Physiotherapy for Knee Ligament Rupture (ACL)

Physiotherapy is indicated for the treatment in case of rupture of the anterior cruciate ligament (ACL), being a good alternative to surgery to reconstruct this ligament.

Physiotherapy treatment depends on age and whether there are other knee problems, but it is usually done with the use of apparatus, stretching exercises, joint mobilization and strengthening of the anterior and posterior thigh muscles, mainly to ensure the stability of this joint and the return of daily activities as quickly as possible.

When to start physiotherapy

Physiotherapy can start on the same day that the knee ligament ruptured and the treatment should be progressive and carried out daily until the individual has recovered completely. The sessions can last from 45 minutes to 1 or 2 hours, depending on the treatment chosen by the physiotherapist and the resources available.

How knee physiotherapy is performed

After evaluating the knee and observing the MRI exams, if the person has it, the physiotherapist can determine how the treatment will be, which must always be individualized to meet the needs that the person presents.

However, some features that can be indicated are:

  • Exercise bike for 10 to 15 minutes to maintain cardiovascular fitness;
  • Use of ice packs, which can be applied during rest, with the leg elevated;
  • Electrotherapy with ultrasound or TENS to relieve pain and facilitate ligament recovery;
  • Patella mobilization;
  • Exercises to be able to bend the knee that initially should be performed with the help of the physiotherapist;
  • Isometry exercises to strengthen the entire thigh and the posterior part of the thigh;
  • Exercises to strengthen the thigh muscles (abductors and adductors of the hip, knee extension and flexion, squats, leg press exercises and squats on one foot);
  • Stretches that initially must be performed with the help of a physiotherapist, but that can then be controlled by the person himself.

After the person is able to not feel pain and it is already possible to perform the exercises without great restrictions, you can put on weight and increase the number of repetitions. Normally, it is recommended to do 3 sets of 6 to 8 repetitions of each exercise, but then you can increase the difficulty of the exercise by adding weight and increasing the number of repetitions.

Check here some strengthening exercises for the knee that, although in the video they are indicated in case of arthrosis, they can also be indicated for recovery from ACL rupture:

How much time does the treatment last

The number of sessions required depends on the person's general health, age and treatment adherence, but generally young adults and adolescents in good health, who do physical therapy sessions at least 3 times a week, recover around than 30 sessions, but this is not a rule and more time may be required for full recovery.

Only the physiotherapist who is directing the treatment will be able to indicate approximately how much treatment time will be necessary, but during the sessions, the physiotherapist will be able to continually reevaluate the individual to verify the results and, thus, be able to change or add other physiotherapy techniques, which better comply with the intended objective.

When to return to the gym or sports

Returning to the gym or playing sports can take a few more weeks, because when you practice any type of sport such as running, football, muay thai, handball or basketball, you still need a final treatment, aimed at improving your ability to move during this type of training.

In this case, the treatment should be done basically with exercises on the trampoline, bosu and others like, carioca run, which consists of a lateral run crossing the legs, running with sudden changes of direction, cuts and turns. The physiotherapist can personally indicate the best time to start running slowly, like a trot, or when you can return to weight training depending on the limitation of movements and if there is any pain.

This last phase of the exercises is important for all people, but especially in the case of practitioners of physical activity because they help in the final adjustments and complete recovery from the injury and also in the person's confidence in returning to the sport, because if the person returns but not yet if you feel safe, a new injury to this ligament or other structure may occur.