ACL Prehab/rehab help please

Hi I am a final year student doing an assignment on ACL in general. The problems I am having is finding articles ( that I dont have to pay for and are avaliable in the search engine my uni uses) . I am just wondering treatment people are doing from the initial injury to surgery stage ( supposing surgery is the option) so basically prehab and also preventitive measures to try and prevent injury and also in the post surgery what neuromuscular,proprioceptive and balance exercises have been meantioned in recent text is it similar to preventative exercises. and finally ( a lot i know) if anyone has seen the eccentric quads article for acl rehab does any know the specific exercises they used couldnt really understand from the article itself.
Any ideas/ help would be much appreciated and I am sure the latest evidence would be of interest to many.
thanks

Which physio school are you studying at?? I find it hard to believe that you can't access journal articles through the physio school. Are you doing your final year through Otago?? If so where are you based?? Also what texts are you using as recommended reading. There is SO much info out there on ACL rehab that it's almost impossible not to find it. I'd start by logging on to the NZSP website and using their recommendations on journal sites to search (including free ones). I'd then approach one of your tutors if you are having problems accessing relevant information.

It's not going to help you if people like me give you all the answers as you don't learn a thing that way. Sorry!!!! Part of the process of studying however is getting used to accessing information which is something that will stay with you for life as physios are constantly learning and updating their knowledge.

Good luck.

sports coach


TRY THIS ONE!!!!

o Icing frequently
o Elevating the affected knee
o Using crutches

Some surgeons recommend the use of a brace after ACL surgery. This is controversial, and many surgeons choose not to use a brace at this time.

Another controversial subject is the use of a CPM, or motion machine, after surgery. Again, some surgeons will use the CPM despite a lack of evidence that it helps your recovery.

Weeks 1-2:

Range of motion exercises can begin immediately after surgery. The initial focus is to regain full extension (the ability to fully straighten) of the knee. In general, flexion (ability to bend) is much easier to regain than extension.

Patients will work with physical therapists to work on gait training (walking), gentle strengthening, and aerobic work. I like to get patients on a stationary bicycle as soon as possible after surgery as this improves strength, motion and aerobic activity.

Weeks 3-6:

Work is continued with physical therapy. As motion increases, emphasis is shifted to strengthening. Specifically balance and proprioceptive exercises.

Once normal motion has been achieved, some sport-specific activities can be started. Before beginning these activities, motion must be near normal and the swelling in the knee gone.

Weeks 7-12:
Early sports activities can be started and patients can often begin light jogging, cycling outdoors, and pool workouts. Side-to-side, pivoting sports -- such as basketball, soccer and football -- must be avoided.

Toward the end of this phase, some athletes can begin shuttle runs, lateral shuttles and jumping rope.

Months 4-7:
Continued progression with sports specific activities. This phase of rehabilitation is often the most difficult, because patients may have a knee that "feels" normal, but is not ready for the stresses of some sport activities.
Additional Comment I forgot:
I 'LLL telll u more of it s mslf also student and i hv the same project!!!!!!!!

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Originally Posted by scarfie

Hi I am a final year student doing an assignment on ACL in general. The problems I am having is finding articles ( that I dont have to pay for and are avaliable in the search engine my uni uses) . I am just wondering treatment people are doing from the initial injury to surgery stage ( supposing surgery is the option) so basically prehab and also preventitive measures to try and prevent injury and also in the post surgery what neuromuscular,proprioceptive and balance exercises have been meantioned in recent text is it similar to preventative exercises. and finally ( a lot i know) if anyone has seen the eccentric quads article for acl rehab does any know the specific exercises they used couldnt really understand from the article itself.
Any ideas/ help would be much appreciated and I am sure the latest evidence would be of interest to many.
thanks

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Suggest it's time to begin building the library of books that aren't sold to you as a student. Kahn and Brukner's Clinical Sports Medicine comes to mind.

I have to agree with physio fix me, I'm going to assume your a forth year otago grad? You have more ability to research than anyone else here, the university has a huge range of journals - far more than any of us have. So just check that you adequately know how to research through the univerity website.
You can email the tutors at the school - Martin knows his stuff or paul. Get our your brukner and kahn (physiobob - this is the prescribed text for otago students). Whats in your prescribed readings from musculo? Go find that book and see if any ACL there and look at your lectures for the referances given, remember who gave you the knee lecture in your musculo lecture and send them an email re: referances for you to look up.

That said if someone is going for surgery - then the knee becomes weaker immediately following that surgery, so a rule that i follow is get that knee as strong and as stable as possible before the surgery so the post op will be easier. Don't let them play sport as they will injur further, and work on safe strengthening in the gym to strengthen pre op - working with their level of pain.

Most ACL's are traumatic and thus hard to prevent, but that said there are things to think about. With sport ensure the biomechanics are correct from the ankle so that the knee isn't under any undue tibial torsion - this will of course affect the proprioreception of the knee and make it more likely to be injured. It's harder to protect a joint if you don't have adequate proprioreception. Exercises such as one leg squats with a swiss ball are brilliant as they encourage propriorecption while working the stability of the knee.

Also think about the attachment of the ACL - from ant tib to post femur hense limiting ant translation of the tibia in open chain and post translation of femur in closed chain. So when giving exercises avoid open chain with weights as the quadriceps will cause anterior translation of the tibia - good to think about post surgery to not pull on the repair too much.

is this your community placement assignment? Don't sweat it, it's hard to please anyone at the physio school. I remember having 130 articles that I read and referanced and then my feedback said I didn't research adequately.