Client Case Study: Early Stage ACL Rehabilitation

Anterior Cruciate Ligament (ACL) injuries are by far the most common injury in the sporting world and can occur from a range of different mechanisms. The mechanism of injury with the highest percentage of occurrence is non-contact ACL injuries, with a whopping 70% of all ACL injuries falling into this category. Non-contact ACL injuries are caused by forces generated within the individual’s own body from activities such as sudden changes of direction, poor landings and rapid deceleration.

Enter client case study: Cody

Cody is a very fit, healthy and strong male athlete in his 30’s, he participates in many different sports and fitness modalities, and also a competitor on the Australian Ninja Warrior TV show. Cody sustained an ACL injury when he fell awkwardly while completing an obstacle, dislocating his left knee. An MRI later revealed a complete rupture of his ACL, full thickness tearing of the Posterior Cruciate Ligament (PCL) and Medial Collateral Ligament (MCL), complex tearing of the lateral meniscus and partial tearing of many of the accompanying stabilising ligaments in the knee joint. Cody was required to wear a full leg splint for 6-8 weeks to assist in healing of the PCL and MCL before surgery was undertaken to repair his ACL.

Cody commenced guided rehabilitation immediately and commenced exercise rehabilitation with Absolute Balance at approximately 3 weeks post-operatively. The initial goals of Cody’s exercise programme for 6-8 weeks post-op were to gain full passive knee extension and a minimum of 90 degrees flexion, increase his proprioceptive awareness around the knee joint and begin to complete some closed kinetic chain (CKC) exercises to stimulate muscle activity surrounding the knee joint. Cody attended a review with myself at 8 weeks post-op and at this stage he had reached all of his phase 1 goals and we were able to progress him onto more complex activities such as balancing, gait retraining, cycling on a stationary bike and more complex CKC exercises including full range body weight squats, bridging and increasing time under tension for the quadricep and hamstring muscles. A short video showing some of these exercise progressions can be viewed on the Absolute Balance YouTube channel and on our other social media platforms.

Cody is due for his 12-week review next week which I will be attending with his surgeon. After this appointment, I will be updating his exercise rehabilitation programme again, so keep an eye out for more videos on how he is progressing through his recovery!

Alixe Luckins
B.Sc. Exercise Physiology
Senior Accredited Exercise Physiologist (AES, AEP) (ESSAM)