With over 200,000 ACL injuries per year and over half of those injured going to go surgery, the ACL is a hot topic within the performance and health fields alike. But what is the ACL? What does the ACL do? Do you need surgery after an ACL injury? What all is entailed in an ACL reconstruction surgery? We answered all those questions and more in this fantastic interview with an orthopedic surgeon!

 

Dr. Nima Mehran Discusses ACL Reconstruction Surgery

We interviewed orthopedic surgeon Dr. Nima Mehran to talk all about all things related to the anterior cruciate ligament (ACL) including injury, surgery, rehab, and much more. Be sure to watch the entire video!

 

What is the ACL? What is its Purpose?

The anterior cruciate ligament connects the thigh bone (femur) to the shin bone (tibia) and crosses in front of the posterior cruciate ligament (PCL). It prevents the majority of anterior tibial translation (the tibia shifting forward relative to the femur). It also provides rotational stability, as well as, some side-to-side stability.

Surgical View of a Real ACL

 

Current Or Previous ACL Injury? Rehab Your Knee Today!

knee rehab program the prehab guys acl rehab

The ACL is one of the most commonly injured structures of the knee. However, preventative and rehabilitative exercises can help you stay away from this injury! Whether you’re a weekend warrior, competitive athlete, superhero parent, or just someone interested in improving their knee health, you can benefit from this program. We make it easy and teach you how to self [P]Rehab your knees and keep them healthy for anything life throws at you. Using the latest evidence-based research and our clinical experience, we have pioneered a very safe and effective [P]Rehab program that can take you from rehabbing old aches and pains all the way to maximizing your athletic performance on the field or in the gym. Learn more by clicking HERE!

 

How Do You Injure Your ACL?

Most commonly it occurs during sporting events as a non-contact injury. However, it can also occur in landings from jumps and contact injuries. Working on proper jumping and cutting mechanics is the most important aspect of rehab from an ACL injury and preventing that injury in the first place! Check out this video to learn how to introduce and progress cutting.

 

What Sports Have the Highest Rates of ACL Tears?

Basketball, soccer, football, skiing, and martial arts. In regards to soccer, there is an especially high rate of ACL tears in female athletes. Learn more about our soccer [P]rehab program HERE.

 

How Can I Prevent Tearing My ACL?

Generally, the best thing to do is to work on mechanics and strength in hopes of avoiding noncontact injuries. You cannot plan for contact injuries, but if you work on hamstring strength, hip mobility, and landing mechanics that is a great place to start. Talk to a therapist and a performance coach to come up with a great plan for your deficiencies. Just remember, the hamstrings are the secondary stabilizer to the ACL so don’t skip those exercises on leg day. Also, plyometrics have been shown to help as well!

 

Deceleration and Landing Mechanics Training

We teach you every jump and landing technique you should practice and master with our Jump Fundamentals Program!

 

How To Get Back To Jumping After An Injury

 

Progressive Hamstring Strengthening

 

Is There Any ACL Injury Prevention Programs?

We helped put together the ACL injury prevention exercise programs for the orthopedic section of the APTA. Each program has 3 tiered phases. The 1st phase is the dynamic warm-up which addresses mobility restrictions and general primes the body and nervous system for more intense movement. The 2nd phase is your foundational strengthening phase. We cannot stress enough how important strength is to prevent injuries! In particular for reducing ACL injuries, the goal is to strengthen the quadriceps, hamstrings, glutes, and core. The 3rd phase is the movement coordination phase. You can have all the strength in the world, but if you don’t know how to properly move, decelerate, and cut all that strength isn’t doing you any good! This is the most important aspect of an injury prevention program. Each phase is divided into multiple tiers based on the difficulty level. Start with Tier I, and don’t move up to the next tier until you can complete all the exercises with perfect form.

Open kinetic chain exercises are a heavily debated topic within the literature, especially for ACL rehab. Read our blog post below on the knee extension machine, and why it is vital to load the quadricep muscle not only in the closed chain but also in the open-chain after an ACL reconstruction!

READ: IS THE KNEE EXTENSION MACHINE SAFE TO USE?

knee extension machine the prehab guys what is the acl

 

ACL Injury Prevention – Field Version

The field version is for all your field sports like soccer, lacrosse, field hockey, etc.

 

Prehab Membership The Prehab Guys

The Prehab membership is the anti-barrier solution to keeping your body healthy. Access state-of-the-art physical therapy, fitness programs, and workouts online in the comforts of your own home or gym! Taking control of your health with exercise & education from the palm of your hand has never been easier. Get access to 50+ programs, 100+ unique workouts, and 3000+ exercises to build your own workout routines. Trial it for free, and learn how to get out of pain, avoid injury, and optimize your health with [P]rehab!

