ACL Reconstruction and Rehabilitation:
The First Days:
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.
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.
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.
Toward the end of this phase, some athletes can begin shuttle runs, lateral shuttles and jumping rope.
Emphasis of rehabilitation should be on sport simulating activities. These will include figure-of-eight drills and plyometrics, and over time will include sport drills. For example, a tennis player may start light hitting, a soccer player some controlled dribbling, etc.
Return to Sports:
- Functional Progression
The decision to return to sports must be based on each individual's progression through their therapy.
- Graft Type
Some surgeons may delay return to sports if the graft used to reconstruct the ACL came from a donor. Because these grafts are sterilized and frozen, there is a belief that they take longer to heal well inside the patient.
- Surgeon Preference
Your surgeon will guide your rehabilitation, and the ultimate decision about return to sports.
Bracing After ACL Surgery:
Sources:Beynnon BD, et al. "Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized, Double-Blind Comparison of Programs Administered Over 2 Different Time Intervals" Am. J. Sports Med., Mar 2005; 33: 347 - 359.