Longevity Personal Training and Exercise Physiology Edgecliff, Lindfield, Marrickville and Randwick regularly see ACL injuries. In the final part of our ACL injury series we will be discussing the surgical treatment approach.


Who Is Eligible For A Surgical Route?


Advancement in science over the past decades have made ACL reconstruction a very routine procedure that is an option for virtually anyone who has ruptured their ACL and is in good health. ACL reconstruction surgery is even more indicated in those participating in high risk activities and/or those who are predisposed to injuring their ACL. This includes highly active individuals, females and those under 50-year-old at the time of their injury.


How Is The Surgery Performed?


The surgeon will recreate your ACL by drilling holes in your femur and tibia then using a graft from your hamstring tendon, patellofemoral tendon or a synthetic tendon to attach the two bones together in the same location the native ACL originally occupied.


What Is The Prescription For A Surgical ACL Repair?


Pre surgery: Increase strength of the quadriceps, hamstrings and calves in isolation to increase knee stability and improve outcomes from your surgery. Simply put, the stronger you are before the surgery the better result you will have.


Post surgery: Refer to part II of the ACL injury series, as recovery from the surgery will mimic the recovery plan if you didn’t have the surgery. There are a couple extra things to take into account when training after the surgery:


    1. The new tendon, especially if it is a synthetic tendon, will not be as resilient as your native ACL


    1. If a graft is taken, the standard 6-8 week recovery timeline for that tissue to heal is introduced. This means slower progression of quadriceps/hamstring strengthening exercises compared to a non-surgical approach.


    1. Range of motion post-surgery will be dramatically reduced and will take longer to regain, although this is dependant on the individual


The final stage of recovery is when you introduce sport-specific training. Once you have cleared your initial return to basic activity, returning to sport is highly individualised and will always be progressed on the following variables:


    1. What are the demands of your sport and how can they be predictably replicated?
    • Rest : work intervals
    • Common movement patterns
    • Infrequent high-risk maneuvers performed in your position


    1. How does your knee respond when situations are unpredictable?


    1. Are you prepared to introduce predictable and unpredictable contact?


    1. Can you simulate a full game, contact included, with little or no knee pain?




Written By: Mitchell Hooper