The cruciate ligaments are an important part of the stabilizing ligament apparatus of the knee. They run between the upper and lower leg and fix the two bones together. A distinction is made between an anterior and a posterior cruciate ligament: the anterior cruciate ligament (ACL) runs from the front top outside to the rear inside down.
The posterior cruciate ligament (ACL) runs from the upper back inside to the lower front outside. When viewed from the front, the ligaments cross over each other in their course – hence the name. Together they protect against the lower leg slipping relative to the thigh and limit the rotational movement in the knee joint. In every joint position, parts of the cruciate ligaments are tensed, so that the knee joint is continuously stabilized.
Physiotherapeutic intervention
If a cruciate ligament rupture is treated conservatively, i.e. without surgery, the knee is immobilized for about 6 weeks. Lymphatic drainage and cooling is performed to remove the swelling, the leg is moved passively to protect adjacent joints for stiffening and loss of function, followed by active movement without loading the knee and static strengthening exercises. Once the structures are stable again, an intensive active training therapy is essential to restore the stability of the knee joint.
Coordination is also trained again, depth perception and stretching to release the tension and shortening caused by the injury. Patient cooperation and regular exercises are essential for a successful therapy. The therapy also includes education for correct warm-up in sports and the observance of regeneration times to avoid injuries.
Also integrated are gait training and the optimization of movement sequences. In the following some exercises on the subject of depth perception (proprioception) and muscle building are presented.
- Pain in the hollow of the knee
- Physiotherapy for a rupture of the inner and outer ligament
- Physiotherapy exercises knee
- Physiotherapy after meniscus surgery
In order to train the depth perception after a cruciate ligament rupture, aids such as a wobble cushion, uneven surfaces, parkoure or trampolines are suitable.
1) Exercises for home In order to be able to practice at home, a sofa blanket can be rolled up. First stand upright on the roll with both feet. Here you can practice knee bends, rolling your feet forward and backward and a tip-toe stand.
In advanced, stand with one leg on the roll, the other in front of the body at right angles to the hips and knees. First try to keep your balance and stand still. Then slowly bring yourself up into the one-legged tiptoe position.
Here again, balance is maintained. To make things more difficult, the eyes can be closed or a ball can be thrown up and caught again. Alternatively, a partner/therapist can manually give resistance to the body against which counter holds are to be held.
2) Exercises with the therapy gyroscope In physiotherapy, a therapy gyroscope can be used to help with training. Both feet are placed in a stable and upright position and by controlled shifting of weight the therapist tries to slowly bob from one side to the other and back and forth. Here, too, if the stand is stable, distraction can be added to the difficulty, such as throwing up or bouncing a ball or combined exercises with the arms.
In advanced stages, one-legged training is also possible here.
A Parkour with different surfaces can be built. For example with balancing on an upside down bench and lungeing steps on a soft sports mat.
There are no limits to creativity. Some physiotherapy practices use vibrating plates or hanging boards on which the balance is to be kept or additional exercises are to be performed. More exercises can be found in the articles:
- Exercises for the knee joint
- Exercises against knee pain
- Exercises for a cruciate ligament rupture
Further measures in the regeneration process of a cruciate ligament rupture include electrotherapy applications, ultrasound, massages of surrounding structures, fascial techniques to loosen the entire muscle chain and later tape installations, especially to support the return to sports and everyday life. The following articles may also be of interest to you in this regard:
- Fascial Training
- Kinesiotape
