An Anterior Cruciate Ligament (ACL) tear used to be a career-ending injury. As one of the four main ligaments of the knee joint, the ACL is crucial for stability during lateral (side-to-side) movement, and any fast-moving sport that involves sudden stops or direction changes requires healthy ligaments. Without a properly functioning ACL, your knee will not be stable, you’ll experience a loss of strength in your leg, and your chance of experiencing further injury will increase substantially. Hockey players, soccer players, basketball players and downhill skiers are all examples of athletes who have a higher chance of sustaining an ACL injury.
Fortunately, improved surgical techniques and enhanced rehabilitation programs now mean that an ACL tear no longer has to be the devastating injury it once was. If you’ve suffered through an ACL injury and are dying to “get back in the game”, here are three critical points to focus on before returning, in order to avoid being sidelined again.
Make Sure You’re Physically Ready
It might sound obvious, but it’s not as obvious as you might think. The amount of time it takes an injury to heal, and the nature of the recovery will differ from person to person. The main factor in determining the length of your own recovery will be the severity of the tear (i.e., whether or not surgery was required).
Returning to activity too soon can be very dangerous and can put you at serious risk of reinjury. Your physiotherapist will work with you to guide your rehabilitation through a mix of passive and active physiotherapy. Passive physiotherapy may include soft tissue massage and myofascial release for increasing blood flow to promote healing, breaking up scar tissue and stimulating the stretch reflex. Active physiotherapy is more about building strength, stability and range of motion through exercise and dynamic/static stretching.
Following a structured treatment plan is essential to your recovery. It’s very important that you restore both strength and stability to your knee in order to reduce your risk of re-injury. The recovery program designed by your physiotherapist will help to ensure that the muscles around your knee regain enough strength to support you and that your range of motion has returned. The quadriceps, hamstrings and calf muscles are all vital to restoring normal knee function, and many of the exercises performed will focus on those muscle groups. You should also be performing exercises to strengthen your core muscles, as well as focusing on learning correct technique and how to avoid incorrect movements. Your physiotherapist will also want to ensure that any post-activity swelling is limited and properly managed and that you’re using the necessary supports. These supports might include bracing, a compression sleeve or even orthotics depending on the nature or your injury, recovery and unique physiology.
Make Sure You’re Psychologically Ready
The psychological aspects of an injury are often overlooked. However, addressing them as a part of your rehabilitation program can be essential for making a successful return. As an athlete, not only must you regain your physical ability; you must also regain your psychological strength, your confidence and edge, in order to perform and enjoy the game the way you did before. If you find that you’re struggling in the beginning, it may be due to psychological factors. Often time, the expectations we set for ourselves aren’t realistic and that can severely affect your progress.
It’s common to experience a lack of trust in the recovery process or to find yourself worrying about suffering a re-injury. This is especially true if your recovery has been lengthy and if you’ve been out of the game for a long time. You might find that, as you prepare to return to activity, your motivations have changed, and your goals may not be what they once were. This can be completely normal and it’s advisable to explore these types of feelings if they come up. Remember that whatever you’re feeling, it’s important not to ignore it. Your emotional well-being and your resiliency, your ability to cope with new challenges as they arise, will be paramount in your ability make a successful return.
Once final but very important consideration is that you fully understand the risk factors posed by returning to sports and the possibility of reinjuring that goes with it. Athletes, particularly those that return to high-level sport, have a high rate of re-injury. Your physiotherapist is the best person to speak to about mitigating the risk of future knee injury but a psychotherapist may be the best person to speak to about managing the fear or doubt.
Focus on Prevention to Avoid Re-Injury
You may have heard the saying that “an ounce of prevention is better than a pound of cure”. That’s definitely the case when it comes to returning to activity after an injury. Be sure to ease into your return by gradually increasing your intensity and duration. You should always listen to your body and never push past your limits. Continuing with your exercise program to support retraining balance, coordination, flexibility and strength evenly is also very important. Ideally, this will include continued support from your physiotherapist to ensure that any challenges or issues that arise are addressed immediately and properly.
During your recovery, you will have gained an increased awareness of the difference between proper and improper movements and techniques. Knowing the best posture and techniques for jumping, landing, accelerating, pivoting and stopping, and by working hard to make these proper techniques second nature, you will have a much better chance of avoiding re-injury in the future.
Finally, a key element of any prevention strategy is incorporating a proper warm up and cool down program, including the use of dynamic and static stretching, as part of your regular routine (you should also continue to use any necessary bracing or other supports as needed). This will help you maintain the strength, flexibility and range of motion necessary for your sport and for supporting proper rest and recovery afterwards.
An ACL tear doesn’t have to be the career-ending injury it once was. With the proper recovery plan in place and with the help of an experienced team of healthcare professionals, you can get back to living an active life - including playing your favourite sports.
If you’ve had an ACL injury and need help with getting back in the game, contact us today and let us show you why at Physiomed… Healthier Starts Here.