Case Scenerio ACL Tear Rehabilitation

🩺 Case Scenario: ACL Tear Rehabilitation in a 22-Year-Old Football Player

Patient Profile

  • Name: M.A. (initials only)

  • Age: 22 years

  • Gender: Male

  • Occupation: University student & football player

  • Medical History: No previous surgeries, non-smoker, no comorbidities

Presenting Complaint

M.A. reports severe pain and swelling in the right knee after landing awkwardly during a football match. He describes a “popping sound” at the time of injury, followed by instability while walking.

 Initial Examination & Findings

  • Observation: Swelling around the right knee joint, antalgic gait.

  • Palpation: Tenderness at medial aspect of the knee.

  • Range of Motion (ROM): Painful & limited flexion beyond 90°.

  • Special Tests:

    • Lachman’s Test → Positive

    • Anterior Drawer Test → Positive

  • MRI Report: Complete tear of the Anterior Cruciate Ligament (ACL).

Diagnosis: Right ACL Tear (post-traumatic, sports-related).

 Physiotherapy Management Plan

🔹 Phase 1: Acute Phase (0–2 Weeks)

Goals: Reduce pain, swelling, and maintain ROM.

  • Rest, Ice, Compression, Elevation (RICE).

  • Isometric quadriceps sets.

  • Ankle pumps to improve circulation.

  • Gentle passive knee extension (avoid hyperextension).

  • Crutch-assisted walking, weight-bearing as tolerated.

🔹 Phase 2: Subacute Phase (2–6 Weeks)

Goals: Restore ROM and improve muscle activation.

  • Heel slides (flexion exercises).

  • Stationary cycling with low resistance.

  • Straight leg raises in multiple planes.

  • Patellar mobilizations to prevent stiffness.

  • Begin closed-chain exercises (mini squats, step-ups).

🔹 Phase 3: Strengthening Phase (6–12 Weeks)

Goals: Regain quadriceps & hamstring strength, improve stability.

  • Resistance band exercises for hamstrings & hip muscles.

  • Leg press (light weight, controlled movement).

  • Proprioception training (single-leg stance, wobble board).

  • Gradual progression of functional activities.

🔹 Phase 4: Advanced Training Phase (3–6 Months)

Goals: Return to sport-specific drills.

  • Plyometric training (box jumps, side hops).

  • Agility drills (zig-zag runs, shuttle runs).

  • Sport-specific movements (kicking practice under supervision).

  • Continue strengthening & flexibility exercises.

🔹 Phase 5: Return to Sport (6–9 Months)

Goals: Full recovery and safe return to competitive football.

  • Functional testing (hop test, agility test).

  • Return-to-play protocol after clearance from orthopedic surgeon & physiotherapist.

  • Injury prevention program (warm-up drills, neuromuscular training).

 Progress Notes

  • Week 1: Swelling reduced, patient able to walk with crutches.

  • Week 4: Improved ROM (0–120°), quadriceps activation achieved.

  • Week 8: Patient performing closed-chain strengthening & balance training.

  • Week 16: Jogging on treadmill, no instability.

  • Month 6: Passed functional tests, returned to practice sessions.

 Discussion & Learning Points

  • Early mobilization prevents stiffness and speeds recovery.

  • Closed-chain exercises are safer for ACL rehab than open-chain in early stages.

  • Proprioception & balance training are as important as strength training.

  • Gradual progression → avoids re-injury.

 Key Takeaway for DPT Students

“ACL rehabilitation is not just about strengthening the quadriceps. It is a step-by-step process that restores mobility, stability, proprioception, and confidence. Always individualize the rehab plan based on the patient’s progress.”


Comments

Post a Comment

Popular posts from this blog

What is a dpt program?

 🩺 What is the DPT Program?  If you've ever been fascinated by how the human body moves and heals — and want a career that blends science, care, and impact — then a  Doctor of Physical Therapy (DPT)  program might be your perfect match. Whether you're a high school student exploring health careers, a college graduate looking to specialize, or just curious about physical therapy education, this article will break down  what the DPT program is , what it includes, and how it prepares you to become a licensed physical therapist. 🧠 What is a DPT Program? The  Doctor of Physical Therapy (DPT)  program is a  postgraduate professional doctorate  designed to train students to become licensed  physical therapists (PTs) . It’s the  entry-level requirement  for anyone who wants to practice as a PT in many countries, including the United States. This degree focuses on: Movement science Patient rehabilitation Injury prevention Manual thera...
Read more

What is osteogenesis imperfecta?

Image
What is Osteogenesis Imperfecta? | Causes, Types, Symptoms & Treatment Osteogenesis Imperfecta (OI) , also known as “brittle bone disease,” is a rare genetic disorder characterized by fragile bones that break easily , often with little or no trauma. It affects the production of collagen , a key protein that provides strength and structure to bones and connective tissues.  What is Osteogenesis Imperfecta? Osteogenesis Imperfecta is a hereditary connective tissue disorder . It primarily affects the bones but may also involve the teeth, skin, ligaments, and eyes . The condition is caused by mutations in genes—mostly COL1A1 or COL1A2 —that control the production of type I collagen . As a result, bones become brittle, leading to frequent fractures and skeletal deformities.  Types of Osteogenesis Imperfecta  There are at least eight recognized types of OI, varying from mild to severe. Here's a simplified breakdown: Type Description Severity Type I Most...
Read more

what is brain encephalitis?

Image
Brain Encephalitis: Causes, Symptoms, Diagnosis & Treatment Encephalitis is a serious and potentially life-threatening medical condition characterized by inflammation of the brain . It is often caused by a viral infection   but may also occur due to autoimmune reactions , bacteria, or other pathogens. If not treated promptly, encephalitis can lead to severe neurological complications .  What is Brain Encephalitis? Encephalitis is the inflammation of brain tissue. The inflammation causes the brain to swell, which can interfere with normal brain function and lead to a wide range of neurological symptoms. It can be classified as: Primary encephalitis : Direct viral infection of the brain. Secondary encephalitis : An immune response following an infection elsewhere in the body. Causes of Encephalitis 1. Viral Infections (Most Common Cause) Herpes Simplex Virus (most common and severe) Enteroviruses Varicella-zoster virus (chickenpox) Measles, mump...
Read more