NYU Langone physicians may recommend nonsurgical treatment for an anterior cruciate ligament (ACL) injury, from immediate strategies for reducing inflammation to ongoing physical and occupational therapy to strengthen and support the knee.
These therapies may be an option for people who are not candidates for surgery because of an underlying condition, or for those who do not routinely put a lot of stress on their knee joint through pivoting or contact sports.
Using rest, ice, compression, and elevation, also known as the RICE regimen, as soon as possible after injuring your knee can help reduce pain and swelling.
Your doctor may suggest using crutches to keep weight off your knee or a knee brace to protect the joint from instability for a couple of weeks. Staying away from the physical activity that may have contributed to the ACL tear is also necessary.
During the first few days after the injury, applying ice and elevating your knee for 15 minutes, 3 times a day, can reduce swelling. Wearing a compression bandage on the knee may also reduce swelling.
Your doctor may remove fluid from the knee as soon as possible after injury to help relieve pain and swelling and to improve range of motion. For this outpatient procedure, the knee may be first numbed with a local anesthetic. Then a needle is inserted in the joint to withdraw fluid into a syringe. Your doctor may use ultrasound to help guide the procedure, although this is not always necessary. Your knee may be sore for a couple of days afterward.
Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen can reduce inflammation and pain caused by an ACL tear. The short-term use of prescription medications may also be also be an option. Your doctor discusses the best pain relief medication for you.
Physical and occupational therapists at NYU Langone Orthopedic Center can create a personalized rehabilitation plan that reduces swelling and improves muscle strength around the knee joint. Riding a stationary bike may help to reduce swelling, and stretching the knee, thigh, and lower leg can help improve range of motion.
After swelling has subsided, your physical therapist may concentrate on strengthening the muscles around the knee to help support it. Exercises such as body squats, heel lifts, and leg lifts can strengthen the thigh and lower leg muscles. If your job requires manual labor or you need to be on your feet most of the day, occupational therapists can help you to adapt your physical activity to avoid future knee injuries.
Your doctor and physical therapist may recommend a few weeks or more of physical therapy, depending on the severity of the injury. If your goal is to return to sports, your doctor may refer you to our Sports Performance Center, where specialists can refine your movements to prevent future knee injuries.
While physical therapy can improve strength, range of motion, and flexibility, it cannot heal a torn ACL. If you experience instability in the knee, despite receiving an appropriate course of physical therapy, your doctor may discuss surgery with you.
Our sports medicine specialists offer a preoperative physical therapy program to minimize inflammation, pain, and swelling and to restore range of motion to a pre-injury level. This rehabilitation often improves the results of an ACL reconstruction and reduces the chances of postoperative stiffness.
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