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Are all the therapy exercises necessary after ACL injury?

Q: I need a little advice. I'm 42-years-old and I tore my ACL skiing. I'm pretty much ready to hang it up anyway, so I'm wondering if I really need to do all the exercises the therapist has given me. I just don't want to work that hard but I'm a little embarrassed to say so.

A: You are not alone in this dilemma. Rehabilitation after ACL injuries is often a lengthy process with therapy two to three times a week for several months and a home program for much longer than that. Studies show that athletes preparing to return to their individual sports programs often continue improving in strength, agility, speed, and control for up to 24-months after the surgery.

The average citizen like yourself may not be motivated to follow a dedicated daily program for six weeks much less six months and beyond. Being honest with yourself (and your therapist) is a good place to start. Finding a program that works for you is important. Keeping a training diary might help you track your progress and keep you focused longer than if you just wing it from day-to-day.

Sometimes writing down all the things you are doing actually helps you see that you are doing more than you thought. For example, the number of visits and hours spent with the therapist count. Leisure activities, recreational activities, walks, bike riding, dancing, gardening, bowling, golfing or anything else you might enjoy doing can also be part of the training program.

Next time you see your therapist, bring this up to him or her. Think ahead what your short-term and long-term goals are and present these to the therapist. Having reasonable and practical goals to work toward that are important to you is the way to go. You'll be far more likely to stick with a program that's getting you where you want to go than where your therapist thinks you want to go. Time for a little honesty -- you'll probably be pleasantly surprised that it's not that hard to discuss this and find a solution that works.

May Arna Risberg, PT, PhD, and Inger Holm, PT, PhD. The Long-Term Effect of 2 Postoperative Rehabilitation Programs After Anterior Cruciate Ligament Reconstruction. In The American Journal of Sports Medicine. October 2009. Vol. 37. No. 10. Pp. 1958-1966.