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Anterior Cruciate Ligament (ACL) Injury

Injury to the Anterior Cruciate Ligament (ACL) is one of the injuries that can occur during sports participation and which implies a longer period of stoppage and rehabilitation. This injury, which may be associated with trauma - due to contact with other athletes - or not - when changing direction or landing after jumping - causes acute pain in the knee, with the immediate onset of edema and loss of knee joint ranges.

One of the main questions associated with an Anterior Cruciate Ligament injury is whether or not rehabilitation should involve surgery. Currently, we know that there are individuals who are perfectly able to continue their lives without decreasing their functional capacity or activity level, with conservative rehabilitation, thus establishing itself as the first line of intervention in several cases. There are, however, situations in which this may not be the case.

Occasionally, the ACL injury also involves other structures, examples of which are the meniscus or other ligaments or cartilage in the knee. When these associated injuries are relatively extensive, surgery should be considered as the first-line intervention. In addition, even in situations of isolated ACL injury, surgical indication may be useful if 1) individuals who have the ambition to return to sports practice at a high competitive level and 2) individuals who have functional characteristics or during conservative rehabilitation that suggest the surgical option.

In the case of post-surgical patients, who are more associated with fear and lack of knowledge from the general public, rehabilitation in the acute phase should involve restoring knee joint amplitude (mainly extension), recovering muscle volume and the ability to production of strength in the quadriceps, and restoring capacities to the donor muscles (where the grafts for the new ligament come from) in particular, and to the remaining muscles globally. Finally, ideally, you should try to maintain your body composition and maintain activity levels and cardio-respiratory health.

For all these reasons, the strategy of choice that should form the basis of the rehabilitation process is exercise, which should be adjusted and parameterized according to the individual and his abilities, and according to the phase and characteristics of the injury and surgery. However, and in order to support the exercise, manual therapy and/or electrostimulation or thermotherapy, in the form of ice, may also be used.

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