ACL Reconstruction Rehab

These candidates may become future candidates for joint replacement which is a much bigger problem to solve.

In addition to forward restraint, the ACL also acts as a restraint to inward rotation of tibia during knee flexion.

These rolling and gliding motions between the surfaces allow for full flexion and extension of the joint.

The shallow and incongruent articular surfaces are unable to provide the necessary stabilisation in weight bearing positons for these subtle movements.

The cruciate ligaments along with the menisci and muscles are accountable for the functional range of movement (ROM) and joint stability in standing, running, walking etc.¹

The complex knee motion recruits all the 4 major ligaments in various combinations to provide stability as the knee bends.¹⁷

The ACL provides more than 80% of restraint between 30-90 degrees of knee flexion.

It also restrains excessive inward rotation of tibia during extension.¹⁸

Injury to the ACL thus impacts the knee function by affecting the dynamic stability.

The sensory receptors in the ligament send feedback about the position of the joint (proprioception).

This feedback reduces after injury.

The feedback from knee governs the muscle coordination between the hip and ankle during running, cutting etc.

This in turn affects the knee position and increases the chances of a second ACL injury.¹⁹

Dynamic stability of the knee is dependent on accurate sensory input and appropriate motor responses to rapid changes in body position during cutting and landing. ^20,24

Neuromuscular control of the hip, trunk, and knee is based on feedback control.

The position of each segment affects the position of segment below.¹¹

Poor feedback from the knee, impairs the trunk control further enhancing the risk of ACL injury. ²⁹

When are not rehabbed, knee injury create many types of compensatory mechanisms changing your movement biomechanics, muscle unitisation and tend to cause much bigger problems escalating rapidly.

Thus, during the examination of a suspected ACL injury, mechanism of injury becomes crucial.

Would you like to get rid of your knee pain, and successfully rehabilitate your ACL injury?

Contact us now through this link, HERE.

How Your Sport Medical Doctor Evaluates an ACL injury

The ACL is the most frequently injured structure in the knee with more than 70% cases resulting due to non-contact injuries where the foot is firmly planted on the ground and the athlete changes direction suddenly.

Direct contact injuries are seen in tackle sports such as football.

The client or the athlete may also report of severe pain and an audible pop or crack at the time of injury with episodes of giving way while running or pivoting.

He may also complain of instability.

There may be visible swelling.

Knee extension may be painful and limited.

There are reliable specific tests help to identify the ligament involved.

The Pivot shift test (rotatory instability) and the Lachman test (forward back ward instability) are more accurate in detecting a subacute or chronic ACL tear as compared to the routine anterior drawer test (forward back ward instability). ²⁰

How Grade 1, 2 and 3 Knee Sprains Will Affect Your Knee Recovery  

Depending on the symptoms, the ACL tear is graded as below:

Grade 1 sprain: The ligament fibres are stretched with no actual tear.

There is mild tenderness and swelling with no feeling of instability or giving way.

There is a firm end feel with no ligament laxity elicited while testing.

Grade 2 sprains: The ligament fibres are partially torn with haemorrhage.

There is tenderness and swelling around the knee with noticeable loss in function due to pain.

Ligament laxity with firm end feel is noted while testing.

The athlete reports of episodes of giving way or instability during activity.

Grade 3 sprains: There is complete breach of ligament integrity.

The knee is unstable with more episodes of giving way.

There is tenderness and moderate swelling but less pain.

There is rotational instability with no firm end point.

This is also referred to as an ACL deficient knee which needs ligament reconstruction to return to activity.

Would you like to get rid of your knee pain, and successfully rehabilitate your ACL injury?

Contact us now through this link, HERE.

Why Your ACL Injury Affects Other Ligaments and Knee Muscles and How to Avoid This Before Is To Late

ACL injuries rarely occur alone.

When occurring along with MCL and Medial meniscus injury, it is called as an Unhappy Triad or O’Donoghue triad.

There may be a very small injury to the subchondral bone, cartilage, tibial surface etc.

In some cases, there may also be associated injuries to the lateral collateral ligament, the posterior capsule and the popliteus muscle and tendon.

These are more evident on X-rays or MRI.

Since your body weight relies on healthy legs and the ACL injury has the ability to affect both positively and negatively your life forever, the knee rehabilitation is a very serious matter.

After a full screening of the knee joint it is important to assess the functional status of the patient, lifestyle, risks and his quality of life.

These and other very important elements will help us to set effective rehab goals for you and decide the very fine personalisation approach according with your particular needs, knee rehabilitation phases as well as the progression or regression of exercises.

The Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire also evaluates the functional status and quality of life (QoL) of patients with any type of knee injury who are at increased risk of developing OA; i.e., patients with anterior cruciate ligament (ACL) injury, meniscus injury, or chondral injury.²²

It has been proven that patient based outcome measures give a better picture of the quality of life than clinical tests alone.

Risk Factors for ACL Injuries

There are certain factors that up the risk of ACL injury.

