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A "Balanced" Diet of Exercise after ACL Surgery

You've had surgery on your knee to repair a torn anterior cruciate ligament (ACL). Now you're being sent to physical therapy for weeks of exercise. At first it's fun and interesting, but after a short while, you're bored and wonder: Do I really need to keep doing this? Won't my leg just get better on its own?

Physical therapists want the answers to those questions, too--and more! How soon after surgery can exercise begin? What types of exercises are necessary, and exactly what does each exercise do for the knee? Many new studies aimed at answering these questions are being reported.

This information will help physical therapists plan the right exercise program for each type of surgery. For example, in the case of the knee, exercises will be different for a weak ligament than for a ligament that has been repaired surgically. Therapists have been studying the ACL of the knee. They have developed a particular kind of exercise called neuromuscular training that may be useful after ACL surgery.

Neuromuscular training is used to help the muscles respond quickly and without "thinking." If you need to stop suddenly, your muscles must react with just the right amount of speed, control, and direction. After knee surgery, this ability doesn't come back completely without exercise.

Neuromuscular training includes exercises to improve balance, joint control, muscle strength and power, and agility. Agility makes it possible to change directions quickly, go faster or slower, and improve starting and stopping. These are important for walking, running, and jumping, and especially for sports performance.

The results of numerous studies show that neuromuscular training shortens the time it takes for muscles to react. This kind of exercise also increases the speed of muscle contraction, maintains knee function over six months, and reduces the number of knee injuries in the long run.

This information is just the tip of the iceberg for physical therapists. More research is needed to show which exercises help coordinate the muscles for walking, running, and other activities after ACL surgery. Therapists are studying how long it takes to return to pre-injury activity levels when doing neuromuscular exercises. Studies showing how long to do each exercise and the effects of activities other than exercise are also underway. 

It's like your mother always told you: eat your vegetables, drink plenty of water, and oh yes, follow your therapist's advice about exercise.

References: May Arna Risberg, PT, PhD, et al. Design and Implementation of a Neuromuscular Training Program Following Anterior Cruciate Ligament Reconstruction. In Journal of Orthopaedic & Sports Physical Therapy. November 2001. Vol. 31. No. 11. Pp. 620-634.

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