💥 ACL Tear Anniversary(附中文) “ No Surgery: Function > Structure “ - 6th May 2020 marks the day of my right ACL anniversary playing 🏈. It has been one of the most devastating injuries by far as I still remember I heard a “snap” when I was trying to go past the offensive line - I decided not to have surgery. Nothing was more difficult than walking stairs after the tear. But I looked on the flip side as being a physical therapist myself, I read all the journals I could find and designed my own rehab program. Day in and day out of the gym now I can squat 160 KG again - If you went to a doctor after an injury like this they would 10/10 suggest a surgery. After a year of research and working with ACLR clients , I have made a conclusion of 3 scenarios where you should consider Rehab before surgery: - 1️⃣ Isolated full ACL tear : No complications on meniscus or lateral ligaments. No pain after acute swelling 2️⃣ Grade 2 partial-tear : No acute swelling after injury. Still remnants of ACL ligament can be strengthened with strength training to stimulate ligamental growth 3️⃣ Unidentified : No acute swelling after injury, nor pain. Unclear to reach diagnosis on MRI - 🎯 As long as you can maintain good “function” of your leg, like day to day commute, full squat without pain. There is not an urgent need for surgery, and instead, rehab training should be prioritized to maximize “function“ - 🧠 Function + Movement > Structural Damage ——————————— 💥前十字韌帶斷裂滿一週年 “沒有十字韌帶不可怕" - 這週是我因為打美式足球時右腳前十字韌帶斷裂的一週年。這一年來，從走樓梯都有困難，到現在可以深蹲回到160公斤，真的花了很長一段時間。很幸運自己是一位物理治療師，復健自己做，為自己設計課表，從開立十字韌帶訓練團課，到現在一對一的術後訓練，把學過的看過的，融會貫通，幫助那些像我一樣，走出傷痛，重回運動的懷抱 - 可以不開刀嗎？ 這是我常被問的問題，受傷後我並沒有開刀 - 如果你去看骨科，醫生一定叫你開刀。好像沒了韌帶，就不能跑，不能跳，不能回去正常生活，不過事實是如此嗎? - 綜合了我這一年的經驗，與病人的交談，看過的學術文獻，得出以下3種情況，可以先不做十字韌帶重建手術: - 1️⃣ 只有前十字韌帶斷裂，沒有合併半月板受傷(Isolated ACL tear): 我的狀況就是這樣，我只有斷前十字韌帶，沒有半月板或其他軟組織受傷，所以也不會疼痛 2️⃣ 前十字韌帶第二級拉傷(Grade 2 Tear): 第二級的意思是指斷了一些，沒有全斷，可以透過物理治療做訓練，加強膝關節周邊肌肉，增加膝蓋穩定度 3️⃣ 不清楚是不是斷裂(Unidentified): 受傷後沒有腫脹，沒有痛，也沒有聽到「啪」一聲，照核磁共震也看不太清楚，我建議先不要急著開刀，先自我訓練，或找物理治療師評估 - 🎯 重點是，只要功能是可以的，不影響日常生活，能繼續上健身房，打球不會痛不會覺得不穩，那就不用急著去開刀，當然這跟病人自身的目標也有關。假如是在打社會組，競技性比賽，一般還是建議直接選擇開刀，術後趕快做物理治療 - 🧠 功能+動作 > 結構性損傷 . #jamesthephysio signing out