Yuval recovery story

Case Description

Yuval, an 18-year-old male, sustained a complete anterior cruciate ligament (ACL) tear following a fall at school. While waiting approximately one year for ACL reconstruction surgery, he participated in a rehabilitation program aimed at preserving knee function, maintaining range of motion, muscle strength, and endurance.

Despite these efforts, Yuval's primary complaint was recurrent episodes of knee giving way (instability), which became more frequent and pronounced as his activity level and physical demands increased. The persistent instability significantly affected his confidence during movement and limited his ability to participate in higher-level physical activities, ultimately leading to ACL reconstruction surgery Phase 1 – The First Weeks After Surgery

The goals of rehabilitation during this phase were to reduce pain and swelling, achieve full knee extension, gradually improve knee flexion, and restore initial quadriceps activation and control.

Treatment included:

Continuous Passive Motion (CPM) to improve knee range of motion. Neuromuscular Electrical Stimulation (NMES) to facilitate quadriceps activation. Patellar mobilizations to maintain patellar mobility. Isometric exercises (static contractions) for the quadriceps and hamstring muscles. Ankle pump exercises to reduce swelling and promote circulation. Gait training with crutches and gradual return to a normal walking pattern. Phase 2 – Restoration of Range of Motion and Muscle Control

As pain and swelling decreased, the focus shifted toward achieving full knee range of motion, improving neuromuscular control, and gradually strengthening the lower extremity.

The rehabilitation program included:

Continued work on achieving full knee extension and flexion. Quad Sets – isometric quadriceps contractions. Straight Leg Raise (SLR) – straight leg raises. Ankle Pumps – ankle mobility exercises. Strengthening exercises for the gluteal muscles and hamstrings. Introduction of weight-bearing exercises according to the patient's progress and tolerance. Phase 3 – Advanced Strengthening and Functional Improvement

After achieving full range of motion and good muscular control, the focus shifted toward advanced lower-extremity strengthening and improving functional performance in preparation for return to activity.

The rehabilitation program included:

Quadriceps strengthening through knee extension exercises against resistance bands. Progression of Squat exercises, emphasizing control of knee and pelvic alignment. Step-up and step-down exercises to improve strength and functional control. Balance and proprioceptive training on a balance cushion (air cushion) with progressive difficulty. Gluteal strengthening using Hip Thrust, along with hamstring and calf strengthening through functional exercises. Progressive hip abductor (ABD) strengthening, beginning with side-lying exercises and progressing to Side Plank variations. Progressive hip adductor (ADD) strengthening, beginning with side-lying exercises and progressing to Copenhagen Plank variations. Stationary cycling to improve endurance, range of motion, and aerobic capacity. Practice of proper movement patterns in preparation for return to daily activities and sports.