The importance of Categorizing your ACL patients

Since the beginning of my career (as a sports physical therapy resident), I have been fortunate to have seen many ACL patients post surgery.  Not because of the injury itself but because of how much practice and experience I have gained through seeing these patients over and over again.  However, throughout my time seeing these patients I have noticed that some fall into different categories.  Understanding which patients have psychological problems, motor control problems, low tone problems, etc can have a profound impact on your treatment decisions.  

Many of our ACL patients begin their post op treatment very similarly.  Working on extension ROM, swelling, quad control, and gait is the most important.  But early on we must delve deeper into the patient's psyche and history for proper treatment.  I've noticed that some experience fearful behavior very early into the rehab process and must have a different cues from me to progress with ease.  Others present with a low tone pattern and I know they will need a lot more strengthening and motor control training later in the rehab process.  The point is, we must recognize the other "significant" factors early on in the rehab process post op ACL.  Just because there are guidelines or a "protocol" doesn't mean every ACL patient is on that path.  Adjustments must be made to fit that individual's needs.  Make sure that you look at some of the different factors that will contribute to your patient's success in their rehabilitation following ACL surgery.

Brian Schwabe, PT, DPT, SCS, CSCS 
Board Certified Sports Clinical Specialist in Physical Therapy/Strength & Conditioning Coach/Fitness & Medical Writer
Sports Physical Therapist in Los Angeles, CA​

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