ACL Rehab Journey – So you’ve torn your ACL… What next?

I am writing about my recovery and rehab after rupturing my ACL last February.

Throughout this, I will cover the pre-injury period, the non-surgical and surgical rehab options, along with the prehab and post injury management for these.

I am a private practice physiotherapist at Be Your Best Physiotherapy in Cranbourne, and a physiotherapist for Port Melbourne Football club. I frequently see patients with sporting injuries (including ACL tears), along with treating those in the community with neck and back pain.

The upcoming section will cover the period directly after my ACL rupture, and the rehab following it.


For the first two weeks post injury, I had firmly believed I could manage this injury conservatively and get back into my normal lifestyle. After seeing my scan results, and speaking to my boss at work, my next step was to book in with a trusted sports doctor, for further opinion and consultation.

Following the consultation, we reached the conclusion that surgery would be the best option.

I was surprised at how easily I had made the decision, after consulting with other physios at work, and with the sports doctor. Looking back, I feel that I was mostly in denial about the injury for the first two weeks, which quickly changed after considering the situation in its entirety.


I went to the surgeon and was placed on a waitlist for an ACL reconstruction and meniscal management (this basically means that they decide during the surgery, if they need to fix the meniscus or not), using a graft from my hamstrings.

At this point I was still uninterested in immediate surgery and was more focused on continuing with work. I was still working at a football club and had taken a short break from running out after injured players, being limited to working from the bench.


I was happy to wait for the ACL reconstruction. I felt that a longer wait would only give me more time to strengthen up and prepare my knee. With so much research showing the benefits of a good rehab period before surgery, I wanted to give myself the best option.

Consider also that we were enjoying a short burst of ‘Covid AND lockdown-free life’ in Victoria at this time (March 2021), so the last thing I wanted to do was go in for surgery!


At four weeks post injury, I started practicing hopping, skipping, and jumping. I was at the gym most days, working on any leg exercises I could safely do.

Leg exercises involved squats, split squats, lunges, Romanian deadlifts (double and single leg), calf raises, step ups and step downs! I progressed my strengthening carefully and gradually, ensuring I used a wide range of exercises, to improve any deficiencies I could find.


By six weeks post injury, I went out onto the track and tried my first run. I recorded a video of myself attempting my first ACL free running effort (it was not pretty). I watched back the footage, rested, repeated, and continued to practice my straight line running occasionally over the following 6 weeks.


At 12 weeks post injury, I was back running 3-4km along beach trails, and in August (5 months post injury) I completed a 10km run along the beach, without an ACL.

There was lots of hard work and training involved with reaching this level post injury. I was running 3-5 times a week and going to the gym 3-4 times weekly, continuing my strengthening rehab.

From day 1 post ACL injury I was doing exercises, and this helped maintain strength and function. I strongly believe that being able to continue working immediately after my injury, was also very helpful in speeding up my recovery.


Finally, I was at a level with my rehab where I had returned to pre-injury levels in almost everything. I was running, working, exercising regularly, and even going for the odd nature hike.

I wouldn’t have felt comfortable going on a very challenging hike or climb, and didn’t feel like I was ready to play any physically challenging sports. For most people, this would be a comfortable level of function, without any need for surgery.

At the start of spring in 2021, I felt adequately prepared for the ACL reconstruction, and I was hopeful that the surgery date would come soon.

ACL Rehab Journey – Intro

I am writing about my recovery and rehab after rupturing my ACL last February.

Throughout this, I will cover the pre-injury period, the non-surgical and surgical rehab options, along with the prehab and post injury management for these.

I am a private practice physiotherapist at Be Your Best Physiotherapy in Cranbourne, and a physiotherapist for Port Melbourne Football club. I frequently see patients with sporting injuries (including ACL tears), along with treating those in the community with neck and back pain.

This is intended to help those in similar situations, and to provide a different perspective on ACL recovery, compared to those seen more commonly in professional sports.


