At JAG Physical Therapy, our therapists have years of experience treating knee injuries successfully and can offer expert guidance on overcoming an injury and protecting your knee from future problems. Schedule an appointment now at your nearest JAG PT location or read further to learn more about the types of knee injuries and the physical therapy techniques used to heal them.

What Types of Injuries Can Affect the Knee?

You can injure your knee in any situation – slipping on ice, on the soccer field, or even just doing household chores. The knee joint supports your weight and is involved in almost every type of leg movement. It’s also the largest joint in the body and has several major ligaments and cartilaginous structures that can become inflamed or torn.

Some knee injuries are complex and require a lengthy recovery, physical therapy to restore function and mobility, and other treatments like surgery. Others aren’t as serious but still require rest and the appropriate treatment and rehabilitation to support healing.

Here are some of the most common types of injuries that affect the knee:

Meniscal Tear

The meniscus is a rubbery section of cartilage that cushions your knees by absorbing shock. A torn meniscus can cause pain, stiffness, and swelling. Your leg might feel unstable, or it might be difficult to fully straighten your leg.

ACL Tear

The anterior cruciate ligament (ACL) is attached to the tibia and femur, helping to keep the knee stable. Damage to the ACL can cause swelling, pain on the outside or back of the knee, instability, and discomfort while walking.

Bursitis

Bursitis is inflammation of the bursae, or the sacs of fluid that cushion the joints. Knee bursitis usually results from overuse injury and is common among runners, wrestlers, and breaststroke swimmers. Bursitis can cause pain that gets worse when you bend the knee or at night.

Patellar Tendinitis

The patellar tendon attaches the surrounding muscles to the shin bone. It can become inflamed or damaged with excessive jumping. Patellar tendinitis, or jumper’s knee, is common among athletes who jump regularly, such as dancers, volleyball players, and gymnasts.

How Does Physical Therapy Aid in Treating Knee Injuries?

Treating a knee injury with physical therapy helps to increase mobility, restore function, and strengthen the knee.

Your physical therapist will develop a personalized treatment plan to help you recover from your injury and prevent further knee issues. If you play a sport or put regular pressure on your knee when you work, you might learn specific exercises and strategies to help you safely return to your sport or your job.

What Are Successful Rehabilitation Strategies for Knee Injuries?

Knee physical therapy can include a range of exercises, stretching, and strengthening to help reduce inflammation and support your body’s healing process.

You can expect a combination of the following rehabilitation strategies to help you recover from your knee injury:

• Exercises for knee pain, such as quad sets, straight leg raises, and step-ups
• Knee injury prevention exercises that strengthen the hip and knee, such as single-leg squats, skaters, and the lateral walk
• Healing modalities, like ultrasound massage, electrical stimulation, and hot and cold therapy
• Functional training to prepare you to return to your sport or other activity
• Gait analysis and training to reduce the stress on your knees and minimize the chances of future injuries

The aim of a physical therapy program for a knee injury is to support healing while also teaching you how to prevent further knee injuries from occurring. By strengthening the knee and surrounding muscles and learning how to walk, run, and jump in ways that won’t put as much stress on your knees, you can not only recover but also improve your performance.

Recover Stronger with JAG Physical Therapy

JAG Physical Therapy offers individualized knee injury rehabilitation programs that will put you on the path to better flexibility, mobility, and strength, as well as injury prevention. Schedule your appointment now in NJ, NY, and PA to get started with better knee health.

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While surgery is the best remedy for severe ACL tears, it takes time and effort to restore knee strength and mobility. In fact, a big part of the procedure’s success will depend on how well you take care of the knee immediately after surgery.

At JAG Physical Therapy, pre- and post-operative PT is one of our top specialties. We’ll design a personalized recovery program to rehabilitate your knee, making it as strong and flexible as before the injury. Book your appointment at your nearest JAG PT location in New Jersey, New York, or Pennsylvania today, or read further to learn more about the ACL surgery recovery process.

What Should You Expect in the Initial Days After ACL Surgery?

