What is the current prevailing narrative of an athlete who sustains an ACL tear?
This was the first question that I was asked when completing the Global Specialist Physiotherapy course on Non-Operative ACL management. The answer is that patients immediately think, and are advised that surgery is the only option for optimal healing.
BUT, this is no longer true.
Over the last couple of decades, research has been trickling through showing that the ACL can spontaneously heal with the right rehabilitation. It has also debunked some common myths
surrounding ACL reconstruction surgeries, such as:
– having a reconstruction will get you back on the field sooner – this is WRONG and arguably will lead to a longer recovery time
due to the second trauma from the surgery
– not having surgery will mean you can’t return to pivoting and landing sports – WRONG – there are many studies showing return to running, jumping and cutting sports with non-operative management. Don’t believe me? Look up Tiger Woods for an example!
– having the reconstruction will mean you have less risk of osteoarthritis – WRONG, in fact, more recently, studies have been showing that the reverse may be true.
And if you do decide surgery? Evidence suggests that those who go through at least three months of prehabilitation to regain knee range of motion and strength have a much better outcome post-surgery than those that don’t. And you may not even need surgery after this anyway!
In saying this, non-operative management is not always for everyone and is not the new one-size-fits-all approach. It is a conversation that you will need to have with your physiotherapist, who will take you through all the information that you need to make your decision.