NEW RESEARCH: Full ACL tears may not always need surgery!
By Dr. Taylor Austin, Chiropractor
Anterior Cruciate Ligament (ACL) injuries are one of the most common knee injuries, often resulting from sports activities or traumatic accidents. Historically, surgical intervention has been the primary treatment option for ACL tears. Over the recent years in Australia alone ACL reconstruction surgeries have increased by 43% within the last decade (1). However, recent research has shed light on the effectiveness of non-surgical rehabilitation protocols in ACL repairs, revolutionizing patient outcomes and challenging traditional treatment approaches.
The ACL is a crucial ligament in the knee joint which detects changes in direction, position of the knee, and changes in speed, acceleration and rigidity (2). When the ACL is torn, patients often report hearing or feeling a pop, swelling and experience pain, instability, and difficulty engaging in physical activities (2). Previously, surgical reconstruction was considered the gold standard treatment for ACL tears (1). However, advancements in non-surgical rehabilitation have shown promising results and have become an attractive option for many patients.
The Evolving Approach: Non-Surgical Rehabilitation:
Early Intervention and Structured Rehabilitation Programs: Recent studies have emphasized the importance of early intervention following an ACL tear. Patients who undergo supervised, structured rehabilitation programs soon after the injury have shown remarkable improvements in their range of motion, strength, and stability. These programs are typically tailored exercises to the patient's specific needs, ensuring a safe and progressive recovery process.
Targeted Strengthening and Neuromuscular Training: Non-surgical rehabilitation focuses on targeted strengthening exercises that address muscle imbalances and promote joint stability. This includes exercises to strengthen the quadriceps, hamstrings, and gluteal muscles, which play a vital role in knee stability. Neuromuscular training, such as balance and proprioception exercises, enhances muscle coordination and reduces the risk of future ACL injuries (3).
Biomechanical Analysis and Individualized Treatment: Advancements in technology, such as motion capture systems and force platforms, allow for detailed biomechanical analysis of patients' movements during functional tasks. By identifying movement patterns that may contribute to ACL injuries, therapists can create personalized treatment plans that target specific deficits. This individualized approach has shown to improve patient outcomes and reduce the risk of re-injury (4).
Benefits of Non-Surgical Rehabilitation:
Avoidance of Surgical Risks: Though surgery is sometimes necessary it doesn’t come without its risks. These can include infection, blood clots, and complications from anesthesia. Non-surgical rehabilitation offers a conservative approach that eliminates these risks, making it an appealing option for patients who may be hesitant or unable to undergo surgery.
Faster Recovery Time: While surgical reconstruction often requires a prolonged recovery period, non-surgical rehabilitation can lead to faster recovery times. Patients can begin rehabilitation immediately after the injury, allowing them to regain knee function and return to their daily activities more quickly (5).
Cost-Effective Treatment: Surgical procedures, including pre-operative tests, hospital stays, and post-operative care, can be expensive. Non-surgical rehabilitation presents a cost-effective alternative, reducing the financial burden on patients and healthcare systems.
Recent advancements in non-surgical rehabilitation have challenged the traditional approach to ACL tears, offering patients a safe, effective, and personalized treatment option. Our chiropractors focus on early intervention, targeted strengthening, and individualized therapy for an ACL injury. Patients who experience an ACL tear should be advised that surgical repair is not the only option and a conservative approach with a rehabilitation plan can be an option. As research in this field continues to evolve, non-surgical rehabilitation will undoubtedly play an increasingly significant role in the management of ACL tears, benefiting patients and improving their quality of life.
