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Treatment Options for a Torn ACL

by Jaydee Vykoukal, PT, DPT February 14, 2020 0 Comments

knee ice machine

Whenever a knee injury is sustained, the first step to ACL injury treatment should always be to seek medical care. This way the severity of your injury and what tissues are affected can be determined via an in-depth examination. This will help determine the best recovery options for you. Keep reading to learn about torn ACL recovery.

Can an ACL Tear Heal Without Surgery?

It all depends on the severity of the tear and the symptoms occurring. There are no black and white guidelines for when surgery is best. Thus, the best treatment will be determined by you and your trusted medical team. Generally speaking, low-grade tears heal well with conservative treatment. On the other hand, a severe tear or a lot of knee instability will most likely require surgery to restore proper knee function.

Non-Surgical Treatment for an ACL Injury

When possible, the least invasive mode of treatment is always recommended. Yet, no matter how severe your injury is, conservative treatment is always the best place to start. It will maximize your results, whether you choose to proceed conservatively or end up having surgery. Here is where you should begin.

  • Swelling Management

    Keep pain and swelling under control with the use of RICE (rest, ice, compression, and elevation). Don’t force any use of the knee initially to allow proper healing. When resting in a seated position, try to minimize the amount of time your knee is below your heart and prop it up. Lastly, use of ice or a compression wrap can help provide knee pain relief and decrease overall swelling.

  • Rehab

    Physical therapy is the most common option for recovering from an ACL injury. A physical therapist will assess your knee function and work with you to build a personalized home program. Additionally, they can optimize your body’s healing capabilities with electrical stimulation, education, manual therapy, and recommendations for appropriate program progressions. A PT can take a lot of the unknown and anxiety out of the healing process and get you back on track and to normal life as soon as possible.

    ACL Rehab

  • Strengthening Exercises

    What exercises you can complete with a torn ACL will depend on the severity, stage of healing, and overall strength and flexibility of the knee. It is always a delicate balance between healing and minimizing loss of knee function. The initial focus will be on regaining leg muscle strength, especially in the quadriceps and a gentle knee joint range of motion. With time, exercises will be progressed to more functional weight-bearing movements, coordination for building knee stability, and an aggressive full range of motion. 

    ACL Tear Exercises

  • Braces

    A well-fitted brace can protect the knee from further injury and potentially encourage movement at an earlier stage. However, it can also encourage overconfidence resulting in starting too much activity too early. Generally speaking, a brace for milder injuries may allow a quicker return while providing better knee support.

    For high-risk sports, an athlete may even choose to wear a specialized brace to protect their knee and prevent further injury as well. Talk to a physical therapist or orthopedist for the best options for you.

Torn ACL Recovery Time

For a partially torn ACL, the prognosis and healing time varies with each individual person. This is especially true with an ACL tear since it can also coincide with injuries to other knee ligaments, the patellar tendon, or any of the meniscus (cartilaginous cushions in the knee joint itself). However, you can expect an average of 3 months of recovery time (up to 6 months). During this time, you should focus on maximizing the above treatment options so that you can comfortably return to your normal daily activities and exercise routine. 

ACL Surgery

Opting for ACL reconstruction can occur for many reasons. A severe tear, gross instability of the knee, participation in high-risk sports, or a more active lifestyle are all reasons that may lead to a recommended surgical intervention. Surgery is completed via a scope (meaning there is little scarring) to either re-attach the ACL or implant a new one (usually synthetic, hamstring graft or cadaver).

What to Expect After Surgery

Due to pain and weakness, the use of crutches is recommended for the first several weeks following ACL reconstructive surgery. Crutches are usually used until you can tolerate full weight through your knee without limping. You may be given restrictions for how much weight you can put through your injured leg. Lastly, post-surgical braces are common for protecting the knee from extreme ranges of motion that could compromise the healing ligament.

No matter what, you can expect to experience swelling and pain that you can address with ice, compression, and prescribed pain medications. The key is to follow your orthopedic surgeon’s instructions, including Potential use of a brace, exercises, nutrition, rest, and medication.

How Long Does Recovery Take?

Full recovery typically takes about six to nine months. Most patients can walk immediately after surgery. Physical therapy is usually initiated immediately after surgery, starting with pain management and knee range of motion and progressing to strengthening and functional activities as healing allows. With physical therapy, you can expect to regain full use of the knee and return to your previous activity level.

Precautions During ACL Recovery

Your recovery success is dependent on restoring full knee function while allowing enough time for proper healing. Pay attention to your symptoms throughout the recovery process to help guide you. If something causes a moderate to severe increase in pain, increases feelings of instability in the knee, or just simply feels off, back off from it. Talk to your sports medicine doctor or therapist for modifications.

Sources:

https://www.physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Rehabilitation

https://www.ossurwebshop.co.uk/cti-knee-braces/a-guide-to-cti/do-i-need-a-cti.html

https://orthoinfo.aaos.org/en/treatment/acl-injury-does-it-require-surgery/

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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