In physical therapy school, ACL injuries receive a great amount of attention. I remember learning extensively about the mechanism of injury, ACL anatomy and physiology, biomechanics, and reconstruction protocols. Following an ACL reconstruction (ACLr), the graft undergoes a series of changes to eventually mimic the anatomical ACL. A good protocol stresses the importance of avoiding open kinetic chain activities during the 'middle weeks' of post-surgical rehab because the ACL graft is weakest at this point. In school, I had a difficult time conceptualizing why the ACL is weakest during this phase. Check out the youtube video below which does an excellent job demonstrating how the ACL remodels following ACLr. -Jim
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