01 Jul Preoperative Knee Ligament Rehabilitation
If you are unlucky enough to sustain a knee ligament injury which requires surgery you may not be aware that your rehab starts immediate after the injury itself. The second the injury occurs the body begins the process to repair the injury site.
This starts with inflammation which we all want to limit traditionally but contemporary practice involves embracing inflammation as it’s here that the base strength of all future healing takes place. The better the base scar the stronger the final scar. This includes all the signs and symptoms we know.. Redness, swelling, pain and lose of function.
If you go down the surgical path the better you go into it, the better you will come out of it with better outcomes immediately after surgery and at a two year follow up (Grindem et al., 2015). Delayed surgery is shown to have better outcomes (Shelbourne et al., 1991), as this gives you a chance to address these three things to reduce your chances of complications during rehab.
1) Removal of swelling: we all know what a swollen knee looks like but did you know that it only takes a tea spoon (5ml) of swelling within the knee to inhibit your quadriceps from working, specifically vastus medialis. So it’s removal ensures one hurdle is overcome.
2) Full knee extension: Swelling or effusion within the knee will stop you being able to fully straighten it. This subtle but vital range of motion is essential for normal walking to be established as soon as possible .
3) Good quadriceps activation/bulk: After these types of injuries you may notice that your muscle bulk reduces. It’s vital to start fighting this as soon as possible in a pain free manner. Low level activation is the starting point to ensure the connection between the muscle and brain are as good as possible. This also ensures you lose minimal bulk and gets the maid as strong as possible as you enter theatre. An aggressive program to restore 90% of quad function was undertaken by Hagglund et al. (2015) with superior results in those who reached the marker.
This type of work often gets ignored in general population whereas in elite sport it is a vital part of the process. Ensuring the patient returns from surgery in the best possible condition to maximise outcomes and get them back in the field.
Hopefully you’ll never need to act on the information above but if you don’t delay, invest in your knee and a good therapist to help you achieve the best outcome possible!