Post by Sam Donaldson, Sports and Exercise Physiotherapist
Australian’s love their high intensity sport. Our athletes are incredibly athletic and our young people look up to this athleticism with admiration and inspiration. Sports like AFL, Soccer, Netball, Basketball and Rugby are all considered the highest risk sports for lower limb injuries, with a not-so common but significant injury being a rupture or the Anterior Cruciate Ligament (ACL) in the knee.
The rate of knee reconstructive surgery has rapidly risen in recent years by more than 70% as reported by the Medical Journal of Australia.
With the care of a physiotherapist, patients are often capable of a full return to sport, however it doesn’t go so well for everyone (as with everything in life).
Interest is now gathering around various surgeries performed on the body, almost as standard. Meniscal surgeries for degenerative meniscal tears in the knee are highly contested in research and now certain shoulder surgeries are being questioned as to their benefits. What we are seeing in these cases is that many people do just as well, if not better, without the surgery and simply doing the rehab.
ACL injuries in Scandinavian countries (where almost all health care is public), are starting to move towards what is now considered the gold standard in care for these patients.
This includes up to three months of rehabilitation after the injury, giving the patient a chance to return to normal function on a knee within which they are confident. A set of tests can be applied to determine whether the patient is then suitable to continue rehab without an operation, or whether an operation is warranted.
This includes several hop tests, the patient reporting any episodes of the knee giving way, and some questionnaires. The rehab and testing would all be performed under the supervision and guidance of an experienced physiotherapist where possible for best individual outcomes.
Unfortunately, this is not always realistic in the Australian system, where much of this rehabilitation would be self-funded, or if funded by insurance, the process is highly scrutinised and can be a pain to approve. But the truth remains – that many people can return to sport and high function without their knee being reconstructed, when given the opportunity.
An interesting topic to keep our eyes across over the coming years as more information comes to light about the long-term benefits of avoiding an operation.
*Disclaimer* Deciding whether to operate on a knee after an ACL reconstruction should always be a well informed and individual choice made by the patient in question, once having consulted their Sport and Exercise Physiotherapist, and surgeon. Certainly, it is helpful to rehabilitate the knee to as best function as possible, with minimal swelling, prior to making that decision, where possible.
For more information about rehabilitation of your knee injury, be it an anterior cruciate ligament (ACL), meniscus or other sports injury, give us a call at 07 3856 5566 or 07 3184 6844