LOCAL PHYSICAL THERAPY FOR ATHLETES AND ACTIVE INDIVIDUALS

Acl Reconstruction Rehabilitation
Two Weeks After Acl Reconstruction Surgery

Early in the ACL reconstruction rehab process there are two main goals. The first is to maximize quadriceps activity and the second is to restore full knee extension. For us, in addition to our exercises, there are also two absolute necessities immediately following surgery. We must be using nueromuscular electrical stimulation on the quad for the entire session, and we must use blood flow restriction.

While using these modalities, we perform a variety of exercises as seen in this video. We also will be completing your standard lower level activities such as straight leg raises, quad sets, heel slides and knee extensions. Manual therapy should consist of range of motion interventions, along with patella and scar mobilizations.

Six Weeks After Acl Reconstruction Surgery

At the six week mark in ACL rehab we begin to transition from lower level activities to functional exercises. At this point your range of motion should be equal to the non-operated leg, the swelling should be minimal, and the quad strength should be continually improving. If you meet all these requirements it is appropriate to move to functional strengthening exercises such as squats, lunges, lateral lunges, step ups ect.
We should continue to use Blood Flow Restriction and Nueromuscular electrical stimulation throughout the session. Manual therapy should continue for scar and patella mobilization, and range of motion.

What Is Bfr & Why Do We Use It For Acl Rehab?

Blood Flow Restriction is a tool used in rehab to occlude blood flow into and out of the muscle. This occlusion causes pooling in the capillaries of muscles that will issue a hormonal response within the muscle to increase strength and hypertrophy. Using this allows us to increase strength in the quad without increasing external resistance. It is important for ACL rehab because the quad muscle becomes inhibited following surgery. The BFR allows us to build back the strength we need to perform activities and to progress in rehab. It is a vital part of the ACL rehab process.

What Is Nmes & Why Do We Use It For Acl Rehab?

Nueromuscular electrical stimulation is a device used to assist muscle activation. The unit should be applied and kept on the quad muscle for the entire session. Placing your Estim unit on the NMES setting at a high frequency and intensity (high enough to cause visible muscle contraction) can facilitate the necessary muscle strengthening. Early NMES helps to reduce muscle atrophy and has been proven to work on a cellular level to mitigate maladaptions.