 

ACL Injury Prevention – Court Version

The court version is for all of your court sports like basketball, volleyball, and racketball.

 

If I Tear My ACL, What Next?

You should see an orthopedic surgeon to discuss the pros and cons of ACL surgery. If you want to continue playing cutting or pivoting sports such as basketball, soccer, football, tennis, and martial arts you will likely need an ACL reconstruction. Even if you haven’t seen your surgeon yet or are unsure whether you should get surgery or not, you need to address the swelling immediately and work on regaining your range of motion and quadriceps strength. The ACL [P]Rehab exercises below are perfect for both operative and non-operative ACL injury rehabilitation. Get on it!

LISTEN: ACL REHAB WITH EXPERT DR. WESLEY WANG

acl rehab wesley wang prehab guys

 

ACL Prehab Exercises

 

Does Everyone Who Tears Their ACL Need ACL Surgery?

Great question. The answer is no. If you do not participate in activities that require cutting or pivoting, you may be able to have success without surgery and concentrate on physical therapy and rehab. This is an important discussion to have with your local orthopaedist.

 

Surgical View of an ACL Reconstruction

 

If I Decide to Proceed with Surgery, Which Graft Choice is Best?

If you are indicated for an ACL reconstruction, picking a graft is an important part of your preoperative discussion. There is no perfect graft choice. They each have risks and benefits. The most important decision is determining if you should use your own tissue (autograft) or someone else’s tissue (allograft). If you are young and/or playing high-velocity sports autograft is generally the better option. However, if you have a lower activity level and are over 40 studies have shown that there is an equal success with an allograft.

If you and your surgeon choose autograft, there are several autograft options including patellar tendon, hamstring tendon, and quadriceps tendon. Each graft has its advantages and disadvantages, please see the video above for a full discussion of graft options.

Bone Patellar Bone Autograft

Patellar Tendon Autograft From Dr. Nima Mehran

 

Quadriceps ACL Autograft What is the ACL

Quadriceps Autograft from Dr. Nima Mehran

 

If you and your surgeon decide on an allograft, your surgeon will likely pick which allograft he has the most experience or comfort with. You can read more about graft options for surgery by clicking on this link: ACL Graft Options

 

How Long is the Recovery After an ACL Reconstruction?

This process can be 9-12 months. The most important part of recovery is that you listen to your physical therapist and surgeon and do not attempt to go back to sports until both feel that you are ready. Ideally, your physical therapist and surgeon are in communication and making decisions based on objective data points. Remember, not everyone has the same speed of recovery and you should never return until you feel physically, mentally, and emotionally ready.

 

Take Ownership Of Your Knee Health

knee rehab program the prehab guys acl reconstruction surgery

The knees are true hard nosed blue collar workers! They get the job done when the hips and ankles may be taking some extra rest breaks. In this program, you will learn how to restore mobility, learn to get your powerful quadriceps cooperating with you, along with starting the journey to addressing the hip and ankle. In this program, you will learn how to restore mobility, learn to get your powerful quadriceps cooperating with you, along with starting the journey to addressing the hip and ankle.

 

About the Author

Dr. Nima Mehran

Orthopedic Surgeon & Sports Medicine Specialist

Dr Nima MehranDr. Nima Mehran, M.D., is an orthopedic surgeon specializing in sports medicine and joint replacements. He earned his undergraduate degree at the University of Southern California, attended the Chicago Medical School and was Chief Resident during his orthopedic surgery residency at Henry Ford Hospital. Dr. Mehran has published several scientific papers and has delivered numerous scientific lectures. He has been on the physician team for the USC Trojan Football team, Los Angeles Lakers, Los Angeles Sparks, Los Angeles Dodgers, Los Angeles Kings, and Anaheim Ducks.

 

 

 

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

About the author : [P]rehab

4 Comments

  1. Rizwan May 11, 2019 at 4:36 pm

    Hy, Good day,
    I have partial ACL tear, from last 2 years but stable knee.
    Please advise me BONE MARROW OR PRP, WHICH one is more effective.
    Thanks.

    • Michael Lau May 12, 2019 at 9:00 am

      Hi Rizwan,

      Unfortunately, that is not our area of expertise. Best to consult with your local orthopedic surgeon who specializes in sports medicine for that quesiton.

  2. Chad May 28, 2019 at 1:02 pm

    14 months post ACL surgery ( hamstring graft). If there is slight lax in the acl graft compared to the other knee, would this be a cause of concern

    • Michael Lau June 3, 2019 at 8:20 am

      No! Shouldn’t be, but best to consult with your orthopedic surgeon. Get the quads and hamstrings as strong as you can!

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