August 31st, 2012

Health N' Sports: ACL Surgery Rehab

Staff Report


Health N' Sports: ACL Surgery Rehab
from www.Igglesblog.com

Functional Bracing Following ACL Surgery

As a part of the Louisville Orthopaedic Clinic, the Sports Rehab Team physical therapists are knowledgeable and trained in the latest advancements and techniques available in sports rehabilitation.

On a weekly basis, the Health N’ Sports Update will give information on prevention, recovery, and include special offers, as well as general health tips that would be beneficial to all. If there is a specific topic you’d like to know or hear more about, email future suggestions to editor@catholicsportsnet.com.

There is little debate regarding the increased success of anterior cruciate ligament (ACL) reconstructions. Advancements in the procedure have given athletes the opportunity to return to their sport or activity of their choice. On the other hand, the use of functional bracing following ACL surgeries and rehabilitation has been debated. Some believe the use of bracing following an ACL reconstruction is crucial in protecting the new graft.

While this may be true, there is little science to support the use of functional bracing. So which is it?  Should a functional brace be used when a person returns to activity following an ACL reconstruction? Ultimately, the answer depends on the opinion of the orthopedic physician and the patient.

There are a number of benefits in wearing a functional brace after an ACL reconstruction. First of all, subjective studies have shown bracing can help increase the patient’s confidence when returning to activity. It is important for athletes to play with confidence and bracing is often the answer. Some athletes report that it takes 12-24 months before they feel totally confident in the knee. After this time period, use of the functional brace can be discontinued.  

Some opponents to bracing feel that the device affects the performance of the athlete. A number of studies have shown this not to be true.  Testing of athletes wearing functional bracing has not resulted in any reductions in speed, strength and muscle endurance. A period of time to get used to the brace is recommended before the athlete returns to full participation.

Advocates of functional bracing refer to studies which show the effectiveness in protecting the knee during low loading conditions. Bracing reduces the amount of anterior translation of the tibia in relation to the femur as well as the amount of rotation. This reduces the amount of stress on a reconstructed graft. Keep in mind this is during low level activity. The brace also has to be placed correctly on the knee. Proper fit of the functional brace from the initial measurement to each application is critical to reaching the full potential of the device.

 

Finally, a functional bracing device protects the entire knee. ACL injuries are usually not isolated injuries. They often are combined with other collateral ligament injuries or damage to the menisci. The hinged portion of the brace prevents varus and valgus forces on the knee. By using a functional brace, the MCL, LCL and menisci are all protected.

 

Unfortunately, ACL revisions do occur in patients with and without the aid of functional bracing. The majority of opponents to functional braces point to the lack of evidence proving the effectiveness of the brace during high level activities. Until studies provide the evidence, there will always be critics regarding the use of functional bracing. The most important steps in returning from an ACL injury are a quality reconstruction and effective rehabilitation. 

 

Mike Mehring, ATC

Louisville Orthopaedic Clinic & Sports Rehab Center

Main Office: 502-897-1794

Physical Therapy: 502-897-1790

Website: louortho.com

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