After the surgery, your knee will feel tender, painful, numb, and stiff. You may also see swelling, bruising, and redness around the knee, especially near the incision points. But all that is completely normal and should go away after a couple of days.

During this time (phase 1 of post-ACL surgery recovery), recovery efforts focus mainly on pain management and wound healing. For this purpose, your doctor may prescribe painkillers and anti-inflammatory drugs to alleviate the pain and swelling, along with antibiotics to prevent infection.

Until the knee is completely healed, which normally takes about two weeks, you shouldn’t put pressure on the joint. Wearing a knee brace helps keep the knee in place by preventing sudden rotational movements. Also, you’ll need crunches when getting around to avoid exerting your body weight on the healing knee as you walk.

What Does ACL Surgery Rehabilitation Involve, and How Long Does It Take?

Once your doctor confirms that the knee is healed, you can start post-surgery rehabilitation. Knee rehabilitation after ACL surgery starts with gentle extension and flexion exercises. Your physical therapist will encourage the knee joint to extend fully and flex at 90 degrees. The goal is to restore the knee’s full range of motion before moving on to strength exercises. These mobilization exercises may include:

• Knee extension stretches
• Isometric quad contractions
• Leg raises
• Heel slides
• Ankle pumps
• Weightless hamstring curls

After gaining full mobility in the knee, the next phase of ACL surgery recovery focuses on strengthening the knee joint, quads, and hamstrings. This involves exercises such as:

• Stepping
• Mini squats
• Riding a stationary bike
• Heel raises
• Internal and external hip abduction
• Bridges
• Modified deadlifts

With proper physical therapy, full recovery from ACL surgery takes between 4–6 months. However, you should be able to perform non-strenuous activities – such as walking, slow jogging, or mowing the lawn – after the first 12 weeks of rehabilitative therapy. You’ll likely only walk with crutches for the first two weeks, though your doctor may recommend wearing a knee brace for up to six weeks and/or every time you play sports.

It’s important to have professional PT guidance when recovering from ACL surgery. Although you can perform most knee stretches and strengthening exercises at home, your physical therapist will coach you in using the proper techniques and workout regimen for a safe recovery.

Preparing for Post-ACL Surgery Recovery

ACL surgery is considered a major surgery. But it’s a relatively quick procedure, taking two hours at the most under general or local anesthesia.

Minor or major, short or long, any kind of surgical procedure can be scary. Here’s how you can prepare, both physically and mentally, for ACL surgery for your own comfort and to maximize the procedure’s success:

• Talk to your doctor/surgeon about the procedure—how it works, the risks involved, expected outcomes, and your limitations after the surgery.
• Ask your doctor about supplementing your diet with zinc and vitamin C or other nutrients to help accelerate post-surgery recovery.
• Strengthen and stretch the areas around the ACL with pre-surgery exercises under the guidance of a professional physical therapist.
• Cut your caffeine and alcohol consumption for at least a week or two before surgery.
• Create a supportive home environment, for instance, by installing mobility aids around the house.
• Have a professionally guided post-surgery recovery plan in place.

JAG Physical Therapy: Your ACL Recovery Partner

Look no further than JAG PT for professional post-surgery recovery and rehabilitation services. Our highly experienced therapists specialize in rehabilitating physical injuries, including sports injuries, through personalized therapy programs. We also offer injury prevention among a host of other specialized services. Schedule your appointment at one of our 120+ clinic locations today to get started on the road to recovery.

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When you sprain or tear the ACL, you’ll likely have a long road to recovery. An ACL injury can take up to six to nine months to heal, and more severe injuries might require surgery as well as rest.

Whether you need surgical repair for your ACL or not, physical therapy can help you recover faster. But even more vitally, it can help you avoid re-injury and return to your sport with confidence. ACL physical therapy aims to strengthen the muscles and ligaments that affect the knee while increasing stability, mobility, and balance.

With physical therapy, you may be able to return to your sport more quickly. You’ll also have the peace of mind that your body, including your legs and knees, is once again ready to perform at your highest level.

