ACL Reconstruction Surgery Physical Therapy Treatment | Pre-Operative Guidelines | Case Study | FPF Show Episode 50

By dpope2020

September 16, 2022

acl exercises, acl injury, acl reconstruction, acl reconstruction phase 1, acl reconstruction rehab, acl rehab, acl rehab exercises, acl rehabilitation, acl strengthening exercises, acl surgery, ACL tear, acl tear rehab, alex holland, anterior cruciate ligament, anterior cruciate ligament injury, axe physio, best acl exercises, dan pope, fitness pain free, how to recover from acl reconstruction surgery, how to strengthen your acl following surgery, physical therapy

ACL Reconstruction Surgery Physical Therapy Treatment | Pre-Operative Guidelines | Case Study | FPF Show Episode 50

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In today's episode we go over ACL Reconstruction Surgery Physical Therapy Treatment | Pre-Operative Guidelines | Case Study | FPF Show Episode 50:

  • 0:00 Introduction
  • 2:12 Subjective information: Patient age, female, demographics, psychosocial influences
  • 5:37 Mechanism of injury and reason for ACL reconstruction surgery
  • 6:15 Diagnostic imaging and concomitant pathology prior to ACL reconstruction surgery
  • 7:43 Multi-disciplinary decision making prior to ACL reconstruction surgery (Graft choice, surgeon, timing)
  • 11:40 Patient training age and goals prior to ACL reconstruction surgery
  • 12:47 Pre-operative ACL reconstruction surgery physical therapy - Strength, neuromuscular control, return to sport and long term outcomes
  • 14:05 Pre-operative goals prior to ACL reconstruction surgery
  • 16:18 Pre-operative physical therapy - swelling, range of motion and quad control
  • 17:15 Pre-operative physical therapy - Atrophy, neuromuscular control, balance and aerobic fitness
  • 18:55 How to restore range of motion prior to ACL reconstruction surgery
  • 22:58 The importance of PRE-operative quad strength and LONG term (1 year after ACL reconstruction surgery) outcomes and return to sport
  • 26:25 How much weaker and smaller is the quad after ACL reconstruction surgery?
  • 27:34 Contralateral limb training after ACL reconstruction surgery and training the rest of the kinetic chain
  • 29:57 The importance of aerobic conditioning after ACL reconstruction surgery and MAINTAINING as much as possible early on

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Thank you!

Dan Pope DPT, OCS, CSCS

References:

  1. Delaware - ACL-R Physical Therapy Protocol https://cpb-us-w2.wpmucdn.com/sites.udel.edu/dist/c/3448/files/2016/01/UDPT-ACL-Rehab-Guideline-REVISED.pdf

  2. Failla MJ, Logerstedt DS, Grindem H, Axe MJ, Risberg MA, Engebretsen L, Huston LJ, Spindler KP, Snyder-Mackler L. Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction? A Comparative Effectiveness Study Between the MOON and Delaware-Oslo ACL Cohorts. Am J Sports Med. 2016 Oct;44(10):2608-2614. doi: 10.1177/0363546516652594. Epub 2016 Jul 14. Erratum in: Am J Sports Med. 2017 Apr;45(5):NP9. PMID: 27416993; PMCID: PMC5537599.

  3. Kim DK, Park G, Wang JH, Kuo LT, Park WH. Preoperative quadriceps muscle strength deficit severity predicts knee function one year after anterior cruciate ligament reconstruction. Sci Rep. 2022 Apr 6;12(1):5830. doi: 10.1038/s41598-022-09816-3. PMID: 35388112; PMCID: PMC8986796.

  4. Minshull C, Gallacher P, Roberts S, Barnett A, Kuiper JH, Bailey A. Contralateral strength training attenuates muscle performance loss following anterior cruciate ligament (ACL) reconstruction: a randomised-controlled trial. Eur J Appl Physiol. 2021 Dec;121(12):3551-3559. doi: 10.1007/s00421-021-04812-3. Epub 2021 Sep 20. PMID: 34542671.

  5. Thomas AC, Wojtys EM, Brandon C, Palmieri-Smith RM. Muscle atrophy contributes to quadriceps weakness after anterior cruciate ligament reconstruction. J Sci Med Sport. 2016 Jan;19(1):7-11. doi: 10.1016/j.jsams.2014.12.009. Epub 2015 Jan 13. PMID: 25683732; PMCID: PMC4500756.

  6. Lepley LK, Davi SM, Burland JP, Lepley AS. Muscle Atrophy After ACL Injury: Implications for Clinical Practice. Sports Health. 2020 Nov/Dec;12(6):579-586. doi: 10.1177/1941738120944256. Epub 2020 Aug 31. PMID: 32866081; PMCID: PMC7785904.

  7. Charles D, White R, Reyes C, Palmer D. A SYSTEMATIC REVIEW OF THE EFFECTS OF BLOOD FLOW RESTRICTION TRAINING ON QUADRICEPS MUSCLE ATROPHY AND CIRCUMFERENCE POST ACL RECONSTRUCTION. Int J Sports Phys Ther. 2020 Dec;15(6):882-891. doi: 10.26603/ijspt20200882. PMID: 33344004; PMCID: PMC7727417.

  8. Watson A, Brickson S, Brooks MA, Dunn W. Preseason Aerobic Fitness Predicts In-Season Injury and Illness in Female Youth Athletes. Orthop J Sports Med. 2017 Sep 5;5(9):2325967117726976. doi: 10.1177/2325967117726976. PMID: 28904982; PMCID: PMC5588804.