1. Contact and pivoting sports –The pivoting action in sports like football and basketball or recreational plays where the client or the athlete swerves suddenly to avoid collision with another player is the main mechanism of injury.

The foot is planted on the ground and sudden change of direction provides an inward thrust on the bent knee.

This is a typical non-contact deceleration injury. ²³

2. Poor joint position sense and proprioception does not elicit timely recruitment of the quadriceps and the hamstring muscles.

The weak hip and ankle coordination and the low pelvic- hip control (core stability) as a result of poor core stability is another factor for recurrent ACL injury. ²⁵

3. Incorrect landing techniques for example landing with less knee flexion or greater inward deviation (Position of No Return), places greater stress on the ACL. ²⁵

4.  Active contraction of quadriceps (reflective eccentric contraction) during jump stop landings in athletes with weaker hamstrings puts more load on the ACL causing it to rupture.¹

5.  Foot hyperpronation: Athletes with increased foot pronation and internal tibial rotation usually have a greater anterior knee joint laxity which puts the ACL at increased risk of injury. ²⁴

6. Fatigue and Loss of concentration – compound the existing compromised neuromuscular control thus increasing the chances of ACL injury. ¹

7. Anatomic differences in men and women – Difference in the knee joint geometries and generalised ligament laxity make an athlete especially females more prone to ACL injuries. ²⁵

It is hypothesised that increased bone length and body mass, in the absence of matching adaptations in neuromuscular strength and coordinated muscle recruitment, expose the female knee to greater load and likelihood of ACL.^{30,31,12,16,32}

Females are also more prone to ACL injuries in the pre-ovulatory phase.

Estrogen has also been linked to increased risk of ACL damage in females.

8. Increased BMI and inactive lifestyle – Increased body weight in the presence of abnormal knee joint geometries can put increased loads on the knee as well as the ACL ligament raising the risk of injury. ²⁶

Younger individuals are at more risk of ACL injury due to their highly active lifestyle.

Recurrence of injury may be noted when individuals return too early to exercising, competitive sports or high activity games after a conservative rehab program.

Individuals who practice moderately active lifestyle (reduced frequency and intensity of exercise).²⁸

On the other hand, those individuals who opted a sedentary lifestyle due to re-injury fears led a low quotient of happiness and poor quality of life. ²⁸

9. Competition versus Practice – ACL injuries are more likely to occur in competition as opposed to practice matches.

This may be due to the increased aggression during matches. ⁴⁰

Consequences of ACL Injury on The Gait, Alignment and Foot

Client with ACL compromised knee joint, present with quadriceps, hip muscles and calf weakness and increased activation in the hamstrings. ^{35, 37} This results in impaired hip – ankle coordination while walking due to incorrect feedback from the knee.¹⁹ These clients also exhibit weakness in the hip abductors and external rotators. This results in weakness of the major core muscle – multifidus. The resultant pelvic tilt and trunk sway causes further medial knee collapse and re-injury to the ACL. ³³ Weakness of the multifidus resulted in chronic back pain in many individuals with ACL deficient knee. ACL deficiency also causes increased tibial inward rotation and flattening of the medial foot arches. ³⁴

We are all different.

I will professionally work with you and successfully help you addressing all your injury specific technicalities to reduce, retrain and eliminate the negative conseqeances you your knee injury.

Foods rich in Omega 3, Glucosamine chondroitin complex with M&M and antioxidant rich foods (food with Vitamin C and E) have been associated with reduced pain and inflammation and faster healing.

They have also showed energy building, weight loss, improved mental health and anti-ageing properties as they slow the degenerative process.

Turmeric, bromelain and garlic are just a few foods which have been known to contain anti-inflammatory properties.

The American Dietetic Association recommends eating foods with low saturated fat but high nutrient content.

Spinach, turnips and mangoes are rich in vitamin A, important for cell growth.

Kiwis, cabbage, baked sweet potatoes, tomatoes, and cantaloupe offer non-citrus alternatives for vitamin C.

Almonds have a high zinc content, which aids in wound healing. ^38,39

If is required Jazz will design for you an easy to follow healthy nutrition diet plan to helps you to lower inflammation levels, reduce pains, lose weight fast and safe, increase energy levels, improve your mood, skin texture and to reduce the effect of ageing.

Benefits of an ACL Rehab Program

A scientifically drafted customised ACL rehab programme will effectively speed up the recovery of any individual with ACL injury.

Since your knee is sensitive this will help you to avoing any knee re-injury risks.

ACL rehab program can be specifically designed for someone recovering from grade 1or 2 ACL sprains or someone who wishes to avoid surgery or for someone who wishes to return to optimum movement, exercise, competitive sports after a reconstruction surgery.

The incidence of a knee flexion contracture is associated with quadriceps weakness and extensor mechanism dysfunction.¹

The ACL rehab program avoids this by encouraging early weight bearing, ROM exercises, quadriceps strengthening, switching off overactive muscles, activating the right muscles, skill based exercise, correcting compensatory movements but, not limited to.

