3137 Anterior Cruciate Ligament Physiotherapy: Prehabilitation

Hello. You have injured your anterior cruciate ligament or ACL. Your medical team, which includes physiotherapists and doctors, will help you decide how best to treat your knee injury. This will either be with surgery or with a course of physiotherapy. Either way, there are a number of exercises which you should do immediately following the injury to help regain movement, strength and balance in your knee. This video will show you which exercises are suitable at this early stage. Ideally you should also see a physiotherapist who will give you guidance about which specific exercises are appropriate for you, and will help you with any exercises which you find difficult. As with many muscle and joint injuries, we recommend that you ice your knee for the first 3 days. Use an ice pack or a bag of frozen peas, wrapped in a damp tea towel. Place this on your knee for 15 to 20 minutes, three to five times a day. If you use ice too often or for too long you will develop ice burns which could cause blistering, pain and itchiness. You should check your skin every few minutes. We recommend that you should do each of the following exercises for 15 repetitions, at least three to six times a day. To stop your knee from becoming stiff, sit or lie with your knee bent and your foot flat on the floor. Slide the foot of the injured side forwards, until your leg is straight, and then slide it backwards. You will feel some straining, but it should not cause too much pain. To keep your buttock muscles strong, lie on your back with your arms across your shoulders, and both knees bent at 90 degrees, with your feet flat on the floor. Squeeze your buttock muscles together, and slowly raise your bottom, and then your lower back, off the floor towards the ceiling. Slowly lower yourself back to the ground. Make sure you keep your buttocks squeezed together throughout. As you progress, your physio may suggest you try this on a small step, a wobble board, or on one leg. To keep your hamstring muscles strong, lie face down on a bed with both legs straight. Gently bend your injured knee, brining your heel towards your bottom. By doing this slowly and carefully, it should be pain free. As you progress, your physio may add resistance bands or ankle weights. To keep your thigh muscles strong, stand with your feet shoulder width apart, with your finger tips on a table or chair in front of you. Gently bend your knees, keeping your back straight, hold for 1 second, and then stand up straight. This movement should be pain free. If you do get pain, you are bending your knees too much. As you get stronger you will be able to bend your knees further. At a later stage your physio may add weights. ACL injuries can alter your balance; this is also known as proprioception. To improve your balance, stand in front of a solid table or chair, ideally with someone stood beside you. Put one foot in front of the other, heel touching toes, with your legs straight, but not locked. Make sure you keep your back straight and your buttocks squeezed in. Look ahead, and when you feel balanced, lift your hands up from the table. Try to hold this for 45 seconds, and repeat six times a day. Once this becomes easier, try doing it with your eyes closed. Later, your physio may ask you to try this standing on one leg, standing on a wobble board, or throwing and catching a ball at the same time. Throughout this stage of recovery, your physiotherapist will be monitoring your condition to see if you would benefit from surgery. It is very important that you follow their advice and practice these exercises as often as possible to give you the best chance of recovery. Remember to only advance to the next level of difficulty when your physio tells you.