In the eyes of many young athletes, no situation can seem more hopeless than a serious knee injury that requires surgical repair. It may feel career-ending to some athletes, even those who have multiple sports seasons left on the horizon.
Luckily, in most cases, this does not have to be the case. With timely intervention, and teamwork between a surgeon, physical therapist, and athletic trainer, many athletes are able to safely return to sports within six to nine months.
What to Expect Before Surgery
Immediately before surgery most patients will be visited by a physical therapist in their room. The therapist will teach them how to walk with crutches, how much weight they can put through their leg, and how to use their knee brace.
Additionally, the physical therapist will review a handful of exercises that can be started the day after surgery! This is surprising to some patients, but it is safe and strongly recommended to begin working on gentle knee range of motion and quadriceps muscle strengthening exercises almost immediately after surgery.
What to Expect After Surgery
Anywhere from 7 to 10 days after surgery, patients will begin formal physical therapy which will continue at two times per week for the next several months. In the beginning stages of rehab, patients will be weaned from their crutches and brace, may utilize electrical stimulation for re-educating their quadriceps muscle, and perform range of motion and strengthening exercises in order to perform daily school and home activities.
Because the ACL protocol is a combination of time-based and criteria-based progressions, it is crucial during these early stages for each patient to work diligently on their home exercise program in order to achieve initial therapy goals.
What to Expect Long-Term
Around three months after surgery patients may become candidates to transition into Functional Rehabilitation. Whether that is formal Functional Rehab with a Sports Medicine athletic trainer, or continued physical therapy, this phase marks the beginning of sports specific training. At this point, in a controlled environment, the athlete can begin to work on running, cutting, and jumping activities that are specific to their chosen sport. This phase is very important for athletes planning to return to sport, as it allows them to get comfortable with higher level activities while they continue to improve their strength and endurance.
In order for a patient to be cleared to return to their sport by their surgeon, they must pass a series of functional tests to assess their readiness for competition. These tests are designed to replicate the physical demand of an individual’s sport including: running, jumping/landing, cutting, and agility. In order to graduate from rehab, a patient must achieve a certain level of limb symmetry on these tests when comparing their operative and non-operative legs.
Our rehab team has successfully returned athletes to nearly any sport imaginable, from horseback riding, to competitive cheerleading, and football and other contact sports!
Mindy Deno, PT, DPT, graduated from the University of Cincinnati DPT program in 2015. Immediately following graduate school, she began a one-year Sports and Orthopedic Physical Therapy Residency here at Nationwide Children’s. Following the completion of the residency, she plans to sit for, and obtain, her Orthopedic Specialist Certification.
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