What Do I Need To Do After a Knee Injury To Return To Sports?
With this blog I thought I would give all our readers some basic insight to what our physiotherapists are thinking about when we are rehabbing a structural knee injury (ACL, meniscus, cartilage, chondral defect etc) after the knee becomes ‘quiet’.
What I mean by ‘quiet’ is when the knee has full range, is not too painful and has minimal swelling. This is when rehab becomes a bit more exciting and we are looking to return a patient back to their sporting goals. After a major surgical operation (eg. ACL) this may be anywhere from the 2 to 6+ month mark. A less serious injury may start this process at the 2 to 4+ week mark.
Non-surgical and surgical management are very similar. Everything will depend on how you are feeling and how the knee is behaving. Generally non-surgical management is able to start this sportier rehab a bit earlier because they have not suffered from the extra trauma of surgery.
Ultimately we look at the following attributes depending on our patient’s symptoms, where they are in their stage of rehab and their exercise or day-to-day goals! Here is a brief overview of what we look for (it is based on the best sports medicine research!!!):
Quality of Movement:
Double Leg Squat
Injured side moving similarly to non-injured side. Taking weight through both legs evenly
Single Leg Squat on Step (usually 5 reps)
Good quality of movement in the hips, knee and ankle. Ie no collapsing, excessive swaying and loss of balance
We do not just look at your hopping distance (see below), but we look at your quality of hops
Eg. you may get the same hopping distance: but your non-injured leg may have a very elegant jump, your injured leg may have a flat trajectory
Change of direction
When you aggressively turn there is similar movements in your injured and non-injured side, with minimal hip collapse and knee rolling inwards.
Single Leg Sit to Stand = 22+ Reps
Elevated Bridge = 20+ reps
Calf Raise = 25-30+ reps
Sideplank = 45+ seconds
Leg Press, Single Leg = 1.5+ x Bodyweight for 1 Rep Max
Squat = 1.5+ x Bodyweight for 1 Rep Max
AXIT/dynamometry testing: L = R leg.
Hop/Power Tests (Injured side within 95% distance of uninjured side):
Medial Rotation Hop
Fitness, Running and Exposure:
We want to make sure our patient’s have adequate fitness levels when they return to sport and training so they do not get injured when they are in a fatigued state.
Exposure to the sport is VITAL. It would be negligent to clear someone back to playing games without exposing the knee to sporting chaos in training. And it would be negligent to allow training without building up change of direction and faster running in rehab.
At Melbourne Sports Physiotherapy we are lucky enough to have a new AXIT system which allows us to accurately assess muscle strength and power. This system is similar to what they use in professional sport. We use the AXIT for the major knee muscles as well for rehabbing our knee injuries.
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!