Guidance on developing strength and neuromuscular control in bilateral lower extremities and the core ensures a much faster recovery.

Introduction of personalised and complex exercises challenges push the client and athlete to work harder in each progressive phase and also fills him/her up with positive emotions.

Among other things this helps the client to overcome fear of instability.

The ACL rehab program more importantly addresses the issue of prevention of re-injury by correcting the whole or part of the technique.

Also, the closed kinematic chain exercises stimulate coordinated muscle work around the knee reducing the shear force between the knee joint surfaces.

This reduces the stress on the ACL playing a vital role in preventing recurrence of injury.¹

The knee rehabilitation programme also emphasises on maintaining and improving the cardiovascular endurance through customised cross training strategies.

This professional service also teaches you how to stay in shape after knee surgery and how to lose weight with a torn acl thus, working safe with an elite personal trainer after ACL surgery benefits you beyond the knee rehab.

The ACL knee rehab also works on the exercise enthusiast or athlete’s ability to focus and deal with distractions in the form of on negative street events, field perturbations or opponents.

During this phase, the client or the athlete is counselled on his ability to return to regular exercise or competitive training and professional guidance in terms of planning his/her competition year.

The client/athlete is guided on how to space major events like charity runs, marathon, triathlon, tough mudder, skiing competitions etc, or tournaments with some minor matches and rest periods to prevent recurrence.

The knee rehab also addresses any coexisting ligament or meniscal injuries which may be inhibiting full recovery.

The ACL rehab is futuristic as the athlete also gets advice on any exercise and activity modification that may be needed to stall the development of early onset arthritis.

Would you like to rehabilitate your ACL injury, to feeling again at your best ?

Contact us now through this link, HERE.

Personalised ACL injury Rehab Programmes by Jazz Alessi

Coming back from an ACL injury can be frustrating especially when the client or the athlete is at the top of their physical form.

The urge to hasten the rehab and overdo the exercises must be supervised and checked by a personal trainer after acl surgery as it will only delay the recovery by months whilst increasing dramatically the re-injury risks and a negative rehab outcome.

As a professional service provider of personal training after knee surgery with special interest in ACL knee rehab and an elite personal trainer, I understand what an ACL deficient knee needs.

Since more than 10 years, I have been rehabilitating around 20 – 30 people with acute and chronic knee injuries (ACL, PCL and Meniscus), each year on a one to one basis.

Using cutting edge technology, latest investigative tools and comprehensive assessment can help you to get an accurate picture of your injury.

I believe in working closely with your physiotherapist and sport medical doctor to conduct a thorough diagnostics and risk assessment before creating personalised and effective rehab plans for you.

This scientifically formulated knee injury rehab plan is tailor made for each individual and if required I will liaise with your physiotherapist and sport medical doctor.

As I deal with a variety of clients on and off the field, I understand the stresses put on the knee in various type of movements, sports and occupations.

My expertise in body mechanics and physiology is an important skill set, as this helps me understand the functional expectations of my clients.

As an injury rehabilitation trained elite personal trainer, and 2^nd Generation Pilates teacher I understand how a body as a whole, responds to ACL injury.

I focus on understanding the client’s current needs, fitness levels prior to the injury, his movements, lifestyle, game style (if the client is an athlete), biomechanical variations in the knee and the entire lower and upper extremity and his expectations after the ACL tear.

Each rehab case is different; some clients may have an isolated ACL tear while others may have other concomitant injuries to the meniscus or other ligament or other type of knee imbalances.

My ACL rehab programme covers all these issues.

I use a multidimensional approach in the management of ACL injuries, combining effective and personalised ACL rehab exercises but, also selected body conditioning, Pilates, Yoga, gymnastics, martial arts and weights to get the best results whilst keeping your training very entertaining.

As a 2^nd generation Pilates trainer, I use advanced biomechanics and knowledge of the core to design a preventive rehab for ACL injury cases.

A personalised nutrition diet plan will improve your energy levels, performance, and skin, enhance healing and prevent ageing and joint degeneration.

All these play an important role in returning to optimum movements, better mental health and achieving peak performance.

My clients are banking executives, CEO’s, lawyers, doctors, actresses and actors, marathon runners, Olympic athletes and footballers who enjoy my entertaining sessions as they get a complete rehab package when it comes to their ACL injury rehab.

I also focus in working with the client physical structure as a whole, rather than the joint alone.

Your personalised rehab package is very effective, fun, challenging and goal oriented.

All knee injuries rehabilitation packages are provided in Canary Wharf, Kensington, Central London, North London, whilst I am covering all Greater London and I am very flexible with time.

If you are suffering from an ACL injury wish to get rid of pain, regain your optimum movement for day to day living and peak performance, you can contact me on now by clicking on this link HERE,  and I will get back to you.