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New game-changer in physio-led ACL Rehabilitation

Following an ACL injury, the majority of people prioritise looking into their surgical options first. New evidence is suggesting that this may not be the best course of immediate action, or in some cases, required at all.

Instead, there is an increasing push for patients to undergo a period of prehab with optional delay of surgery, to improve physical and mental readiness and advance post-operative outcomes in the short (12 months) AND long term (5 years).

The new game-changer in physio-led ACL prehab is the recent 2019 KANON trial. Their findings demonstrated that the loss of patellofemoral cartilage thickness over 5 years following ACL injury depends on the initial treatment strategy. Those that opted for immediate surgery (no prehab) had a significant increase in cartilage loss 5 years later, compared to those that delayed surgery in favour of an initial period of prehab. This suggests that in young active individuals, delaying ACL reconstruction and managing ACL rupture with exercise therapy may alter their prognosis and 5-year outcomes in a positive direction.

ACL prehab, completed in preparation for surgery, aims to minimise the effects of swelling, stiffness and deconditioning. At least 6 weeks of prehab is recommended, and should include progressive quadriceps strengthening, restoration of full knee extension (straightening) range, stability exercise and elimination of swelling. This serves as an excellent time to prepare for what is to come following surgery.

Lastly, a course of prehab has also favoured a higher return to sport outcome compared with those that did not complete pre-surgical rehabilitation.

If you have recently injured your ACL and are currently contemplating rehab and surgical options, contact our clinic to book in with one of our physiotherapists. Our physio’s pride themselves on staying up to date with knowledge and skills in ACL rehabilitation management. We can help provide a personalised discussion regarding the likelihood of better or worse outcomes with each management option available based on the your personal and injury-related characteristics.

Book online or call (02) 4861 1223 for an appointment.


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