The anterior cruciate ligament, or ACL, is considered by many to be the most important ligament contributing 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 slipping or rotating on the femur. Due to its location and purpose, the ACL is very susceptible to injury, especially in a sporting environment that requires the athlete to quickly change direction or cut. In fact, an estimated 70% of all ACL tears occur under these exact circumstances.

Once an individual has injured their 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 choose 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 the same or similar condition as before the injury. 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 he rehabilitates from his injury and returns to his 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 faced with combined knee injuries, surgical treatment is likely to be their only option. However, studies show that non-surgical methods may be effective or even indicated in patients:

· Who have sustained a complete tear but do not exhibit knee joint instability during low-impact activity.

Who live a more sedentary lifestyle and only do light manual labor.

· Without instability and with partial breakage.

They are still developing and growing.

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

The mainstay of non-surgical treatment of an ACL tear is to improve stability. As such, these treatments may 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 belt stretches, heel slides, and quadriceps stretches 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 insults or tears her ACL, he often finds that he loses control of his leg. Not only does the joint become unstable, but the thigh muscles often become extremely weak. So if the patient takes a wrong step or his weight shifts off center, his knee will collapse and the joint will give way completely. The only way to combat this factor of an ACL tear is to increase strength.

Along with physical therapy, the patient will need to be mindful of their injury, regardless of the setting. At home and at work they will need to rest as much as possible and only increase their activity as directed by their physical therapist. As part of this process, the therapist may require you to be on crutches for a week or two while the swelling and pain subside. The goal is to rehabilitate the patient without aggravating the knee or, even worse, re-injuring the joint.

If a patient meets the requirements for non-surgical ACL rehabilitation and is dedicated to their treatment, then they can 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 the individual 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 the flexibility of the joint. 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 assess the individual patient and measure their desired daily level of activity. At that point, it is possible to recommend treatment options and move forward.