Using technology and home exercises to prevent ACL injuries

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MURRAY, Utah (ABC4 Utah) – Tearing your ACL used to be a career ender for professional athletes. Not anymore. But what if you can prevent the injury in the first place.

Some people are using the precise post-surgery techniques and technology in rehab to prevent injuries. 

In part 5, of focusing on our ACL, our partners with Intermountain Healthcare are alerting healthy people of weaknesses in their knee with pin point accuracy.

Sally Trawick,16, is a sophomore at Juan Diego Catholic High school in Draper.
Volleyball is her life.  

“It’s everything I do. Everything I think about. I love it.”

That’s why Sally is getting an athletic injury risk assessment, so she doesn’t get served an injury that takes her out of the game for a season.

“We have 10 motion capture cameras surrounding you and those are picking up down to the millimeter of movement,’ said Tristin Turner, physical therapist.

When we showed Surae Chinn’s personal journey after she tore her ACL, we showed you the effectiveness of post surgery analysis at the biomechanics sports science lab at Intermountain TOSH, The Orthopedic Specialty Hospital in Murray. 

But for healthy people like Sally, they’re coming here to prevent an injury in the first place.

“We are going to have you do different movements that we know are risky or important for your sport,” said Turner. 

Sally goes through a series of exercises.  

“You can’t feel whether you’re internally rotating 2 degrees when you’re running when your foot lands on the ground, so we can find that,” Dr. Jim Walker, TOSH Sports Science Director.
 
That one to 3-degree difference can predispose you to arthritis or injuries.

“When you do that you’re putting a strain on something else,” said Walker.

Professional athletes come here to get pinpoint analysis. But TOSH tries to make the technology driven pre-injury assessment available to the community. 

Health experts say most ACL injuries happen with no contact.  

The international soccer association, FIFA and the International Olympic Committee each came out with their own routines to prevent ACL injuries. These are exercises you can do at home.

A combination of strengthening your hip, quad, and hamstring and working on balance.

“They need to be done 2 times a week, and they need to be done pre-season and during the season in order to be effective,” said Dr. Clair Gross, Intermountain Healthcare Sports Medicine.

Studies have shown these warm-up programs put out by FIFA  reduced leg injuries by 30 percent.

Sally has now altered her workouts.

“Some things to stabilize my knee and to get out of bad habits.”

Correcting those bad habits have not only made her stronger but has improved her game.

Nearly 250,000 people a year injure their anterior cruciate ligament or ACL, according to the Center for Disease Control.

One of those people was ABC 4 anchor and medical correspondent Surae Chinn, who injured her knee while skiing. Dr. Vern Cooley, and orthopedic surgeon at Intermountain TOSH and the Rosenberg Cooley Metcalf Clinic in Park City, performed the ACL repair surgery on Surae and joined her today as she continues her recovery. 

Some ACL fact: 

The ligament is at the center of a person’s knee and is key to holding the knee in place. The injury often comes during physical activity. Many patients report hearing a “pop” in their knee followed by pain and discomfort. 

Thirty years ago, an ACL tear meant the end of a sports career, or doing less intense physical activities that patients once enjoyed. Thanks to advances in surgical techniques and tools, along with rehabilitation techniques, patients are feeling better faster, while getting back to activities they love.

As one of the leading orthopedic and sports medicine centers in the nation, Intermountain TOSH researchers use data from 40 yrs of experience to perfect breakthroughs in evidence-based care.

One of the biggest advancements in ACL surgery has been the knowledge gained around rehabilitation and strength training before and after surgery.

Having strong muscles before a surgery can help healing after a procedure. That’s why doctors try to do a surgery quickly after an injury before the muscle begins to atrophy. 

A vital step to post operation recovery is moving around afterwards. Over the last five years, Intermountain has made it a goal for patients to be seen by a physical therapist six hours after surgery.

Because TOSH has so many experts under one roof it makes this process seamless and patient-centered.

They do an evaluation to see where the patient’s strength is and get them used to moving. 

Data has shown it not only helps in the healing process but avoids serious complications such as blood clots, skin infections, and intestinal problems.

At TOSH more than 90 percent of patients go through these steps before heading home. Doctors have found early mobility is key to healing and gaining strength back into a knee.

In the past it was believed not moving the leg was better and some even used a hard cast after surgery. Now it’s shown that getting range of motion back and putting weight on the leg as soon as possible is a better process.

The evidence of these successes has allowed for better procedures and processes to improve orthopedic surgery throughout the Intermountain system.

By giving the most effective and efficient musculoskeletal care we are getting people back to living their healthiest life possible.

Technology advancements have also allowed for less invasive and quicker surgery process. Arthroscopy cameras are used in the knee to assist a doctor in seeing what’s there without cutting it open.

During surgery doctors don’t “repair” an ACL but replace it entirely. 

They do this using an autograft, which takes tissue from another part of the patient’s body. The two most common places being the knee cap tendon or the hamstring tendon. 

The doctor removes the torn ACL, tunnels through the bone, and holds the new ligament in place with screws or other devices. As the bone heals it will fill in, holding the ligament in the same place as the old ACL.

The entire surgery takes about 30 minutes to an hour.

After the initial post-surgery evaluation, a patient will normally start full time physical therapy within the week.

Patients can often do controlled running within three months.

Even with the advancements in procedures and rehabilitation, a person normally doesn’t return to strenuous activity and sports until about 6 months after surgery. 

Doctors note that 3-4 months after surgery is a danger zone for patients. That’s when their leg feels back to full strength, but the tendon is still vulnerable to another tear during hard activities like sports.

The Bridge Program at TOSH helps patients gradually return to their sport to reduce the risk of re-injury.  

Women are two to eight times more likely to have an ACL injury due to body formation, and how their legs connect to the hips.

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