Josh Valentino

Physical Therapy: ACL TearsClients with ACL InjuriesJosh ValentinoACL stands for Anterior Cruciate LigamentIs one of four ligaments in the kneeLocated on the anterior part of knee (front of the knee)

What is an ACL?

How to Tear your ACLThis ligament can easily be injured or torn and cause major damage to your kneeSuddenly stop running, foot pivots and knee gets pushed in with valgus force (knee pushed inward)Twisting of the kneeHyperextension of the kneeForward movement of the tibia on the femur

Completely Rips ApartKnee Twist Inward Signs & SymptomsPopping SoundSwelling & Bruising Very painfulUnable to Bend Knee

3 ClassesClass 1 Tear:a small number of fibres are torn resulting in some pain but allowing full functionClass 2 Tear:a significant number of fibres are torn with moderate loss of functionClass 3 Tear:all fibres are torn resulting in knee instability and major loss of function. Surgery is often required

Extremely Painful

7Real Life Situation

Derrick Rose ACL Knee Injury 4/28/2012 NBA Playoffs Game 1http://www.youtube.com/watch?v=jo1UlzDeY-o Bulls1

What to do?RICE: -Rest-ICE-Compression-ElevationSee DoctorSurgery might be necessary

Recovering Without surgery(not recommended)Physical therapy to strengthen muscles around knee to make up for weak ACL-Ex; hamstring, quadriceps, calf, hip, and ankleKnee braceIce May still feel unstableRecovering with surgeryCrutches to walkKnee braceIce/Heat padsPhysical TherapyNo sports or physical activities involving bad knee

Post SurgeryMonths 3-4: Jogging PhaseMonths 4-5: Agility PhaseMonths 5-6: Return to Drills PhaseMonths 6-7: Return to Practice PhaseMonths 7-8: Return to Competition

Rehabilitation6-12 monthsShould begin from the time of injury, not from the time of surgery.3 stagescontrolling pain and swelling in the kneerecovery of ROM and strengthfinally a graduated return to full activity

Rehab ExercisesKnee Bend to Straighten-Bend and straighten knee as far as possible without increasing pain. Repeat 20 timesStatic Quadriceps Contraction- Tighten quadriceps by pushing your knee down into a towel. Put your fingers on your inner quads to feel the muscle tighten during contraction. Hold for 5 seconds and repeat 10 timesStatic Hamstring Contraction- Sitting down bend knee to about 45 degrees. Press heel into the floor tightening the hamstrings. Hold for 5 seconds and repeat 10 times

Knee Bend to StraightenStatic Quadriceps Contraction

Static Hamstring ContractionAfter MathAfter 6+ months of rehab your knee should be back to its regular range of motionWont be at 100% until 12-18 monthsThere should be no pain and you should be able to play sports and do activities again

Return to Sports?The decision to return to sports is determined by how good a persons progression is during therapyPhysical therapist should be the decision makerReturning to activities too early may injure the knee againRecommended 6+ months after surgery before returning back to sports

Before RehabAfter RehabMy career is over :(CANT STOP ME!Long TermAfter surgery it is crucial to let your knee heal and to not participate in activities involving your knee unless it is through rehabilitation. This is help with long term affects Recent studies have shown that people who have ALC tears with surgery have ended up with reduced range of motion in their kneeAlthough it has kept it stable enough to continue to participate in active sportsEND