At JAG Physical Therapy, we are the New Jersey, New York, and Pennsylvania area’s leader in specialized PT, including pre- and post-surgery rehabilitation and sports medicine, including return-to-sport therapy. Find your nearest JAG PT clinic location today, or read on to learn more about how we help our patients recover from ACL injury.

How Does Physical Therapy Help in the Recovery from ACL Injuries?

Physical therapy will help to restore the knee’s full range of motion while also strengthening the muscles around the knee. The goals of physical therapy for ACL injuries are to:

• Improve core strength and lower body strength
• Improve body posture and muscle memory so you know how to land correctly after jumping
• Pain reduction through therapies such as ultrasound, hot and cold therapy, and manual therapy techniques
  

Research on ACL rehabilitation shows that outcomes for ACL patients are generally positive with three to nine months of intensive physical therapy. This is true whether the patients had surgery or not.

ACL Injury Recovery Exercises

At JAG PT, our physical therapists target muscles and areas of the body that support the knee and your body’s overall stability throughout your rehabilitation. You’ll work on:

• Hamstrings and quadriceps muscles
• Core muscles
• Hip strength and range of motion

You’ll also perform exercises that target the knee throughout your recovery. When your knee is still fragile, you might begin with knee exercises you can do while seated or lying down. Here are some examples:

• Isometric quad contractions: This exercise strengthens the muscles around the knee.
• Heel slides: This movement helps to improve mobility without putting weight on the knee.
• Prone knee flexion: This is another non-weight-bearing exercise to help restore mobility and function.

When you’re ready for increased movement, your physical therapist will focus on restoring mobility, strength, and stability of the knee through balance training, range-of-motion exercises, and strength training. You might do:

• Core exercises such as the plank and side plank
• Range-of-motion exercises such as half squats and knee extensions
• Hip exercises, such as hip flexors and abductors, to strengthen the hips

You’ll also learn about exercises that can help with ACL injury prevention and recovery.

What Can Patients Expect from Physical Therapy for ACL Injury Recovery?

The timeline for recovery hinges on the severity of your injury and how quickly you heal. If you have surgery for an ACL tear, you can expect around six months of recovery time, possibly longer. But every few weeks, your knee will be stronger and more functional. Here’s what to expect:

Pre-surgery: You’ll use rest, ice, and gentle exercises that aren’t weight-bearing.

Weeks 1-3 post-surgery: After ACL surgery, there will be swelling, so you might need more therapy techniques to relieve pain and inflammation. Your therapist might have you do several range-of-motion exercises, such as seated full extension and knee flexion exercises.

Weeks 2-6 post-surgery: Physical therapy might include strengthening with light weights and full-range-of-motion exercises. You’ll be able to do some endurance activities, such as using an elliptical or walking on a treadmill.

Week 6 to 3-4 months: You’ll increase your strength training for your knees, legs, hips, and core. You’ll learn techniques to improve your posture and proper form. You might do gait training, pivoting techniques, and mobility drills.

Months 4-6+: This is the last recovery phase. You will continue strengthening and working on mobility and stability. You’ll learn what footwear and protective gear to use to prevent injury. You’ll also learn exercises to help with injury prevention.

When you no longer have soft-tissue or range-of-motion complaints — and you meet your physician’s other criteria — your doctor will clear you to return to your sport.

The recovery timeline is usually shorter if the tear was mild to moderate. In that case, you might not need surgery, and you could be back to your sport in three to four months.

Either way, you’ll still benefit from the same range of treatments and interventions involved in physical therapy for ACL injury. These include manual therapy techniques, therapeutic exercises, and functional training.

Manual Therapy Techniques

Manual therapy involves the use of hands rather than medical devices. Your physical therapist will use their hands to ease your pain and swelling, increase blood flow, and improve mobility. For an ACL injury, they might include soft-tissue mobilization and strain-counterstrain therapy.

Therapeutic Exercises

Therapeutic exercises are meant to restore flexibility, strength, and mobility to the knee. During ACL injury physical therapy, your therapist will help you with balance training, such as standing on one leg; range-of-motion exercises, such as knee extensions; and strength training, including lunges and half squats.

