Anterior Cruciate Ligament (ACL) Injuries Surgery & Physiotherapy In Pre Post Rehab

Anterior Cruciate Ligament (ACL) Injuries Surgery & Physiotherapy In Pre Post Rehab

Introduction

Generally, a completely torn anterior cruciate ligament essentially requires surgical procedures for treatment. Surgeries are also usually recommended in cases where the patient is an athlete and wants to continue his / her high demanding sport, there is injury in more than one ligament, the patient is young and very active, and there is loss of stability in the knee due to the injury. However, pre and post-surgery rehabilitation therapy becomes pertinent. This is mainly because ACL injuries have a risk factor developing into knee osteoarthritis and a rehabilitation therapy programme negates that risk.

Pre-Surgery Rehabilitation Therapy

The significance of exercises in the pre-surgery period lie in the fact that they help in reducing the pain and inflammation after an ACL injury. Additionally, the exercises help regain motion and strength in the knee after the surgery, while negating the risks of knee osteoarthritis. It also helps prepare the patient mentally for the surgery.
Exercises generally include bridging, glute sets, hamstring curls, heel raises, heel slides, quad sets, shallow standing knee bends, straight-leg raise to the front, and straight-leg raise to the outside. These exercises are done under the thorough guidance of the physiotherapist, in a progressive manner, so that no stress is caused due to the exercises. Additionally, RICE (rest, ice, compression, elevation) and electrotherapy help reduce inflammation and pain, whilst ensuring one’s regain of motion range and joint flexibility.

Post-Surgery Rehabilitation Therapy

After the surgery / the ACL reconstruction, the rehabilitation therapy needs to be resumed as it is critical for full recovery. At this stage, several comprehensive steps, including a wide range of exercises are used to attain full flexibility and motion in the knee while avoiding knee osteoarthritis. Exercises include open-kinetic-chain knee-extension, open-kinetic-chain knee-flexion, and closed-kinetic-chain knee exercises.
The therapy and exercises are easy at the beginning, aimed at removing blood clots and gradually are increased in intensity aimed at restoring knee strength and stability. Weight bearing exercises are added depending upon the patient. The final phase of the therapy increases stress on the knees to a bearable extent. This therapy may take 5-6 months to help the patient be free of any pain and regain complete motion range. Generally, after 12 months of rigorous post-surgery rehabilitation, athletes can return to their heavy demanding sport.

Conclusion

Generally, the orthopaedic surgeon of the patient works with or in coordination with the physiotherapist. An ACL injury treatment that includes surgery is a very long procedure. The treatment starts at the very beginning, right after the injury. It starts with rehabilitation, moves into surgery, and then again ends with rehabilitation. It is a very comprehensive treatment procedure and enables the complete and effective cure of the ACL injury while negating any risk factor at the same time. We at Eva Physiocare are developing rehabilitation therapy programme both before and after surgery, where we coordinate with the orthopaedic surgeon of the patient, including diet therapy and an integrated wellness programme for ACL injury patients and focus on their complete care and cure.

Treatment_Osteoarthritis_Knee_Pain_Physiotherapy_Eva_Phsiocare

Treating Osteoarthritis of Knee: Surgery versus Physiotherapy

Introduction

Osteoarthritis is a situation that involves the wear and tear of the cartilage / natural cushioning between joints. The shock-absorbing capacities of the cartilage are reduced and results in the bones at the joints rubbing against each other causing pain, swelling, stiffness, inability to move, and emergence of bone spurs.
Knee pain is a standout amongst the most well-known yet ignored musculoskeletal conditions. Osteoarthritis is one of the leading causes of knee pain. While it can happen even in youngsters, the possibility of osteoarthritis ascends after the age of 45. Women are more prone towards it. Cases of osteoarthritis are rapidly increasing in India due to the changing lifestyles and eating habits.

Causes

The most common causes for knee osteoarthritis include factors of age; weight gain; heredity factors; gender (women above 55); repetitive stress injuries such as kneeling, squatting, or lifting heavy weights (55 pounds or more); athletics involving soccer, tennis, or long-distance running; and other illness such as rheumatoid arthritis, metabolic disorders (iron overload) and excess growth hormones.

Treatment: Surgery Versus Physiotherapy

Surgery is said to be the last resort for treatment of osteoarthritis of the knee. This is because in a revolutionary study on meniscal tears and the treatment of Osteoarthritis by the New England Journal of Medicine, it was resolved that there were no irrelevant contrasts between patients settling on surgery over an escalated regiment of non-intrusive treatment / physiotherapy.

The differences between the two procedures include:

  1. While surgical procedures involve arthroscopy, osteotomy, and arthroplasty; physiotherapy includes hamstring stretches, calf stretches, standing quadriceps stretches, seated leg raises, step-ups, straight-leg lifts, single-leg dips, hamstring curls, wall squats, half squats, knee stabilization series, static hamstring contractions, sit/stands, heel cord stretches, leg extensions, hip abductions and adductions and leg presses with resistance bands, in accordance to the physiotherapist’s guidance.
  2. The underlying problem with surgery is the possibility of adverse effects / risks due to intrusive procedures. Due to this, physiotherapy being a non-intrusive technique is considered safer.
  3. Surgery focuses on realignment of bones in joints, artificially, by the addition of artificial parts, cutting of excess bone, and general realignment. Physiotherapy, however, focuses on restoration of mobility and strengthening of muscles, in addition to weight management. Stretching, strengthening, and flexibility exercises, along with proprioception and balance exercises, and joint mobilization and manipulation, are effective in pain management, lowering inflammation, and restoring optimal balance after an injury.
  4. Most patients can administer to themselves and resume typical everyday exercises inside 6 weeks and drive inside 4 to 6 weeks. It might take 3 months to a whole year to completely recoup and acknowledge the advantages of knee surgery. Physiotherapy, on the other hand, needs no special recovery time and it spans over a period of 6 to 12 weeks only.
  5. In addition to all of this, it is to be acknowledged that surgeries are costly unlike physiotherapy.

Conclusion

Despite the problems posed by surgery, it is a definite tool in the treatment of osteoarthritis of knee, but only recommended in extreme conditions. Physiotherapy is in every way the best procedure to go about it. Physiotherapy is aimed toward biomechanical corrections of the affected knee, thereby preventing the osteoarthritis from taking a serious shape. It’s therapeutic nature and capacity to provide relief often postpones the need for surgery or dismisses it altogether. We at Eva Physiocare are working on preventive care that includes diet management in the integrated wellness programme.