Rehabilitation after an ACL injury: what can you expect?.

The anterior cruciate ligament is one of the four main ligaments in your knee, responsible for stability and control during all kinds of movements. In most cases, an ACL injury occurs due to a sudden rotational movement of the knee, direct impact or a wrong landing after a jump. Anterior cruciate ligament injuries can occur through both contact and non-contact mechanisms. Contact injuries involve direct interaction with another object or person, such as a collision during a sports game. This type of injury often occurs in sports such as soccer, where players regularly come into contact with each other. Non-contact injuries, on the other hand, occur without direct outside impact. This usually occurs during sudden movements such as twisting, jumping or abrupt stopping and starting. These movements can lead to excessive stress on the knee, which can rupture the anterior cruciate ligament.

Unfortunately, if an injury is severe then other ligaments in the knee may be damaged in addition to the anterior cruciate ligament (VKB). Here is an overview of the various possible other ligament injuries in the knee:

1. Posterior cruciate ligament (AKB) Injury:
• Function: Stabilizes the knee by preventing the lower leg from sliding too far back.
• Injury: Can occur from direct impact on the anterior part of the tibia, often during a sports accident or car crash.
2. Medial Collateral Ligament (MCL) Injury:
• Function: Stabilizes the inside of the knee.
• Injury: Can result from a direct blow to the outside of the knee, causing it to bend inward (valgus stress).
3. Lateral Collateral Ligament (LCL) Injury:
• Function: Stabilizes the outside of the knee.
• Injury: Caused by a direct blow to the inside of the knee, causing it to bend outward (varus stress).
4. Posterolateral Angle (PLC) Injury:
• Function: Provides stability to the outer-rear side of the knee.
• Injury: Can occur due to a combination of hyperextension and rotation, often in contact or rotational sports.

Pre-operative training at Physio Fitaal for anterior cruciate ligament reconstruction

For successful rehabilitation after anterior cruciate ligament (ACL) reconstruction, it is crucial to begin targeted physical therapy even before surgery. At Physio Vital, we understand that a well-prepared knee and surrounding muscles can contribute significantly to a faster and more effective recovery after surgery. Also known as prehabilitation, this process helps put the knee in the best possible condition. It also reduces postoperative complications and, in some cases, reduces rehabilitation time.

Pre-operative training focuses on optimizing muscle strength, range of motion and stability of the knee. Our physical therapists at Physio Fitaal develop a customized program to achieve these goals. An important part of this program is strengthening the quadriceps and hamstrings, the front and back of the thigh muscles. These muscles are essential for supporting the knee. In addition, we work on the hip and gluteal muscles, which play a crucial role in stabilizing the knee joint. We also pay attention to core stability, as a strong core contributes to overall balance and control of the knee.

Improving range of motion is another important aspect of prehabilitation. This includes stretching exercises aimed at maintaining and improving the flexibility of the muscles around the knee. Mobilization exercises are specifically designed to improve knee joint mobility, which is essential for a smooth recovery process.

In addition to physical training, mental preparation is an essential part of prehabilitation. At Physio Fitaal, we place a high value on properly conveying information to our patients about what to expect during and after surgery. By providing them with information and support, we help reduce fear of surgery and increase motivation for the recovery process. Our physical therapists provide ongoing support and motivation, which contributes to a positive mindset and successful rehabilitation.

What steps do I go through during my anterior cruciate ligament treatment in Tilburg?

The rehabilitation after an anterior cruciate ligament (VKB) surgery consists of several carefully planned phases to promote optimal recovery. At Fysio Fitaal Tilburg, we guide you step by step through this process, closely monitoring your progress and regularly evaluating and adjusting your treatment plan.

Rehabilitation begins with the acute recovery period (0-2 weeks). In this phase, we focus on reducing pain and swelling, restoring range of motion and beginning light muscle activation. We do this through the use of ice and compression and light mobility exercises. Then, in the early rehabilitation phase (2-6 weeks), we focus on improving range of motion and muscle strength through more intensive mobility exercises and controlled muscle strengthening exercises.

In the strength training phase(weeks 6-12) we work to restore normal gait patterns, increase functional strength and stability with exercises such as squats, lunges, and step-ups. Mobility exercises focus on knee flexion and extension, as well as hip and ankle mobility. Light sports-specific movements are introduced to prepare the you again for sports activities.

Every six weeks, we evaluate your progress, analyze your gait pattern, measure your muscle strength and assess your functional skills. Based on this, we adjust your rehabilitation program to ensure that you make optimal progress and reach your goals.

In the Return to Run phase after anterior cruciate ligament (VKB) surgery is an essential part of your rehabilitation, where you slowly begin running again and resume physical activities. This phase takes place between 12 and 24 weeks after surgery. This phase focuses on restoring your running technique, building strength and endurance, and improving the functional stability of your knee. You build up this progressive running training gradually starting with short distances and low intensity. This phase combines strength training with balance and stability exercises. 

In the Return to Jump phase (24-36 weeks) we prepare you for jumps and explosive movements with strength training, plyometric exercises, and sport-specific drills. Eventually, in the Return to Sports and Performance phase (6-12 months), we work to fully restore your athletic capabilities and strive to optimize your performance.

Evaluation and Progression during anterior cruciate ligament rehabilitation

At Fysio Fitaal, we believe that measuring is knowing. By using advanced equipment and technology, we collect accurate data to optimize your rehabilitation process and help you recover safely and effectively.In our data-driven approach to rehabilitation, we use advanced equipment and technology to provide accurate measurements and analysis. For example, we use the LSI (Limb Symmetry Index) to compare the strength and balance between both legs and detect any asymmetry. By using all the training data and tests, we can collect detailed data about your progress. This data is then analyzed to make adjustments in the rehabilitation process. This approach allows us to use objective metrics to monitor recovery and make informed decisions throughout the rehabilitation process. Based on the results of these evaluations, we adjust your rehabilitation program to ensure that you progress appropriately and achieve your goals.

In our brochure, which you can download below, you will find a schematic overview of the different phases of rehabilitation and the corresponding goals. This brochure provides a clear and detailed picture of what you can expect during your ACL treatment at Fysio Fitaal Tilburg.

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