Functional Training

Functional training helps you regain your knee’s function. This type of training might occur later in your recovery — usually around four to six months post-injury. Functional training can involve jumping exercises, starting and stopping, and changing direction.

The Importance of Personalized Physical Therapy When Recovering from a Knee Injury

JAG PT is always committed to helping you recover with a PT plan that’s customized to your needs. Throughout your rehabilitation, you might work on everything from dynamic strength to your knee’s power and performance. There may also be sessions that focus more on pain relief, posture, balance, and mobility. However, the specifics depend on you, your body, and your sport.

Some people heal faster than others. Usually, younger athletes recover more swiftly than adults. Depending on the severity of the injury, you might experience more pain and inflammation or benefit from certain therapy techniques.

You might be able to progress through therapy at a faster rate, depending on your body and commitment to recovery.

You’ll require specific functional training exercises based on your sport. For example, a gymnast will require more jumping exercises. A soccer player might benefit from more agility training.

These differences are why it’s important to have an individualized rehabilitation plan. It should reflect your injury. And your body.

A physical therapist with experience in sports medicine will be able to create a personalized plan that lets you progress at the right pace for you. They’ll know which manual therapy techniques, therapeutic exercises, and functional training to use to optimize your ACL injury recovery outcome.

How Does Physical Therapy Enhance ACL Injury Recovery Compared to Resting Without Intervention?

With ACL physical therapy, you can expect a faster recovery, reduced pain and swelling, and training that will help your body restore its original functioning, or close to it. Using targeted neuromuscular and strength training can increase dynamic stability in the short and long term. That means you’ll be less likely to damage your ACL again in the future or require future surgery.

Studies on pre-operative rehabilitation show that physical therapy before surgery, as well as after, can make a big impact. Here are some of the positives:

• Improved knee and muscle strength — patients with pre-operative physical therapy have higher single-leg jump values at 12 weeks.
• You might feel more mentally prepared for surgery and more mentally prepared to return to your previous activity levels.
• Return to sport, on average, happens at 34 weeks instead of 43 weeks for those without physical therapy.
• People with an ACL injury who used physical therapy during their recovery are also less likely to develop osteoarthritis later on.

Can Physical Therapy Help Prevent Future ACL Injuries?

There’s always the risk of a future ACL injury, even with physical therapy. However, because you’re strengthening the knees, as well as the muscles that impact your knee’s stability and power, you’re less likely to get injured again.

About four out of every five athletes who return to intense sports don’t experience a second tear. With the right amount of rest, recovery, and physical therapy, you can increase the likelihood that you’ll be able to get back to the activities you love without getting injured again.

Take the First Step to ACL Injury Recovery with JAG Physical Therapy

JAG PT is the leading provider of physical therapy in New York, New Jersey, and Pennsylvania. Our experienced team can help you recover after an ACL tear or any other injury, and we always deliver care with skill and compassion. Contact us to learn more or schedule an appointment to start on the path to recovery today.

Learn More from JAG PT:

• ACL Injury Prevention Exercises
• Occupational Therapy Techniques for Athlete Recovery
• How Does Physical Therapy Help Athletes?
• Types of Sport Injuries

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Are you staying up to date on post-op knee rehab protocols and surgery techniques, including those for a new implant to repair ACL tears?

By John Gallucci Jr, MS, ATC, PT, DPT

As a comprehensive outpatient physical therapy company, and a major healthcare resource for the community, JAG Physical Therapy is always striving to advance our skills and treatment techniques to provide the most up-to-date evidence-based care. The field of physical therapy is ever evolving, as are medicine, surgery techniques, rehabilitation protocols, etc, and we, as an integral piece in post-operative recovery, make it a priority to stay connected with the latest research and newest products for the benefit of our patients and their outcomes. This includes post-op knee rehab.

