Big thanks to Dave Chalmers who wrote this guest blog post. Dave is an athletic trainer who currently writes on behalf of DME Direct
It’s every athlete’s worst nightmare. Tearing your anterior cruciate ligament and sustaining a devastating ACL injury. The reason these injuries are so terrifying to athletes is that the road to recovery is long and arduous, and even then there is no guarantee you will ever be the same player and you always run the risk of re-injury. However, over the years there have been major advancements in ACL rehabilitation and it is now much more plausible to return to competition after an ACL injury and compete at a high level.
One aspect of ACL rehabilitation that often gets overlooked is the important time following the injury prior to surgery. As more people are realizing the significance of getting a recovery program off to a good start, the practice of prehabilitation is being implemented more frequently.
Typically the aim of prehab is to reduce swelling and stabilize the knee prior to surgery. This can be achieved through cold therapy and wearing a knee support to compress and stabilize the knee. Some mobility exercises can be performed at this stage if you experience no pain while doing them.
After successful reconstructive surgery, the rehabilitation process begins. This process can be broken down into a timeline with various phases. It is important that you stick to this timeline and do not rush things and risk re-injury.
The first two weeks immediately following surgery should be spent focusing on reducing swelling and controlling swelling. Similar to the processes of prehab, icing and compression should be applied here and the use of crutches combined with rest is commonly advised. At this time you can begin with static strengthening exercises such as lying down quadriceps and hamstring contractions.
After these two weeks, you should being a second phase of recovery. Mobility and strengthening exercises should continue and you can start to introduce exercises like shallow lunges and half squats. You can also start implementing adduction and abduction exercises for hip flexor strengthening as well as begin proprioception and balancing exercises.
At about the six week mark you can begin another phase of the rehabilitation. At this stage you can advance to full lunges and squats. You can now start to add weight for increased resistance and begin straight line jogging exercises.
Approximately twelve weeks after surgery you can begin to mix in training activities specific to your sport. The key here is to gradually increase speed and intensity of drills. Along with sport-specific drills, you should also focus on exercises that strengthen hip abductors and external rotators such as monster walks and single leg glute bridges.
Return to Competition
When and only when, your surgeon gives you permission to return to competition will you be able to start competing again. If you follow the processes outlined here you will give yourself the best chance to return to competition physically capable of competing at a high level. However, there is also a mental aspect that many athletes overlook.
Even if your body is ready physically, you may not be mentally prepared to trust your knee in live competition. Again, it is important to be patient and avoid returning until you are fully ready. Use the exercises mentioned above at the end of your recovery program to test yourself a bit and build confidence in your repaired knee. Once you return to competition, wearing a trusted ACL knee brace can give you extra support both physically and mentally.
The long road to recovery after an ACL injury can seem overwhelming at times. Dedication and discipline are required to rehabilitate yourself successfully. However, if you put in the work to reach a level where you are properly prepared physically and mentally to return, you can begin competing at a high level again.
Dave Chalmers is an athletic trainer who currently writes on behalf of DME Direct on topics related to sports medicine and physical therapy. When he’s not writing, you will most likely find Dave at the Staples Center cheering on his beloved Lakers.