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What's the best way to chart my progress and improvement during rehab for an ACL injury? I know what I want to get out of the program, but I don't know how to tell if it's happening.

Your physical therapist or other sports team member guiding you can help identify a scale or scales for measuring outcomes. There are many available for assessing patients with knee injuries. Some of the more common tools include the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), specific to osteoarthritis of the lower extremity, and the Knee Injury and Osteoarthritis Outcome Score (KOOS), geared toward sports injuries. Other knee specific (mostly focused on ligaments) include the International Knee Documentation Committee Subjective Form (IKDC), Lysholm Knee Scale, Cincinnati Knee Rating Scale, and the Anterior Cruciate Ligament Quality of Life (ACL QOL) score. The WOMAC may not sound like it fits young, athletes, but it does include subscales on pain, stiffness, and physical function. Each of these scales measure various aspects of physical functioning, emotional well-being, pain (and other symptoms), limp, work-related concerns, and sports participation. Sometimes specific activities such as running, cutting, decelerating, and pivoting are assessed. Just as important are measures for social functioning, emotional vitality, and quality of life. It may be helpful if you come up with a list of things you want to achieve to help gauge your own progress. Tools and scales such as these mentioned are helpful but they aren't meant to be used at the end of each day to mark progress. Your physical therapist will be measuring motion, strength, and flexibility. These short-term measures can be extremely helpful. At the same time, you may be self-evaluating symptoms such as pain, stiffness, and sports-related (or recreational activities) function.


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