Follow-up treatment of a torn cruciate ligament


In general, the Follow-up treatment of a torn cruciate ligament Achieve a lot with consistent exercises.
However, it is important to tailor the exercises precisely to the respective condition, since overloading itself can be harmful again.

Exact exercise plans are available as book or E-books or can be discussed with the treating physiotherapist. Often these already provide exercises for at home that are at least as important as the guided training.
From about the point in time when the forearm crutches can be dispensed with is also a moderate exercise possible on a bicycle ergometer.

In general, however, you should consult the attending physician and physiotherapist for all activities, as the individual resilience can be very different.
For this reason, weekly information in exercise books etc. should only be taken as a guide. In general, you should stay on the ball when it comes to the exercises, but always make sure that you do not strain yourself too much.
It makes sense to listen to your body and stop doing the exercise if you experience unusual pain.

Conservative action

The conservative treatment after a cruciate ligament tear consists first of all in immobilization.

Rail systems are used that stabilize the knee and only allow mobility within very narrow limits.
The flexion and extension angle of the knee can be precisely adjusted to the respective needs.
The relief by crutches is very important in the initial phase. Gradually, in addition to stabilization, the promotion of mobility and strength also takes on an important role.

Physiotherapeutic exercises can already be performed with the splint, which are then gradually increased. Good physiotherapy is very important for healing and the later course and should not be underestimated. Pain therapy is also part of the conservative follow-up treatment after a cruciate ligament rupture and enables good physiotherapy and increased stress.
Measures such as cooling, Elevate or one Lymphatic drainage help improve healing.

After approx. 12 weeks, light sport can often be started and the strengthening of the muscles can be continued. It is important to discuss all activities with the attending physician.

Please also read our topic on this Cruciate ligament splint

Appointment with a knee specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

  • Lumedis - your orthopedic surgeon
    Kaiserstrasse 14
    60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Pain after surgery

After Operation of a torn cruciate ligament pain is a normal side effect of the healing process. (please refer: Symptoms of a torn cruciate ligament)
Nevertheless, it is important to adequately treat this pain.

It doesn't make sense to want to endure the pain. Especially after operations and in the subsequent rehabilitation, it is important to be as pain-free as possible in order to be able to perform the strengthening exercises at all.
If you have too much pain, this not only prevents good physiotherapy but can also lead to relieving postures or in the worst case to the development of chronic pain.

For pain therapy after surgery, typical painkillers, including over-the-counter, are usually used, such as Ibuprofen or Diclofenac used. In addition to relieving pain, these also have a decongestant and anti-inflammatory effect, which promotes healing after the operation.
But also with simple measures like Cool, Elevate and performing the arranged exercises, the pain can often be reduced and healing improved.

The timing

Post-treatment scheme Patellar tendon graft

1 day

Positioning on foam splint, no load, isometric exercises hip flexors, abductors and knee extensors, active exercises healthy leg - cocontraction.

2 day

Movement exercises active and passive 0-0-90, 1/2 body weight load, motor splint 2 x 1/2 hour daily, full extension, patellar mobilization.

up to 3rd week

Movement exercises active and passive 0-0-90, 1/2 body weight load, individual physical therapy with PNF, active movement therapy with resistance, cocontraction, stabilization and coordination exercises with partial load, Strength training of the sciocrural muscles, cryotherapy 5 minutes at the end of each exercise series.

4th to 6th week

Movement exercises active and passive 0-0-90, full load, increasing resistance during muscle training, coordination training, swimming pool, Isokinetics, stationary bike.

7th to 12th week

Free range of motion, full load (everyday resilience usually achieved after 8 weeks), treatment plus treadmill, coordination and skill training (tilting top, trampoline), exercise time 2 - 3 hours daily.

from the 13th week

Free movement, full load, training according to demands and progress, isokinetic muscle training, bike, swim.

Avoid dynamic sports in first postoperative year because of the risk of graft stretching!

Post-treatment regimen of semitendinosus graft

1st-3rd Day:

Immobilization in a dorsal plaster splint or positioning splint in 15 ° flexion (flexion)
Cryotherapy (cold therapy), isometric tension exercises

4th day:

Adjusting the Don Joy Goldpoint orthosis with extension / flexion: 0-10-90 °
Mobilization and gait training under full load
first physiotherapy exercise therapy according to PNF

7th - 8th day:

If there are no complications, discharge the patient.

11th day:

Thread removal

End of 6th weeks:

Follow-up examination
Removal of the 10 ° stretch inhibition, Ext./Flex. of the orthosis: 0 - 0 - 90 °
the orthosis can be removed at night

from week 13:

Follow-up examination
Removal of the orthosis,

Avoid dynamic sports in first postoperative year because of the risk of graft stretching!

The aim of the externally performed physiotherapy (physiotherapy) is also to achieve a knee joint flexion of 90 °, an extension of 10 ° and after six weeks of 0 ° as well as strengthening the muscles that stabilize the knee joint. The training of proprioception can be supported by training devices (mini trampolines). As soon as the patient reaches an active flexion of 90 °, movement training could be carried out on an exercise bike. Jogging on a level stretch with the knee orthosis on is approved no earlier than 12 weeks postoperatively, sports such as football, basketball, etc. only after one year.

Please also note the related topics: Torn ligament at the ankle.
You can find more information in the section sports medicine.