Total Knee Arthroplasty

Total Knee Arthroplasties (TKAs) are on the rise, with more than 670,000 currently being performed annually in the United States and an expected increase to nearly 3.5 million by 2030.¹ TKA is one of many commonly seen surgeries in the outpatient physical therapy world. Typically, TKAs have a straightforward post-op knee rehabilitative process with a quick and easy recovery. Less commonly, you will come across complications such as higher than expected pain levels, severe swelling, joint contracture, or deep vein thrombosis. In these less frequent situations, we continuously re-assess the patient’s status, increase communication with the patient’s family and physicians, and modify our treatment plans.

An initial plan that focuses on frequent icing, early range of motion, and weight bearing activities are critical in achieving early goals and preventing setbacks following total knee arthroplasty. Additionally, education on compliance with a home exercise program and an icing protocol should be a priority, as this can also have a huge impact on pain and swelling management and can prevent complications.

Post-Op Knee Rehab After ACL Reconstruction

The most common ligamentous injury seen at the knee is an anterior cruciate ligament (ACL) tear, with approximately 80,000 to 250,000 injuries seen per year.² Post-operative rehabilitation after an ACL reconstruction follows a defined protocol with incremental stages addressing range of motion, weight bearing, strength, and functional milestones. It is critical, as the physical therapist, that we educate the patient and closely follow each phase of rehab to prevent any setbacks.

Initial phases will consist of icing often to control swelling and pain, gradual progressive range of motion to prevent contracture and muscle setting to avoid muscle atrophy. As the patient progresses through the phases of rehabilitation, range of motion, strengthening, and functional performance will advance based on the patient’s progress.

Lastly, there will be a big focus on retraining muscles for return to sport. To prevent re-injury, this phase requires attention to detail and additional challenges as patients get closer to a return to higher level activity. In preparation for return to sport, following any knee surgery, it is important to apply very specific tests and measures to confirm that muscle strength, balance, and control are adequate for sport demands. At JAG Physical Therapy, through extensive research, we have formulated a “Lower Extremity Return to Sport Assessment,” which encompasses a variety of objective measurements and functional- and sport-specific movement assessments to best determine safe return to activity.

BEAR Implant for ACL Repair

A more recent advance in orthopedic knee surgery is the Bridge-Enhanced ACL Repair (BEAR) Implant from Miach Orthopaedics Inc, which is an alternative to ACL reconstructive surgery. The BEAR Implant acts as a bridge to help ends of the torn ACL heal together. The surgeon injects a small amount of the patient’s own blood into the implant and inserts it between the torn ends of the ACL in a minimally invasive procedure. The combination of the BEAR Implant and the patient’s blood enables the body to heal the torn ends of the ACL back together while maintaining the ACL’s original attachments to the femur and tibia. As the ACL heals, the BEAR Implant is resorbed by the body, within approximately eight weeks.

There are specific criteria for being a candidate for this surgery. At JAG Physical Therapy, we have several physical therapists who are certified to rehabilitate patients following the BEAR Implant procedure, which follows a strict protocol.

The protocol includes recommendations for the products and types of treatment physical therapists should use with patients through seven distinct phases over the course of a year. Each phase is defined by specific goals and criteria for progression to the next phase.

Recommendations in the initial stages include crutch use, bracing, range of motion exercises, muscle activation and strengthening, NMES (NeuroMuscular Electrical Stimulation), and cryotherapy. Toward the end of recovery, patients are undergoing advanced training, with goals of mastering running patterns, jumping, and hopping. Recommendations at this point include more advanced strengthening, agility drills, neuromuscular training, and rigorous cardiopulmonary training.

Post-Knee Surgery Physical Therapy Tools

As we can see, it is critical for any physical therapist to have a variety of “tools” in their toolbox to be able to provide comprehensive treatment. In knowing the potential obstacles following any orthopedic surgery, we want to have a wide range of modalities and products to apply to mitigate complications and to ensure a successful outcome. Listed below are a few of our favorite items to include in post-operative physical therapy treatment.

Cold Compression System

Initial phases of rehabilitation following any knee surgery, our first focus is to reduce pain and swelling. A cold compression system which offers a combination of intermittent compression and cryotherapy can provide therapeutic benefits such as decreased pain, decreased swelling, and increased range of motion.³ This is a great start to rehabilitation following knee surgery.

