Physiotherapy after knee surgery for sports injuries

Knee injuries are a common complaint among anyone who plays sports or runs.

That’s why we have a dedicated team of physiotherapists who routinely see individuals with a sports knee injury in Twickenham. We understand the pressures different sports put on your body, as well as the subsequent injuries, treatment and rehabilitation needed for a smooth recovery. So what can you expect from physiotherapy after knee surgery for sports injuries? 

Here we’ll take a look at common sports knee injuries and what you can expect during your post-surgery recovery. 

Which sports knee injuries need surgery? 

By far the most common knee injuries requiring surgery that we see for post-surgery physiotherapy are anterior cruciate ligament (ACL) ruptures and torn menisci. Other less common injuries requiring surgery are posterior cruciate ligament (PCL) ruptures and rarer still, quadriceps and patellar tendon ruptures.

ACL ruptures

The ACL is one of four main ligaments in your knee. It helps stabilise the knee when rotational forces are applied through the joint. ACL ruptures often occur when playing sports where you have to suddenly change direction on a bent knee. Landing awkwardly after a jump or fall, or a direct blow to your knee can also cause an ACL tear. 

In most cases, a torn ACL can’t be sewn back together. Instead, your surgeon will graft new tissue, usually a tendon taken from elsewhere in your leg, to reconstruct it.

Torn meniscus

Your knee contains 2 thick pads of cartilage called menisci. The menisci tend to tear when you twist forcefully on the knee. This can occur while running if you twist awkwardly or if you forcefully change direction playing tennis or hockey. 

Surgery to repair a torn meniscus usually involves sewing the torn cartilage back together. However, in more severe cases, the damaged cartilage may need to be partially removed (menisectomy) or replaced with donor cartilage.

ACL ruptures, Torn Meniscus, etc.

Like the ACL, the PCL helps stabilise the knee when it undergoes rotational forces, such as rapid changes of direction, or accelerating and decelerating while turning. The PCL is also prone to the ‘dashboard injury’ that occurs during a road traffic accident, forcing the shin backwards relative to the thigh bone and consequently, injuring the ligament.

As a rule, it’s only the more severe injuries that require surgical repair — synthetic grafts are becoming the technique of choice.

Patellar or quadriceps tendon tear/rupture

The quadriceps tendon attaches the thigh muscles to the knee cap (patella) and the patellar tendon attaches the patella to the shin. Together with the quadriceps they form a powerful extension (straightening) mechanism for the knee. These tendons can be  injured from landing awkwardly after a jump, a direct blow to the knee or when the force produced by the quadriceps muscles overpowers the tendon during a failed kicking motion. 

Surgery usually involves removing the torn edges of the tendon and stitching the tendon back together, or reattaching the tendon to the bone. In severe cases, the tendon may be reconstructed using a tissue graft. 

What to expect after surgery

Following your operation, you may need to use crutches. However, it is important not to rely on walking aids for too long and get moving so that your knee muscles don’t weaken. Physiotherapy after knee surgery for sports injuries is, therefore, essential to restore the range of motion, flexibility and strength of your knee. 

Typical timelines

In the first instance, post-surgery physiotherapy will be guided by any protocols provided by your surgeon, particularly in the case of ACL or PCL reconstruction and meniscal repair. For standard procedures, where no restrictions are imposed, rehabilitation and treatment will be guided by the judgement of one of our highly experienced and specialised physiotherapists.

Early recovery phase: weeks 1–2

With more complex surgeries such as ACL or PCL reconstruction, meniscal repairs and patellar or quadriceps tendon repairs, the primary goal of the early phase is to protect the repair, which in some instances may involve wearing a brace. In this phase the emphasis with your physiotherapy will be pain and swelling management, restoring movement using specialised manual techniques, and basic exercises to maintain and restore basic muscle function within limits. In this phase, you will most likely need to use crutches.

For standard meniscectomies, where there are no restrictions, the goal is to restore as much range of motion and function of the knee within the limits of pain and swelling to prevent as much muscle wasting (atrophy) as possible. In most cases, you won’t need crutches.

Mid stage recovery: weeks 2–6

With more complex surgeries, the main aim is to restore as much range of movement as possible and encourage quadriceps activity so the muscles can support the joint as you rely less on crutches. In this phase, activities such as walking and a broader range of strengthening exercises can be started.

For standard surgeries, walking can be built up as much as you can tolerate, and activities such as swimming and cycling can be started. In some cases, gentle jogging can be introduced at around 6 weeks but this is generally only appropriate for younger adults. 

Late stage: 6 weeks to 12 months

For complex surgeries, at around 6 weeks, you will stop using any braces. From this point on it’s all about maximising your range of motion and strength for all of your lower limb muscle groups. This is to prepare you for higher level functions, such as walking, cycling, swimming, sport-specific drills, and tailored strength and conditioning programmes. This will all help you return to peak performance.

For standard surgeries, from around 6 weeks onwards, you will likely be able to perform higher level strength work and after around 3 months, return to normal sporting activities.

Starting your road to rehabilitation

Physiotherapy after knee surgery for sports injuries will always be tailored to your specific injury and needs, goals and progress. As physiotherapists experienced in post-surgical rehabilitation we can help you get back to playing the sports you love. Simply give us a call on 0208 898 1213 to find out more.