Using the cruciate ligament, the knee joint is stabilized, which determines its special function in the body. The loads that the ligaments have to withstand are extremely high, this leads to frequent injuries, sprains, and in the most severe cases, rupture. The process of rehabilitation after damage to the cruciate ligaments requires patience, caution, and a thorough approach.
Types of cruciate ligament surgery
Due to the structural features of the joints, self-healing of the ligament after rupture is impossible; surgical intervention is required. The work of doctors begins with determining the degree of damage. The ligament must be restored so that subsequently there are no problems with the functioning of the musculoskeletal system.
Features of ligament injuries are explained by their immediate functions, among them there are:
- simple rupture of the anterior ligament,
- rupture of the posterior cruciate ligament,
- a gap associated with a bone fracture at the attachment points of the ligament,
- rupture of the anterior, posterior, lateral cruciate ligaments, as well as the joint capsule.
Depending on the type of injury, it is sufficient to simply apply gypsum after removing excess fluid in the injured knee, in more complex cases where self-adhesion is impossible, and stitching will not give the desired result, the patient is shown plastic.
Rupture of the anterior cruciate ligament
That is, instead of a torn ligament, the patient is implanted with a graft. Distinguish:
- autografts - namely, fragments of ligaments, other connective tissue, bones taken from the patient’s body, which are implanted in the place of the removed damaged ligament,
- allografts - taken from a donor, specially treated ligaments (usually tendons: Achilles, popliteal, popliteal), in case of their use, healthy ligaments of the patient remain intact, which is preferred.
Appointment of exercise therapy after operations of the cruciate ligament
After direct surgery, the body's recovery process takes, on average, from 3 to 8 months. All rehabilitation measures prescribed by a doctor after stitching or plastic surgery of the anterior and posterior cruciate ligaments depend on the specific condition of each individual patient. Procedures are prescribed as needed, but a number of restorative measures, including physiotherapy exercises, are absolutely necessary.
The entire recovery process can be divided into 4 periods:
- Passive (from 3 days to 2 weeks from the time of the operation) - at this time it is not recommended to load the sore leg, careless movements should be avoided in every way, taking drugs to improve lymph drainage and relieve swelling.
- Preliminary (from the second week to 1.5 months) - the time when you can begin to perform simple exercises to restore muscle activity. Massage and physiotherapy treatments are welcome.
- Active (eighth to sixteenth weeks) - an increase in physical activity, tasks are set to restore the preoperative state of the injured limb, walking without reliance on special means of support is attributed, from the third month you can start exercising on simulators under the supervision of a treating physician.
- Final (Week 17-25) - the final phase of rehabilitation after the operation to restore the cruciate ligament, the achieved result is fixed, the patient must return to the usual load, including independent ascents and descents along the stairs, driving vehicles. Moderate weight lifting is recommended in order to avoid repeated injuries.
Exercise therapy and other recovery procedures
For rehabilitation after surgery on the anterior cruciate ligament, a number of procedures are performed, including:
- ultrasound therapy
Of great importance is the implementation of physical exercises to restore joint mobility and maintain the tone of the whole body. Exercise therapy is prescribed at the end of the first recovery period, although exercises can be performed almost immediately after surgery.
In the first week of rehabilitation after replacing the cruciate ligament, it is recommended to perform the following complex, each exercise is repeated 10 times in 4-5 approaches during the day, being careful and not overworking the injured leg:
- flexion movements in the joint of the injured knee, in case of minor injury (in the final period of recovery), you can perform an exercise with a weighting agent,
- tension and relaxation of the anterior thigh muscles, which ensures blood flow to the ligaments,
- swaying of the foot, circular movements with it - an exercise to maintain tone in the lower leg, stimulate blood circulation,
- step on the spot and walks with a cane, other means of support - you need to start after the doctor gives permission.
The preparatory period is marked by a more complete restoration of motor activity, up to a month and a half you can start:
- Shallow squats
- lifts on the toe of the foot,
- rolling from toe to heel,
- lifts of the elongated leg, abduction to the side.
In the active recovery period, an additional load is added, after the appointment by a doctor, you can start exercising on simulators and other types of activities. The following exercises are performed as the main exercises of exercise therapy:
- squats and flexion of the knee in the supine position with weights,
- exercises with a step platform,
- circle exercises
- lifting a leg with a load,
The final period is designed to consolidate the gains made. This is the time to return to a normal human life. If earlier regular exercise was part of the circle of habits, they can be gradually resumed. Showing short runs, exercise for training balance, flexibility. Aerobics in water is especially recommended, other occupations in the pool.
A possible set of exercises for breaking the anterior cruciate ligament:
Exercises for breaking the posterior cruciate ligament:
Rules for conducting exercises for complete recovery after cruciate ligament surgery
The general rules for rehabilitation after autoplasty of the anterior cruciate ligament have already been identified previously. First of all, it is safety and a reasonable load distribution. All procedures should be performed strictly under the supervision of the attending physician.
The load on the legs is increased gradually, as you get used to the already mastered severity. The main emphasis in the implementation of exercises should be on the development of endurance, restoration of mobility, balance. The knee performs a bearing function, serves as a support for the whole body.
The use of massage treatments
As mentioned above, massage is one of the important procedures in the rehabilitation process after surgery on the cruciate ligament of the knee. You can start it right away, in a state of immobility, the patient needs to restore blood flow, to avoid stagnation. To this end, knead the lower back, the area of the healthy leg, with special care - the area above and below the knee.
With the removal of gypsum, when the swelling subsides, you can proceed to massage directly the damaged part of the leg. In this case, care must be taken: with improper technique, the likelihood of secondary damage to the ligament, stretching is high. The purpose of the procedure is to prevent joint stiffness, to facilitate its bending with the help of a number of simple manipulations.
The next step is the introduction of elastic massage, the tissues are heated using intensive stimulation, rubbing is done in a spiral, soft pats, tingling are added.
During rehabilitation after surgery, in the process of restoring the mobility of the anterior cruciate ligament, it is necessary to continue supporting massage in the conjugated areas - the lower back, thigh, healthy leg, and tonus massage of the diseased limb in order to return to the previous activity.
The features of rehabilitation after surgery depend on in which area it was performed - on the anterior or posterior cruciate ligament, which tissues were affected. From the complexity of the operation and the individual characteristics of the body.
In any case, recovery from a knee injury is a long and laborious process that requires patient patience and perseverance. It is best if it will be supervised by specialists, in a clinic or at home. Timely seeking help, the appointment of the right treatment and the early start of rehabilitation are the key to a complete successful recovery.