Athletes with ACL tears want to return to sport as quickly and safely as possible. Yet only 50–60% of injured athletes are able to return to sport at all. Those who do return to sport are sidelined for an average of 12 months or more.
The accelerated ACL post-op rehab protocol at Shelbourne Knee Center is part of a proven, predictable ACL reconstruction process that enables 85–90% of athletes to return to the same level of sport (1). On average, patients return to sport an average of 5.2 months after surgery.
Honed over 38 years and 7,000+ ACL reconstruction surgeries, the research-based ACL reconstruction process also includes pre-op rehab, use of the patellar tendon graft and precise surgical technique. Our own physical therapists and athletic trainers, who specialize in knees, guide patients through accelerated ACL post-op rehab.
A Focus on Range of Motion Before Strengthening
While the exercises for the ACL-reconstructed knee and the graft knee are different, the goal is the same: improving range of motion before strengthening. Post-op therapy begins in the hospital. By 2–3 months post-op, patients have nearly full extension and flexion:
- Full extension: 98% of patients
- Full flexion: 92% of patients (2).
The accelerated ACL post-op rehab protocol includes:
- Eliminating swelling by lying down with the knee above the heart for the first seven days
- Full extension exercises beginning the day of surgery
- Hospital stay for 23 hours
- Weight-bearing allowed as tolerated for bathroom privileges
- Emphasizing range of motion exercises for flexion while maintaining full knee extension
- Strengthening exercises beginning when full extension and flexion is achieved.
Use of a Cryo-Cuff and a continuous passive motion (CPM) machine also help eliminate swelling. Patents wear a Cryo-Cuff on the ACL-reconstructed knee except for when they are doing their exercises. They use the Cryo-Cuff as long as necessary, as determined by their physical therapist or athletic trainer. The CPM machine elevates the knee above the heart and gently bends and flexes the knee. Most patients use this machine for seven days.
Expert and Convenient Physical Therapy
Shelbourne Knee Center is the only orthopedic practice in Indiana that has on-site physical therapists and athletic trainers, all of whom specialize in ACL injuries and other knee problems, and an on-site gym. “Specializing enables us to provide expert and consistent care,” says Sarah Eaton, PT, DPT, ATC, LAT. Eaton is one of nine physical therapists and athletic trainers at Shelbourne Knee Center.
Close collaboration between the physical therapists, athletic trainers and orthopedic surgeons—K. Donald Shelbourne, MD, and Rodney Benner, MD—helps optimize outcomes. “Because we work so closely with the physicians, we have a clear picture of exactly what’s going on, and can develop a customized physical therapy treatment plan,” says Eaton.
Patients complete most of their physical therapy at home, with guidance from their physical therapist or athletic trainer and periodic visits to Shelbourne Knee Center. Along with convenience, the home-based therapy enables patients to do more physical therapy, facilitating optimal outcomes.
Most physical therapy practices see patients in their clinics three or four times a week. Due to insurance restrictions, physical therapy only lasts a few months and is usually only ordered after surgery.
“We can see patients for a lot longer because of our rehab protocol. This allows us to continually educate our patients so they can maintain their gains after they complete therapy,” says Scot Bauman PT, DPT, a physical therapist at Shelbourne Knee Center.
At Shelbourne Knee Center most patients are seen:
- About 2–3 times pre-op
- About 7 times post-op over about six months.
For more information about the accelerated ACL post-op rehab protocol at Shelbourne Knee Center, call 888-FIX-KNEE.
References
- Shelbourne et al., Rehabilitation for Patients Following ACL Reconstruction: A Knee Symmetry Model. Sports Health, 2009.
- Shelbourne KD, Beck MB, Gray T. Anterior Cruciate Ligament Reconstruction With Contralateral Autogenous Patellar Tendon Graft: Evaluation of Donor Site Strength and Subjective Results. Am J Sports Med. 2014;43:648-53.