ACL Injury and Reconstruction – Overview
The ACL (anterior cruciate ligament) is a ligament deep inside the knee joint, which is designed to prevent the lower leg moving, or shearing forward relative to the thigh. ACL tears and ACL injuries are extremely common in sports, particularly where sudden stop-start running movements are required, such as in soccer, tennis, basketball, netball, etc.
The prognosis and the requirement for an ACL reconstruction is dependent on the degree of tear. If the tendon is severely torn or ruptured completely, then surgery is usually indicated. However, minor tears can heal sufficiently well in most people for normal knee function to be restored.
ACL Reconstruction – Symptoms
Clients with ACL injuries will usually report an audible “pop” at the time of the injury. In response to the injury, the knee will usually swell up considerably within a few hours. They will be unable to carry on playing, report significant pain and loss of movement.
A simple orthopaedic test for ACL injuries is the anterior drawer test, which involves the therapist pulling the lower leg forward in relation to the thigh, when the knee is in a bent position.
Ms E* presented at Ravel Therapies Massage Limassol with pain in the medial knee several months after having had an ACL reconstruction.
Assessment
Our musculoskeletal and remedial massage Limassol therapist, Sunil, carried out a number of orthopaedic tests to rule out any obvious injury to other structures in the knee joint, including the ACL itself. He then carried out movement analysis of the client performing squats, lunges and skips. It was immediately evident that there were still significant muscle imbalances around the knee joint which were giving rise to the client’s symptoms.
It is very common after knee surgery for the vastus medialis obliqus (VMO) muscle fibres to weaken. This is the muscle on the inside of the knee, and weakness here allows the knee to migrate towards the midline when walking and running. This places pressure on the structures inside the knee and can cause medial knee pain.
Ms E showed signs of having tight adductor and hip internal rotator muscles, with weak hip abductors.
Ravel Therapies Massage Limassol –ACL Reconstruction remedial massage
At Ravel Therapies massage Limassol, Sunil’s treatment was focused on restoring proper muscle balance between the muscles around the hip and knee joints.
Deep tissue massage, trigger point therapy and PNF stretching were provided to the TFL muscle, ITB and vastus lateralis (outer thigh) muscles. Similarly, the adductor muscle was released through soft tissue manipulation and stretching.
The client was given exercise to strengthen the VMO and the gluteus medius (buttocks) muscles.
Kinesiology taping was applied to the client’s knee to prevent patellar maltracking (poor tracking of the knee cap) and to improve the client’s ability to retrain her brain to hold correct alignment.
The Result
Ms E noticed immediate improvement after the first treatment, as is usually the case with this kind of client presentation. Within 4-5 treatments, Ms E was generally symptom free, except for a dull ache, after very intense sport sessions. By the 8th treatment, Ms E was unaware of this ache, however her knee alignment was yet not as good as the “good” knee on inspection.
Ms E continues to be symptom free and continues to carry out her exercises diligently. The long-term goal is to restore 100% alignment in her injured knee (if possible), to prevent wear and tear of other structures inside the knee joint.
* Please note that the client’s personal details have been concealed for confidentiality purposes, but this report is a true, factually accurate case study.
Visit Ravel Therapies Massage Limassol
Ravel Therapies
Noe 3, Ayia Phyla
Limassol 3117
Cyprus [map]
Call : 97 783 383
Email : sunil@raveltherapies.com.cy
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Disclaimer : Please note that the contents of this article are the opinions of the author only, and do not constitute medical advice. If you have any symptoms of pain, please consider booking in with Ravel Therapies for a proper consultation.
