Case Study - A footballer who was seen pre and post knee surgery (LCL and ACL Knee ligament repair)

LW is a 20 year old footballer who had a traumatic football injury where he was tackled and landed awkwardly onto his left knee.  He was sent to A&E where an X-ray revealed he had an avulsion fracture of the head of fibula. He had an MRI following this and this showed he had ruptured his anterior cruciate ligament (ACL) and lateral collateral ligament (LCL) as well as sustaining ruptures to his biceps femoris tendon (part of hamstrings) and popliteus tendon. He had an operation to repair his LCL 1 month after injury and attended Aqua physio 1 month after this operation.

He was assessed by one of our aquatic physiotherapists identified what needed to be worked on in the pool and gradually increased the intensity of the aquatic exercises within the sessions. These sessions comprised of gait re-education, weight transfer exercises, strength training, aquatic running and stretching exercises. He made an excellent progress in these sessions and was able to walk unaided with out a limp. He had regained full range of movement in his knee and improved his strength considerably.

LW then went to have his second operation to repair his ACL with a hamstring graft.  He was seen at Aquaphysio 4 weeks after the operation and was re-assessed by one of the aquatic physiotherapists. He was mobilising on land without crutches but limping. He had reduced knee active range of motion and he had poor quadriceps strength and control. There was considerable swelling around his anterior knee. We started a new programme working on his quad and glute strength, active range of movement and gait patterning. Once he had adequate quad control, we started running in the deep well at just 6 weeks post-surgery.

After only 3 sessions, he has made great progress with adequate quads control for open chain exercises and aqua running, active range of movement in his knee from 0-130° and walking on land without a limp.
LW’s aqua programme will be progressed alongside his land physio exercises in line with ACL rehab protocols. He will benefit from Aquaphysio being able to run and increase cardiovascular fitness much quicker than on land. We will continue to treat him until adequate strength and fitness is re-gained in order for him to return to football.