03 Jun ACL Tears – Should we be treating with bracing over surgery?

ACL tears are unfortunately a common injury our Sports Physiotherapists see at Brighton Spine and Sports Clinic, and while it may be something some people are more predisposed to, there are certainly ways to minimise the risk. And if it does occur, treat and recover in a proper way that will avoid it hopefully occurring again, or subsequent injury.

We spoke to one of our sports Physio’s Josh Banky on the topic, who has helped a number of patients recover successfully from ACL tears. Josh provides his insight into ACL bracing which has been in the media recently with this ABC article, when we need surgery, and what recovery should include.

Would you recommend ACL bracing over surgery? Why/why not?

ACL bracing is a new technique that has started to show that the ACL potentially has the ability to heal. Therefore avoiding a reconstruction, or just leaving the ACL rupture all together if that patient has no intention returning to change direction activities. 

The bracing involves being in a brace for a extended time and then extended rehab. The bracing needs to begin shortly after the injury, there needs to be medication to prevent clots and their needs to be other considerations as to whether the bracing will actually assist the healing of the ACL or not. So for these reasons, there needs to be careful consideration as to what the best management option would be for a ACL rupture.

Is there some cases that will not heal without surgery?

Unfortunately, there are some cases that the ACL wont heal without surgery and this can be due to the ACL stumps (the 2 ends of the ACL) not being in an ideal position to promote healing with the bracing technique or the bracing is too long after the initial injury. In those situations, surgery to reconstruct the ACL is the best option if there is a requirement to return to change in direction activities.

Is there anything people can do to avoid tearing their ACL?

Unfortunately some people are predisposed to tearing their ACL (genetics, biomechanics, family history, previous history of ACL tears, amongst other risks), but we can reduce this risk by increasing and maintaining good strength, control and function of our knee and lower limb as a whole. A Sports Physiotherapist can assess and provide this advice for you.

What is the best recovery program for someone that has tore their ACL?

 A tailored, individualised, well structured program, that is suited and aimed at the patients goals with a good understanding of the healing timelines and benchmarks to progress is the best recovery program. This is best assisted by a Sports Physiotherapist who has insight into this, and works closely with your surgeon and medical team to collaborate and work on your goals and progressions. Its around a 12 month rehab process, so it needs to be well guided and progressed appropriately to get you back to your ultimate goals.

If you are recovering from an ACL injury or would like to create a plan to avoid a further injury, you can book in with Josh via Hot Doc or by calling the clinic on 03 9596 7211.