Do You Need Physical Therapy BEFORE ACL-Reconstruction Surgery?

By dpope2020

January 24, 2025

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Do You Need Physical Therapy BEFORE ACL-Reconstruction Surgery?

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In today's video we go over: Do You Need Physical Therapy BEFORE ACL-Reconstruction Surgery? FPF Show Episode 159 

  • 0:00 Introduction
  • 0:54 Do we have evidence to help decide if patients should perform physical therapy before ACL-reconstruction?
  • 1:40 What does PREHAB before ACL-reconstruction consist of?
  • 2:07 Does PREHAB improve SHORT-TERM (3 months) outcomes (strength, hop tests, function, pain) AFTER ACL-reconstruction?
  • 4:35 Evidence Review: Does PREHAB improve LONG-TERM (2 year) outcomes AFTER ACL-reconstruction?
  • 10:40 What SHOULD a prehab program consist of and how long should you prehab prior to surgery?
  • 18:09 Does having a PRE-op quad deficit (weakness) lead to increased weakness 2 years AFTER surgery?
  • 25:04 Shoulder you include plyometrics PRIOR to ACL-reconstruction surgery as part of prehab?
  • 26:50 Should neuromuscular exercises be included as a part of prehab programs and what's the rationale?
  • 31:14 What is the evidence based physical therapy checklist for proper prehab prior to ACL-reconstruction surgery?
  • 37:38  ACL Tear Surgery FACE-OFF [Which is BEST for Patients?

Pre-habbed and ready for surgery...

- Dan Pope DPT,OCS,CSCS

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Carter HM, Littlewood C, Webster KE, Smith BE. The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review. BMC Musculoskelet Disord. 2020 Oct 3;21(1):647. doi: 10.1186/s12891-020-03676-6. PMID: 33010802; PMCID: PMC7533034.

  2.  Grindem H, Granan LP, Risberg MA, Engebretsen L, Snyder-Mackler L, Eitzen I. How does a combined preoperative and postoperative rehabilitation programme influence the outcome of ACL reconstruction 2 years after surgery? A comparison between patients in the Delaware-Oslo ACL Cohort and the Norwegian National Knee Ligament Registry. Br J Sports Med. 2015 Mar;49(6):385-9. doi: 10.1136/bjsports-2014-093891. Epub 2014 Oct 28. PMID: 25351782; PMCID: PMC4351141.

  3. Eitzen I, Moksnes H, Snyder-Mackler L, Risberg MA. A progressive 5-week exercise therapy program leads to significant improvement in knee function early after anterior cruciate ligament injury. J Orthop Sports Phys Ther. 2010 Nov;40(11):705-21. doi: 10.2519/jospt.2010.3345. PMID: 20710097; PMCID: PMC3158986.

  4. Eitzen I, Holm I, Risberg MA. Preoperative quadriceps strength is a significant predictor of knee function two years after anterior cruciate ligament reconstruction. Br J Sports Med. 2009 May;43(5):371-6. doi: 10.1136/bjsm.2008.057059. Epub 2009 Feb 17. PMID: 19224907.

  5. Hartigan E, Axe MJ, Snyder-Mackler L. Perturbation training prior to ACL reconstruction improves gait asymmetries in non-copers. J Orthop Res. 2009 Jun;27(6):724-9. doi: 10.1002/jor.20754. PMID: 19023893; PMCID: PMC3597104.

  6.  Chmielewski TL, Myer GD, Kauffman D, Tillman SM. Plyometric exercise in the rehabilitation of athletes: physiological responses and clinical application. J Orthop Sports Phys Ther. 2006 May;36(5):308-19. doi: 10.2519/jospt.2006.2013. PMID: 16715831.

  7. Cooper RL, Taylor NF, Feller JA. A systematic review of the effect of proprioceptive and balance exercises on people with an injured or reconstructed anterior cruciate ligament. Res Sports Med. 2005 Apr-Jun;13(2):163-78. doi: 10.1080/15438620590956197. PMID: 16392446.