Unfortunately, you have just torn your ACL.  There is often a lot of emotion, concern, and questions that occur at this point.  Please make sure these are all addressed with Dr. Maffet.  Often after the words, “ACL tear”, everything else said is forgotten.  It is important to understand the injury and what your options are as well as the pros and cons of each.

A Pre- ACL Protocol is a rehab program for recovery from the initial knee injury itself.  When the knee shifts during an acute ACL tear, the knee gets swollen and sore.  Motion may be limited, and muscles tend to shut down.  We will usually put you on crutches if you are limping and maybe a brace depending on the type of injury.  It is important to let the knee recover from this initial injury before any surgical intervention is done.  A swollen, stiff knee can get significantly more swollen and stiff if surgery is done too soon sometimes leading to a condition called arthrofibrosis.  The Pre- ACL Protocol helps to avoid this.  It typically lasts 3 – 6 weeks until swelling is down, motion is back, and painful bone bruises have had a chance to heal.

Pre-ACL Protocol

Swelling – To decrease swelling, it is important to back off on activities, and start regularly icing the knee.  3 x per day for 10 minutes minimum.

Range of Motion – It is very important to work on regaining full knee motion especially extension.  Bending will come as any swelling goes down.   Getting the knee straight can take some work but must be worked on diligently.  Normal gait pattern and quad function rely on a straight knee.

Gait training – No limping allowed.  Two crutches to one crutch in the opposite hand to none as you start walking more normally.  Limping can cause other problems fairly quickly.

Early quad strengthening – The quad muscle tends to want to shut down after an ACL injury.  It is important to start early quad rehab to start to regain that quad muscle function.  These exercises include quadsets, straight leg raises, wall squats, etc.  In the gym, the leg presses, and bike are good.

Dr. Maffet will often have a physical therapist help get you started with this. It is important that you learn the exercises, and start doing them on your own every day.  The Pre-ACL Protocol is not wasted time, but rather can give you a headstart after your ACL reconstruction surgery.