Partial ACL Tear....

[MrDJB]

any replies!?! please!

What injuries am a likely to sustain if i go out and play football and the knee buckles? Will i be again in a position where i can't work for a few weeks or will i just have a less stable knee?

[sixphysio]

ok - your meniscus tear has been sorted surgically and won't grow back. the difference between that and your acl is vascularity. if you tear your acl and a is still attached to b by a few threads then it should regrow because of the vascularity (blood vessels). BUT it may not have the same strenght or lenght, potentially making your knee unstable. not necessarily in straight line stuff, but in rotational activities.

this is the dilemma of braces. they'll give you false support by making the muscles around the knee more active, but as a ridgid structure can't protect the rotatory componant (unless they drill into your bone!)

perhaps reattaching is the wrong word, unless the tear is at the bone/tendon junction of the acl then it probably won't, but with the right rehab protocol to improve rotatory control, hammys and gluts then you may not require to rest and depend on the tensegrity of your cruiciate.

don't get it reconstructed unless it's knackered (gives way, blows up type thing). but do get going on rotatory control, plyometrics not just booting a ball around.

cheers

sixphysio

[MrDJB]

Thanks for the reply

How do you recommend i best go about improving the rotational control? Are there specific excerices or am i just best to concentrate on the muscle groups i've been told to.

Even if i improve the rotary control, is the brace a bad idea to use? I mean, is using it as a "mental" aid going to affect the workings or is the brace fine as long as i improve the rotational control?

[sixphysio]

tricky to explain with panache!

rotatory control is about planting your foot on the ground and then controlling the amount of rotating (rolling in or out) your thigh does above it - hence the bit why braces can't fully control this bit.

your cruciate is under greatest strain when your foot is pointing to 2 o'clock and your knee is pointing to 10 o'clock. it's a normal function and usually your cruciate passively controls the extreme's of rotation in your knee. yours being a bit dodgy won't be as efficient so you need your muscles to control this.

you need to practice with your foot static and then get more dynamic with planting your foot. it's all about control - not just doing it. it also gets you to concentrate on not only brute strength around the knee but control around the hip.

as for braces - if you think you need one then your probably not ready to do stuff on it yet! there is no harm in having one, mentally you'll feel tougher but don't rely on it!

cheers

sixphysio

[MrDJB]

thanks for the reply again...

During the rehabilition at the physio, i didn't wear any form of brace. I ran, hopped, jumped and turned without it. I decided to wear it during the kickabout more as a mental booster. I think what i plan to do is as you say - build up the rotary control, and muscles without the brace. Whilst kicking a ball about, i think i'll stick with it for now and gradually do more and more without it as my knee feels stronger and i feel more confident.

A friend of mine has spoken to me about plyometric excericises although he's not a qualified physio (yet!). He beleives jumping up stairs and jumping over and back over an object sideways are good excercises. Is he correct?

Thanks again for the help