Knee Pain and ACL Treatment in NYC

Phase 1: Healing the Knee

The first phase is designed to promote healing and repair within the knee, as it has just undergone the trauma of surgery. Even though surgery is beneficial to the long term, it caused the body to undergo a damaging process that must be kept in mind during treatment.

Your individual process will differ according to the treatment option that your surgeon chose for you. An ACL patient may have received:

• Crutches
• A full-length knee brace
• Both

As most patients will at least be required to use crutches, the first phase involves learning how to walk with crutches, as well as navigate slopes and stairways. Your Knee Pain Treatment in NYC will also involve swelling control techniques, such as when and how to use ice, as well as instructional gentle exercises to help you regain a range of motion in the knee.

Phase 1 Outcomes:

At the end of Phase 1, you will see progress in….

• Surgical Wound Healing
• Walking and Stair Climbing
• Increased Range of Motion in the Knee
• Improved Use of Quadriceps
• Decreased Swelling

Phase 2: Walking without Crutches

This phase is designed to progress past the initial healing phase and move toward using your knee more normally, without crutches. Sometimes, the surgeon has removed the brace at this point, but that is dependent on your individual situation and your surgeon’s discretion.

Your Knee Pain Treatment in NYC, NY will involve a series of processes in order to help you walk without crutches. These include:

• Strengthening your hips through targeted exercises, to graduate from using two crutches to using one, and eventually to walking without crutches
• Improving the use of your quadriceps and hamstrings through targeted exercises
• Increasing the range of motion in the ankle, knee, and hip joints. These exercises are designed to increase your proprioception (your ability to sense your orientation and move without thought)
• Leg Raise exercises, sometimes with light weights

Phase 2 Outcomes:

• Walking without crutches entirely
• Increased ability to bend the knee
• Increased rotation in the joints of the leg (hip, knee, and ankle)

Phase 4: Getting Closer to Normalcy

This phase usually begins at Week 8 post-surgery and can continue until Week 12 or for up to six months post-op, depending on your individual situation and progress.

Phase 4 is highly individualized based on your specific needs. The exercises and rehabilitation methods used are dependent on how well you have succeeded in the previous three phases, as well as the progress of your surgical wound’s healing.

Usually, individuals in this phase at Knee Pain Treatment in NYC work with our physical therapists to….

• Increase the established exercise regimen’s intensity and frequency
• Perform stability testing (usually single-leg hopping) to determine your ability to return to normal physical activity or sports
• Perform frequent evaluations to determine how to change and progress the treatment plan as you heal and strengthen

Phase 4 Outcomes:

• Return to normal physical activity
• Return to sports or high-intensity athletics
• Return to labor-intensive work
• Regain the feeling of normalcy and efficiency in knee and leg overall
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If you’ve recently undergone ACL surgery, it is important to seek physical therapy right away in order to receive the proper rehabilitation methods and ensure that your surgery was as effective as possible.

Knee Pain and Imaging

MRI’s and X-rays are the most commonly performed forms of imaging done on the knees to look for some type of meniscal tear or degeneration, or arthritis of the knees. With these conditions people often get the idea that because they either need surgery to “fix” it, or should avoid certain exercises or positions because it’ll make their knees worse. However, if you never received the imaging, you would never have thought that and would continue doing what you usually do. While it may sometimes be helpful to get imaging done to have an idea what is going on, you never want to let your “diagnosis” define you and how you move and exercise. If we took fifty random people off the street who have no knee pain and took imaging of their knees, a good amount of them would have some type of degeneration or tear show up. In fact there have been multiple studies (some on professional and collegiate basketball players) in which imaging was done on people who reported having no knee pain, yet the imaging showed those people had meniscal tears, arthritis, or some other tissue damage in their knees. These studies have also taken imaging on people with knee pain, and shown that they do not always have more tears or arthritis than the pain free people.
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What these studies show is that you cannot get caught up with your condition. Too often people believe that they have to be less active and protect their knees. They think that they shouldn’t go up and down stairs, work out, squat, walk, etc. As has been stated multiple times in previous posts, doing nothing is the worst thing to do. Degeneration is a natural part of aging, which happens to everyone at different rates, just like any machine that eventually wears out. While you cannot fix or control the extent of the arthritis or meniscal tear in your knee, what you can control and fix is how you move and exercise. This is when having strength and mobility is even more important than ever. You want your glutes, quads, hamstrings and other leg muscles to be as strong as possible to take pressure off of your knees. You want to perform exercises that not only strengthen these muscles, but are also functional and similar to the type of activity or sport you enjoy doing.
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Sometimes getting the imaging does not present you with a fix, but instead can be more limiting. The imaging does not always match up to how you feel, and it shouldn’t dictate how you feel. The relationship between pain and what is going on in the knee is not always clear and direct, and it is up to you, not your imaging results or diagnosis, to take charge and decide what you can do.