Monday 7 June 2010

Just how long DOES it take?

Lets elaborate - just how long does it take to recover from an ACL (Anterior Cruciate ligament) injury?

As promised - this relates to more gymnastics. BBC sport reported this week that British gymnast and recent European champion on Pommel Horse, Daniel Keatings hopes to make an earlier comeback from his ACL injury than expected



"I can't say for definite but I hope to be back in six months," Keatings told BBC Radio Northampton.

"It gives me time to improve pieces like my rings and high bar. I can push my conditioning because I don't have any competitions coming up."

Keatings added: "My knee is going to heal perfectly and it might be even better.

"With the right rehab, it could be a lot stronger than it was before. I had a bad injury in 2006 and I overcame it, so I know what to expect and how to keep positive."

Keatings will miss the World Championships in Rotterdam in October, but is focused on building towards success in the major events leading up to the 2012 Olympics.

Another of my favourite gymnasts - Ivana Hong of the USA tore her ACL at a training camp a few months back and it was instantly desctibed as a 'season ending injury'- this a little over a year after she damaged her ankle, keeping her out of the 2008 olympics.



So this raises the question (in my mind at least) - how quickly can you recover from an ACL injury. The ACL of the knee is a commonly injured ligament in sports. As the unfortunate Rio Ferdinand already showed us this week. The injury often occurs during rotation or landing from a jump, rather than foul play from another athlete!



An ACL tear is often diagnosed by a drawer's sign as shown below. The lower leg moves forward further than it should in relation to the knee. The most common repair of the injury is ACL reconstructive surgery. Particularly in young active people (so... gymnasts then!) or where the knee is unstable.



I got the info below from wiki- please forgive the shameless plagiarism!

The rehabilitation process is the most important part of the surgery. There is a long and rigorous process involved in getting back to one hundred percent. The doctor will start the patient on the rehabilitation program, which is broken down into phases:

Phase 1: This step is called the early rehabilitation phase. This is basically the things that were covered in short term, things to reduce pain and swelling while gaining movement.

Phase 2: This phase covers weeks 3 and 4. At this point the pain should be subsiding and the patient will be ready to try more things that their knee isn’t willing perform. That is why there is a lot of emphasis put on joint protection during this step. The patient will be able to start doing exercises such as mini wall sits and riding stationary bikes. The aim of this is to be able to bend the knee 100 degrees.

Phase 3: This phase is known as the controlled ambulation phase and it covers weeks 4 to 6. At this point the patient will be doing the same exercises from phase 2 plus some more challenging ones. The patient will try to get their knee to bend 130 degrees during this stage. The aim during this period is to focus heavily on improving balance.

Phase 4: This is the moderate protection phase and it covers weeks 6 to 8. In this period the patient will try to obtain full range of motion as well as increase resistance for the workouts.

Phase 5: This is the light activity phase and it covers weeks 8 to 10. This period will place particular emphasis on strengthening exercises with increased concentration on balance and mobility.

Phase 6: This is the return to activity phase and it lasts from week 10 until the target activity level is reached. At this point the patient will be able to start jogging and performing moderately intense agility drills. Somewhere between month 3 and month 6 the surgeon will probably request that the patient perform physical tests so s/he can monitor the activity level. When the doctor feels comfortable with the progress of the patient, s/he will clear that person to resume a fully active lifestyle.

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