.
Adhering to your ACL rehabilitation protocols is a key driver of achieving your ACL recovery goals!
There are not too many injuries in sports that are more devasting than an ACL tear. An ACL injury can bring a sudden halt to a persons sporting career and sometimes even end it.
What is the overall goal of ACL reconstruction surgery?
The long term target for your newly reconstructed knee is ultimately to return your knee stability and function back to similar levels as before your injury (importantly with minimal risk to rupturing your new ACL graft).
What can you expect in the first 2 weeks after ACL surgery?
Following an Anterior Cruciate Ligament operation when you wake up in hospital your injured knee will typically be heavily swollen and immobile.
Final Note
Following on from the early stages of your ACL tear recovery post surgery, you will need to continue to extend your program to include more specific and advanced ACL rehab exercises.
