In the world of sports, ACL injuries are infamous among athletes, parents, and coaches alike – and for good reason: the typical rehab timeline for return to 100% health from a complete ACL tear is typically around 9-12 months, if recovery goes smoothly.
Unfortunately, ACL injuries are fairly common, with most athletes having either experienced it themselves or having known a teammate who has gone through the recovery process.
But just because you’ve injured or torn your ACL doesn’t mean that your goals and aspirations as an athlete are no longer achievable. With proper ACL injury treatment through physical therapy, you can get back to the field, court, or ice as strong as ever.
What is the ACL?
The Anterior Cruciate Ligament (ACL) is one of the ligaments that attaches the femur (thigh bone) to the tibia (leg foot). It provides stability to the knee joint during everyday activities and is especially pivotal for activities that involve pivoting, cutting, or high-speed deceleration, all of which are common movements in sports.
Types of ACL Injuries
Not all ACL injuries are the same. Some are more severe than others, with longer recovery timelines for each depending on the degree of the injury. The severity of ACL injuries can be defined by “Grades.”
Grade 1 ACL Sprain
The least severe type of ACL injury. In this case, the ACL is still intact and is still fully capable of keeping the knee joint stable. However, the ligament has been stretched and you may still experience some of the symptoms of an ACL injury including limited mobility, swelling, and pain in the area. Most Grade 1 ACL injuries do not require surgery, and can heal on their own with nonsurgical treatment such as ice, rest, and proper rehabilitation recommended for full return to function and reducing the risk for subsequent injury.
Grade 2 ACL Sprain
A Grade 2 ACL injury is also known as a “partially torn” ACL. For these injuries, symptoms will be similar to Grade 1 injuries but more intense. Some patients may experience an occasional loss of balance or the feeling that their knee is “giving out” as the ligament fails to stabilize the knee.
Some Grade 2 injuries may require ACL reconstruction surgery; however, many patients are able to make a full recovery through a rehabilitation program.
Grade 3 ACL Sprain
A Grade 3 ACL injury represents a complete tear of the ligament, and is unfortunately the most common for athletes. Patients who experience a completely torn ACL often report hearing a popping sound along with sharp pain, difficulty walking, and swelling within 24 hours of the injury.
A complete ACL rupture can be managed through ACL reconstruction surgery, repair, bracing, or conservatively depending on the individual’s goals. The current recommendation post-ACL rupture is ACL reconstruction surgery followed by 9-12 months of rehabilitation.
Causes of ACL Injuries
While ACL injuries can happen from contact with an opponent during play, most ACL injuries are non-contact injuries that occur during high-speed cutting, pivoting, jumping/landing, or deceleration activities in a reactive, competitive environment.
Injuries are often, but not always, associated with the knee caving inward while the foot is planted during these activities.
Sports Where ACL Injuries Commonly Occur
While an ACL injury can occur to any competitive athlete, they’re most common in field and court sports such as:
Can You Walk With a Torn ACL?
Yes, you can still walk with a torn ACL. Complete ACL ruptures demonstrate high variability immediately post-rupture. Some individuals are able to walk immediately post-injury, while some individuals are unable to bear weight due to the pain. After the knee calms down, weight bearing and walking (without turning) are usually not a problem.
ACL Injury Treatment
ACL reconstruction surgery is strongly encouraged for individuals engaged in high-level cutting and pivoting sports to maximize their return to high-level competition.
Prehab (pre-surgery rehabilitation) is also strongly recommended in order to go into surgery with a “quiet knee” – minimal swelling, full range of motion, and close to full strength compared to the uninvolved knee to maximize outcomes post-surgery.
ACL injuries are accompanied by injury to at least one other knee structure in about half of all ACL injury cases. Injury to the meniscus and/or other ligaments of the knee are common and may change rehab timelines such as time spent on crutches.
After ACL reconstruction begins the post-op rehab process.
In the early stages, our goals at Herlong Sports Physical Therapy are to minimize swelling, regain range of motion, regain quadriceps muscle activation, and normalize walking/discharge from crutches.
In the mid-stage it will look a lot like strength training, with the goal of regaining strength. In the mid stage, plyos/jumping will be introduced followed by a gradual return to running.
In the late stage, speed, power, reactive agility, and return to contact will be the focus of our rehab.
All throughout the rehab process there will be testing and benchmarks that need to be achieved to monitor progress and facilitate the progression to the next stage. We take the “test don’t guess” approach to objectively inform our decision making to facilitate optimal outcomes.
This helps us feel confident in our decision making throughout the entire return to sport process, making sure it is safe to return to sport and checking all of the boxes to reduce the risk of a re-tear from happening based on the most recent research evidence.
Individuals who do not desire to return to cutting and pivoting sports will discuss their options with their healthcare team and may choose not to have an ACL reconstruction surgery.
What Patients Are Saying
Nothing but great things to say about the staff and environment. I went to Herlong Sports prior to and after my ACL surgery and have been walked through every step of the way for my knee rehab. The patience, empathy, and professionalism reflects in each patient they treat. I truly appreciate the attention to detail that the team demonstrates. I would definitely recommend seeing the staff here to get you feeling better
How Long is ACL Recovery?
Typical recovery time for a Grade 3 ACL injury (a complete tear) is 9-12 months, with some patients requiring more time than that to return to sport. Attempting to return to sport before 9 months post-ACL reconstruction significantly increases the risk for a re-tear.
ACL Rehab Exercises
Here are some exercises you can do while you await your first appointment with our licensed physical therapists.
In the early stage of rehab it is imperative to get quadriceps activation back and start to develop quad strength. To perform the exercise…
- Sit on a flat surface with both legs out in front of you.
- Try to push the back of your knee down to the surface you are sitting on and squeeze the muscle on the front of your thigh for a 5 second hold.
This exercise should be performed upwards of 100x per day in the early stage of ACL rehabilitation.
In the mid stage of ACL rehabilitation, split squats can help you continue to increase the strength in your quads and the area around your injured knee. To perform this exercise…
- Stand on the ground with one leg in front of the other, facing forward.
- Bend your knees and lower your body slowly downwards until your back knee is nearly touching the ground.
- Raise your body back up into a standing position.
Repeat this exercise 6-8 times for a single rep, then switch legs.
BECOME A PATIENT
If you are seeking Achilles tendinopathy (Achilles tendonitis) treatment, fill out patient paperwork to get the process started with Herlong Sports Physical Therapy. We are in network with all major insurance plans. Contact us if you have any questions about insurance or our services.