Ask Dr. B Episode 4: ACL Injury Recovery

Reset, Restore & Reprogram (Case Study)

By Dr. Erin Boynton, MD, FRCS

In this week’s episode, Dr. B addresses the reset, restore and reprogram phases of recovery, using an ACL injury as a case study.

Part 1:

Allowing tissues to heal and regain normal suppleness is the first step to recovery, but while this is proceeding you can also address why the injury occurred in the first place.

We will review the crucial steps to establishing normal alignment, balance of soft tissues and correct movement patterns using the anterior cruciate ligament or ACL injury of the knee as our case example.

A brief description of basic anatomy and function of the ACL, the common mechanisms of injury and clinical findings followed by a routine that teaches the 4 phases of recovery to establish our foundation of movement will be outlined.

We have previously reviewed the Relax Phase, now we will focus on Reset, Restore and Reprogram, the 4R’s to regain our foundation for movement.

Completing the 4R’s will have you perfectly prepared for surgery, or return to sport depending upon your age, general health and the activities that you love to do.

Theme of the week: Slow and Steady wins the Race.

Previous Episodes:

Ep 01: “Wear and Tear” Overuse Injuries: Causes, Prevention, Do You Need Surgery?

Ep 02: The Rhythm of Recovery: 4 Phase Strategy for Injury Rehab (Part 1)

Ep 03: 4 Phase Strategy for Injury Rehab: Relax Phase & Special Guest (Part 2)

Part 2:

In Part 2, Dr. B and Coach E answer the following questions:

  • 51:5 – Is it safe to do squats also loaded squats if there in an ACL tear from around 15 years back? What precautions should be taken. No repair surgery conducted?
  • 53:29 – Had ACL revision 4 years ago, meniscus later bit damaged and is irreparable; despie doing lots of physio; am still not confident of twisting and rotation motion when foot is planted fearing tear?
  • 57:00 – Had ACL surery done years ago, how to remove stiffness in knee especially prolonged sitting?
  • 59:2 – How not tear ligament again during skipping and turning required in boxing?
  • 1:04 – Did VMO to no use after acl, femur and tibia grind, your patellar tracking videos helped some, IT band myofascial release seems to aggravate, could it be tightness or imbalance or muscles or posture?
  • 1:05:16 – After sitting excessively from Covid should we focus on fixing the hip first then move to ankle/foot or should we do both to prevent knee injury?

About the Author

Dr. Erin Boynton, MD, FRCS is an orthopedic surgeon who was the team surgeon for the Toronto Blue Jays for 10 years and has worked with other professional teams and athletes from many different sports. She currently serves as the Chief Medical Director of the Rogers Cup WTA Tennis Tournament and is the ITF Canadian Champion in tennis for her age group (we won't say which group that is!).