The knee is a joint which, in addition to flexion and extension, can also rotate. This is a blessing for mobility in everyday life and during sport. However, for every movement, there must be structures that control it (nerves), structures that carry it out (muscles) and structures that limit the movements. The bands, among other things, are responsible for this. If the lower leg is firmly in the grass with the foot and cleats and the rest of the body performs a dynamic movement, the knee has a problem.
“The anterior cruciate ligament is the structure for stabilizing the knee against displacement and twisting. In the case of a crack, that is exactly what happens: simultaneous displacement and twisting. Usually without direct influence from the opponent when landing after a jump or a sudden change of direction,” Dr. Hinterwimmer describes in B42.
If the body is not sufficiently prepared for the rapid and often unexpected movements, there is often this bang, this cracking, which so permanently penetrates the memory of those affected.
Everyone who is affected knows the feeling all too well. And it is anything but pleasant. But what now? First, you should stop the sporting activity immediately. A simple rule of thumb before a precise diagnosis is made is: “BAD LUCK” — break, ice, compression, high storage. Even if these steps are followed, the first signs quickly appear. Knee swelling develops, which limits mobility and the joint can no longer be fully stretched. Acute pain occurs, disappears temporarily and can recur with further exertion. Gradually, a bruise may form. As soon as the diagnosis of “cruciate ligament rupture” is established and the initial shock has been overcome, further thoughts must be processed. Urgent questions arise: Will I ever be on the soccer field again? Is my career over? In today's blog post, we talk about the expected downtime and finally address the most important question: surgery or conservative treatment?
A torn cruciate ligament is unfortunately part of everyday life in soccer, but one thing is certain: No, it doesn't have to mean the end of your career! At least not necessarily. However, it is clear that a long break awaits you. Football games are out of the question at first. According to available data, the average downtime in professional soccer is around eight months. In the amateur sector, the healing process can take even longer, often due to less intensive rehab. A recovery period of up to one year is not uncommon here. This physically and mentally challenging phase is likely to be accompanied by setbacks. Especially for younger people and active athletes, surgery is usually unavoidable if you want to regain your mobility in the best possible way. This applies to both amateur and professional sectors.
“A conservative return to soccer, i.e. without surgery, is ruled out in most cases,” says Professor Dr. Stefan Hinterwimmer (OrthoPlus Munich) in his interview with B42. He is a renowned specialist in the field of cruciate ligament injuries in soccer, with whose help a number of top athletes have made it back on the pitch.
Nevertheless, it is entirely possible to recover successfully even without surgery. There are even cases from the Bundesliga that show that conservative treatment methods can be successful. Surgery may not always be necessary, particularly in the amateur sector, where stress is generally lower. In the end, however, there is no universal procedure, because every cruciate ligament injury is unique and requires individual consideration. Perhaps the article “Cruciate ligament rupture — surgery or conservative treatment? “Help a little bit when making decisions.
Professional training plan after knee injury - start now!
Regardless of which decision you ultimately make, one thing remains clear: Thorough and consistent rehab is essential. Patience is paramount during this long recovery period. Players who return to the pitch early often put themselves at risk of another cruciate ligament injury. In order to provide you with optimal support during this challenging time, we have launched our comeback training. With our app, you can work specifically on your recovery every day. In close cooperation with experts from competitive sports, we have prepared the rehabilitation training of professionals for the amateur sector. We have summarized this valuable knowledge in a comprehensive guide, which offers you helpful tips for various knee injuries, such as:
Rehab after serious injuries such as torn cruciate ligaments, meniscus damage, distortions, inner ligament injuries, etc. is basically divided into three phases. Even though the injuries differ, the same rules apply to all of these violations, albeit in different periods of time.
For the start of the proliferation phase, we have prepared three exercises for you as an example - feel free to take a look! Don't forget to discuss the exercises with your physio!
No, it's not esoteric! Abdominal breathing with closed eyes promotes stress relief and the ability to perceive pain differently (reduced). It also has positive effects on lymphatic circulation. In the best case scenario, do it with your legs shifted to relax your straight abdominal muscles. If that is not possible due to your knee injury, then at least use one leg. It is very beneficial if another person places their hand on their stomach so that you can “breathe away.” But if no one is available right now, you can easily do the exercise alone. Make sure that your exhalation should last longer than your inhale. When exhaling, place your lips on top of each other so that you don't have to focus on moving your jaw. Breathe in and out deeply for a maximum of 6 times before taking a break. This exercise is great to do after a workout.
Many patients describe the proliferation phase as their personal greatest success. During this phase, you often make progress on a daily basis. A movement that didn't work yesterday is already working today with almost no problems. This exercise is the classic after knee injuries to practice flexing the knee. Pay attention to any restrictions that the doctor or physical therapist has set. If you wear a splint, you should check whether you can take it off during the exercises. Many knee patients perform the exercise in hospital beds just a short time after surgery. You can find out the correct dosage from a physiotherapist!
Knee extension is particularly important after cruciate ligament ruptures! The cruciate ligament limits knee extension so that the knee does not pierce. When the responsible doctor restores the cruciate ligament using plastic, the tissue must first grow together. However, activating knee extension after surgery is very important so that the knee joint does not develop a permanent stretching deficit. This exercise not only has the positive effect of restoring mobility, but also activates the lymphatic system to remove the fluid from your knee. As with any post-op activation, you should be careful when performing it and avoid pain!
To avoid having to go through this unpleasant experience in the first place, there are some helpful tips and recommendations. A central aspect of prevention is targeted training for changes of direction. Statistics show that soccer players make around 700 changes of direction during a game. Improved mobility therefore plays an essential role in preventing serious knee injuries. Not only is acceleration training important, but above all controlled deceleration. Especially when braking, high forces act on the knee, ankle and hip joints, which significantly increases the risk of overload. Even in the first few days after an injury, balanced training should not be neglected, regardless of whether surgery or conservative treatment was chosen. The better the muscles and tendon-ligament apparatus are trained, the faster the rehabilitation takes place. In addition, a surgical procedure always results in a loss of strength and function, and the initial state decisively determines how well the body recovers afterwards. You can find out what you can do to prevent this in the article “Prehabilitation.”
Be fearless. Be focused. B42
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