Weight Supported Treadmill

As we progress through the initial phases of rehabilitation following a knee surgery, we begin to prepare for gait training and functional mobility. Most post-operative knee patients will have been placed in a brace or given an assistive device for the first few days, weeks, or months following surgery. This creates compensations, poor habits, and gait deviations. For a patient to transition to full weight bearing after functioning weight assisted is a challenging task.

To achieve a normalized gait pattern with as little compensatory patterns as possible, the utilization of a weight supported treadmill is key. This provides the patient the opportunity to begin walking with their weight supported, at varying amounts. The patient can transition through different percentages of body weight working towards full weight and eventually running (if that is their goal). It also gives the patient more confidence and comfort in those initial stages of increasing weight through their surgical knee.

Blood Flow Restriction

The application of blood flow restriction (BFR), in conjunction with strength and functional training, is a great tool to implement in post-operative rehab to advance muscle mass and endurance. BFR is the application of a pneumatic tourniquet cuff to the proximal portion of an extremity which partially impedes blood flow to the limb and in turn increases muscle strength and size.⁴ We have found that patients enjoy the application of BFR in their post-operative recovery as it gives them an opportunity to perform lifting of lighter loads while still assisting in making the strength gains needed for return to full function and sport.

Functional Dry Needling

Dry needling is a technique that can be performed by physical therapists certified through extensive education and training. It can be applied at any point in the post-operative recovery and has positive impacts on myofascial trigger points and pain level. In reducing muscle tightness and pain, with the utilization of this modality, the patient then can perform their exercise program with improved quality of movement patterns.⁵ We have found that patients respond well to dry needling with reports of immediate pain relief allowing for increased tolerance with completing their exercise program.

Cupping

Cupping therapy is a great option to incorporate into manual treatment. It is thought that this technique releases soft tissue, drains excess fluids and toxins, loosens adhesions, lifts connective tissues, and brings blood flow to an area of stagnant skin or muscle.⁶ It is performed with cups made of varying materials such as glass, bamboo, ceramic, or plastic. Therapists apply the cups to the area treated with a firm suction to create a negative pressure. This negative pressure ensures that the superficial layers of skin, or fascia, are elevated to improve circulation. We have found that including this technique, in addition to tissue and joint mobilization, provides the patient with pain relief and improved function.

Isokinetic Testing

Isokinetic testing is a great option for gathering accurate objective measurements following a knee surgery and in preparation for return to function or sport.  It can be utilized in the assessment of strength, power, and endurance at any point in the patient’s recovery. This can provide the physical therapist, referring physician, and patient with initial, mid-way, and discharge comparative measurements.

The patient’s muscle performance is challenged while the machine provides continuous resistance through a specific range of motion. Detailed objective measurements are automatically calculated and provided through the machine. Because of the objectivity and reproducibility of the measurements, patients and physicians value the utilization of this piece of equipment as it gives us visibility into safe return to activity and sport.⁷

Keys to Successful Recovery

As physical therapists, we must remain committed to continuing education to ensure we are well-versed in the most innovative tools utilized to assist our patients in their recovery. It is equally as important to educate our patients and closely monitor their progression to prevent any setbacks and ensure a full recovery.

Learn More About JAG Physical Therapy

If you've recently undergone knee surgery, you understand how challenging the road to recovery can be. At JAG Physical Therapy, we are here to help you every step of the way. Our post-op knee rehab program is designed to help you regain strength and mobility, and get back to your active lifestyle as soon as possible. Our expert team of therapists will work with you to create a personalized treatment plan tailored to your unique needs and goals. Using the latest techniques and technology, we will guide you through a safe and effective rehabilitation process. Don't let knee pain hold you back any longer. Schedule your appointment today and let JAG Physical Therapy help you refresh your knee rehab. Contact us to learn more!

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Learn More About Injury Prevention From JAG PT:

• Golf Swing Injury Prevention
• Overcoming and Avoiding Hockey Injuries
• 5 Ways to Avoid Winter Injuries

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