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Structured Rehab Program After ACL Injury

Is a structured rehab program needed after anterior cruciate ligament (ACL) injury? Would such a program help athletes recover muscle strength to their preinjury strength? How would their strength compare to normal, healthy adults without an ACL tear? These are the questions asked in this study.

Four groups of men were included. Three groups had an ACL injury of differing lengths of time. The time periods included less than six months, six to 18 months, and more than 18 months.

One group of healthy males with no ACL injury was used as the control group for comparison. The control group exercised regularly at high levels making them a good match.

All men were athletes playing regularly in amateur leagues. Cutting and twisting sports such as soccer, basketball, and handball were the most common. After injury they didn't follow any kind of rehab program. They just did the R.I.C.E. approach with Rest, Ice, Compression, and Elevation.

Quadriceps and hamstring strength were measured for all four groups. A special machine (Biodex) was used to test strength. The Biodex was set at a speed of 60 degrees per second. This setting was chosen because it is less stressful than higher speeds. The 60 degrees per second speed also allows for more comparisons to be made.

The authors report that none of the men in the three ACL groups recovered their full strength. The strength on the injured side slowly improved when compared to the noninjured side. The hamstring muscle was more likely than the quadriceps muscle to come close to normal over time.

The authors conclude that a rehab program is needed after ACL injury. Time and activity will not restore normal strength for the athlete. Supervised training is advised to return to a preinjury level of sports activity.

An organized and guided exercise program may help prevent knee instability during the healing phase. It's possible this type of structured program could benefit patients who ultimately end up with an ACL repair. Improved knee function before surgery may enhance functional recovery after surgery.

References: Elias Tsepsis, PhD, et al. Thigh Muscle Weakness in ACL-Deficient Knees Persists Without Structured Rehabilitation. In Clinical Orthopaedics and Related Research. September 2006. No. 450. Pp. 211-218.

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