What happened when a Physio injured his knee badly?
It was the first night back to formal judo training in 2024. Everyone was excited to start training again in the new year. During the sparring session, I felt my right knee buckle inward with a shifting and a “Pop” sensation. Immediately I collapsed and felt a sudden extreme pain on the inside of my right knee. I then screamed in agony for at least 5 minutes. My coach and teammate had to drag me to the safe side of the mat while I was clutching my knee and shutting my eyes in pain. Below is the throw technique for your reference.
Due to the nature of the injury, I organized a brace fitting and MRI of the right knee. The MRI results showed a Ruptured ACL and Ruptured MCL injury. It is most likely that I would need an ACL reconstruction if I want to return to a contact sport.
During this time of contemplation, I was introduced to the Cross Bracing protocol. It is a new conservative approach to manage an ACL injury. The protocol consists of immobilising the injured knee in a brace at 90 degrees for a period of time, followed by a strict gradual increase in the range of movement. The knee is locked at a specified angle or angle range for 24 hours, 7 days, including during rehab, showering, and sleeping. The total bracing period of this protocol is 12 weeks.
The protocol also includes specific rehabilitation exercises (maintaining the specified range in the brace), hands on treatment, as well as medication to reduce the risk of complications. Some rehabilitation exercises in the early phase of rehab includes isometric wall sits, calf exercise with resistance band, quadriceps and hamstring co-contraction, bridges, hip abduction and extension with resistance band, and hip isometric adduction.
Due to the risk of complications, it is not advisable to commence this protocol without supervision of health practitioners who are knowledgeable or trained in this protocol.
Below are pictures of some example of early rehabilitation exercises with my knee being locked at 90 degrees with a hinged knee brace:
Long story short, I am using cross bracing protocol for the management of my ACL injury. At the time of this writing, I am close to the end of the bracing period. Being braced 24/7 is not easy! There are many activities of daily living that I am not able to do by myself. However, if this allows my ACL to heal without surgery, then I would argue that the benefit outweighs the inconvenience.
If you have a recent traumatic knee injury, you would benefit from Physiotherapy assessment. If ACL injury is suspected we can guide you through the recovery process, regardless of your choice to follow conservative or surgical management.
For more information regarding cross bracing protocol, you can read the research paper from the British Journal of Sports Medicine or the channel 9 news broadcast on Mar 22, 2024.
To book an appointment with one of our experienced Physiotherapist call 03 9859 5585 or book online.