Knee injury: ACL (Part I)

My sister-in-law recently ruptured her ACL playing touch footy and will be undergoing surgery in a month. Hence it prompted me to write about the ACL - what it is, what happens with an ACL injury, and provide an overview of surgery and rehabilitation from a physiotherapist's perspective.

What is the ACL?

The Anterior Cruciate Ligament (ACL) is one of the four major stabilising ligaments of the knee.

The other three are: Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL).

The term 'cruciate' is used as the ACL crosses the PCL in a crucifix position.

Baby milestones: 7 to 12 months

Understanding the developmental milestones of a baby is a good way for parents to monitor their child's growth. It is of course important to mention that all babies are different and some may achieve certain milestones later than others, and this is nothing to be worried about (unless you notice this delay happening consistently).

Following on from my previous article "Baby milestones: 1 to 6 months", here listed below are the major milestones to look out for in your child between 7 to 12 months.

Baby milestones: 1 to 6 months

Understanding the developmental milestones of a baby is a good way for parents to monitor their child's growth. It is of course important to mention that all babies are different and some may achieve certain milestones later than others, and this is nothing to be worried about (unless you notice this delay happening consistently).

Here listed below are some of the major milestones to look out for in your child.

1 month: 

• Lifts head when lying on tummy
• Responds to sound
• May stare at faces

2 months:

• Starts to vocalise (ooh, aah, coos, gurgles)
• Can start to follow objects
• Plays with hands
• Lifts head at 45-degree angle for short periods

3 months:

• Smiles
• Lifts head > 45 degrees (and shoulders) when lying on tummy (mini-push up)
• Visually tracks objects
• Recognises your voice

 

4 months: 

• Smiles and laughs more frequently
• More vocalising and responds by cooing when you talk to him/her
• Starts to roll over (most commonly from tummy to back)
• Starts to bring hands together and swipe at toys 

 

5 months: 

• Plays with hands and feet
• Grasp toys
• Rolls over in both directions
• Imitates sounds

  

6 months: 

• Sits without support
• Imitates sounds
• Turns to sounds and voices
• Mouths objects
• Start solid foods

Question received re: Exercises suitable for when sick with the cold/flu

QUESTION RECEIVED 31/8/10:

"What kind of stretches/exercise can you do when you are sick with the flu and a lot of your body hurts? How can you get your blood circulating well without exhausting yourself?"

Good on you for thinking about exercising even when you are sick. It is often so hard to motivate yourself to get up off the bed or couch, or sometimes you just physically are not able to stand up long enough before feeling dizzy or weak.

Here below are some gentle exercises that I would recommend for you to do to keep the blood circulating and prevent your body getting stiff (without causing too much exhaustion). Just select a few that you like and try to do them 3 x a day. I have also written down the sets/reps that I would recommend. Of course, the key is not to over-do, so do what your body can handle!

Ankle pumps

In lying (1-2 sets, 10-15 reps):

• Ankle pumps
• Static quads (tightening the thigh muscle with your knee straight)
• Straight leg raises

Squats

In sitting (1-2 sets, 10-15 reps):

• Seated calf raises
• Knee bends/extensions
• Seated leg marches
• Sit-to-stands

In standing (1-2 sets, 10-15 reps):

• Mini squats
• Mini lunges
• Calf raises (with arms down by side first; then progress to holding arms straight out to sides)

Light strenghtening exercises using hand weights (eg. 1-2kg; 1-2 sets, 10-15 reps):

Bicep curls

• Bicep curls 
• Tricep curls (palm facing inwards with arm held back, straightening/bending elbow) 
• Deltoid flies (with elbow straight, elevate your arm out to the side)
• Overhead press (push arm straight up into the air)

Gentle fitness exercise (15-30 mins):

• Walking is important - If possible, try to get some fresh air and go for an easy walk around your area, sticking to the flats rather than doing hills

Gentle stretching exercises (hold each for approx 15secs, repeat 2x):

• Neck: tilting head sideways, rotating both sides, looking up and down
• Shoulders: 
• Pull one arm across the front of your chest and feel the stretch at the back of your shoulders



Posterior Shoulder Stretch

• With hands together, stretch arm upwards and hold above the head

•  Reverse shoulder stretch

 

• Wrap around shoulder stretch

 

• Calf stretch

• Quads stretch

Hope this has been helpful for you. If you have any further questions, please don't hesitate to contact me.