Over one year ago, early February 2021, I travelled to Tasmania to complete a multi-day hike.

I was carrying a 3-month-old meniscus (knee cartilage) injury sustained playing futsal, which had fully recovered. I was back playing futsal already (albeit with a well strapped knee) and had full confidence in my ability to climb steep slopes and run across uneven trails.

My original meniscus injury happened towards the end of a futsal match in December 2020. I was sliding in to reach for a loose ball, and during my slide, my right knee gave way.

I went down, hobbled off, and iced my knee. Despite significant swelling, the knee felt stable and pain free. I was able to continue working the following day, with a slight limp (my patients had a great time watching me climb the stairs for exercise classes).

Before returning to futsal, I was back running, was able to skip and hop on one leg and change direction, without any pain. I made sure that everything was stable and ready to go.

Once I returned, initially I felt that I was pulling out of larger leaps and lunges, although I was gradually getting more confidence in my knee. My leg hairs were disappearing as I strapped my knee twice a week.


During one match in March, I felt that my knee was a little less stable than usual. I came off to the bench to test out my knee, after feeling that it wasn’t right. After trying some drills on the bench, I decided that the knee was going to be ready to play, and I went back on the field. This is the moment before I tore my ACL.

The injury itself was quick and innocuous. I was jumping in the air during a defensive action, about to change direction off my right leg. This is when my knee suddenly ‘gave way’ and popped.

Most ACL injuries in sports occur exactly like this. I walked off the pitch. Afterwards, sitting on the bench I could feel my quads and hamstrings twitching and spasming when I tried to straighten my leg. I drove home, applied frozen peas, and got ready for bed.


Over the following two weeks, I continued to work, giving my patients déjà vu as they watched me struggle up and down the stairs again.

I went out and spent time with friends, playing down the seriousness of my injury. Unfortunately, I had to cancel my plans to go wakeboarding that weekend (it was a tough call to make).

After ignoring my injury and hoping it would go away, I eventually decided to pay more attention to it. As I had feared, after a proper assessment of my knee, it was clear that I had ruptured my ACL, among other injured structures.

Here are the gritty MRI details:

  • Ruptured ACL.
  • Subcortical impaction fracture of the posterolateral corner of the tibial plateau.
  • Grade 1 LCL tear.
  • Interstitial tear of proximal popliteus tendon.
  • Complex tear of the body and posterior horn of the medial meniscus.
  • Moderate subcortical contusion of medial tibial plateau.
  • Small grade 2 partial tear of deep proximal MCL fibres.
  • Mild lateral patellar subluxation.
  • Hoffa’s fat pad contusion.

I can imagine how a non-medical or lay person reading this about their own knee, not understanding any of these words, may feel that their knee is stuffed. I knew what most of these words meant, and I was therefore able to understand more clearly that my knee was stuffed.

Strength Classes

We have two strength classes per week! This fun class is ideal for those recovering from injury or illness and looking to return to exercise in a safe and supportive environment.

Bookings are essential: please call the clinic on 5996 2693

Hydrotherapy

Hydrotherapy classes have returned! Hydro is ideal for those returning to exercise after injury or illness. Classes are instructed by our physiotherapists and are claimable on private health insurance.

Classes are at 2pm on Thursdays at Casey RACE.

Bookings are essential: please call the clinic on 5996 2693

National Conference of Incontinence

Michelle attended the National Conference of Incontinence.

The first topic discussed was the management of complications of pelvic mesh. Michelle has seen a number of women with pain following use of mesh in pelvic surgery. The Government has set up a registry of pelvic surgery and the rates of mesh use in surgery in Australia is reducing.

 

The second part of the Conference was about preventing maternal birth trauma. Sadly 1/3 of mothers in Australia report birth trauma – physical, psychological or a combination of both. One of the presentations looked at factors before, during and after delivery to reduce the risk of trauma.