The anterior cruciate ligament, or ACL, is considered by many to be the most important ligament that contributes to knee stability. Attached from the front of the tibia to the back of the femur, the purpose of the ACL is to prevent the knee joint from moving out of place or twisting on the femur. Due to its location and purpose, the ACL is very susceptible to injury, especially in a sports environment that requires the athlete to change direction or cut quickly. In fact, it is estimated that 70% of all ACL tears occur under these exact circumstances.

Once a person has been injured, ACL treatment is necessary. Depending on the severity of the tear, many patients choose to undergo surgery in an effort to restore stability to the knee joint while striving to return to their previous level of activity as soon as possible. However, an increasing number of patients are choosing to rehabilitate their injury without any surgical intervention. In this article we will explore alternative treatment options while discussing which patients are most likely to benefit from this type of therapy.

The goal of non-surgical ACL therapy is the same as any other treatment option, to restore the patient to a condition equal to or close to their pre-injury state. This type of treatment approach also goes hand in hand with patient education. The idea is to show the patient how to prevent instability while rehabilitating their injury and returning to their normal level of activity.

It is important to note that not all patients will qualify for a non-surgical ACL treatment protocol. If a patient is facing combined knee injuries, surgical treatment is likely their only option. However, studies show that non-surgical methods can be effective or even indicated in patients:

Those who suffered a complete tear but do not have knee joint instability during low-impact activity.

They lead a more sedentary lifestyle and only do light manual work.

· No instability and only with a partial tear.

That are still developing and growing.

If a patient meets one or more of these requirements, they are likely an ideal candidate to move forward with non-surgical treatment options.

The foundation of non-surgical treatment for an ACL tear is to improve stability. As such, these treatments can be prescribed in conjunction with the use of a hinged knee brace. Therapy begins with the patient’s initial visit to their healthcare professional. After assessing the severity of the injury, the patient should be sent home to rest while he begins anti-inflammatory therapy and drastically modifies his daily activity. The goal of this first stage is to reduce swelling so that the patient can regain a normal range of motion through the knee joint. Typically, patients will also report an improvement in joint strength during this phase.

Once the swelling has subsided, the patient will begin their non-surgical rehabilitation. This includes targeted treatment with a physical therapist who will work to improve the patient’s range of motion and strength. The patient will work on exercises such as the belt stretch, heel slide, and quadriceps stretch while slowly warming up their body and improving their range of motion. They will then work on strength through a variety of exercises such as heel raises, lunges, hamstring curls, and squats.

Keep in mind that strength is key to a patient’s rehabilitation, especially immediately after their injury. When a patient injures or tears the anterior cruciate ligament, they often find that they lose control of the leg. Not only does the joint become unstable, but the thigh muscles often become extremely weak. So if the patient takes an incorrect step or their weight shifts off-center, their knee will collapse and the joint will completely give out. The only way to combat this ACL tear factor is to increase strength.

Along with physical therapy, the patient will need to be aware of his or her injury from the environment. At home and at work, they will need to rest as much as possible and only increase their activity as instructed by their physical therapist. As part of this process, the therapist may require you to use crutches for a week or two while the swelling and pain subsides. The goal is to rehabilitate the patient without aggravating the knee or worse, re-injuring the joint.

If a patient is eligible for non-surgical ACL rehabilitation and is dedicated to its treatment, they may be able to return to normal activities within eight to ten weeks of injury. However, recovery is different for each individual. What works perfectly in one case may be completely ineffective in another. The recovery process is unique to each patient and will vary. If a patient has been diligent with their non-surgical rehabilitation efforts and is still suffering from knee joint instability, they may want to explore surgical treatment options.

This type of non-surgical treatment can strengthen the leg and improve joint flexibility. You cannot repair the ACL. Because of this, it will not be ideal for all patients. The only way to determine the appropriate treatment plan is to evaluate the individual patient and measure their desired daily activity level. At that point, it is possible to recommend treatment options and move on.