Patients who are older, and do not show signs of instability, are not involved in high-demand activities, or have meniscus tears, may benefit from non-operative management of their ACL knee injury.
Non-operative management of an ACL injury, will consist of rest and limit of activities for a period of 4-6 weeks, followed by rehabilitation and bracing. Icing the knee will be important in the initial recovery process.
Rest
While the ligament itself has a poor blood supply and usually does not fully heal, rest is crucial to help protect the injured knee. Activity modification promotes decreased pain and swelling, along with recovery of range of motion. In addition to prescribed physical therapy exercises, your physician may suggest an extended period of limited activity, and a re-evaluation after 6-8 weeks.
Ice
Icing the injured knee helps to alleviate pain and decrease swelling because cold decreases inflammation. Patients should use an ice pack, crushed ice, or a bag of frozen vegetables (such as peas), wrapped in a damp towel (to prevent frostbite), and apply it to the injured area for 10-15 minutes, every several hours as needed.
Compression
Compression also helps reduce swelling. Some patients will find that by applying compression to their knee, pain relief may occur. Your physician may recommend a compressive brace, or an Ace bandage. Compression should not be too tight; numbness is a sign that the brace or wrap could be too tight.
Elevation
Elevating the knee will also help control swelling. When resting or icing, it is helpful to keep the knee elevated. The most effective way to do this is to place the area under your knee on a pillow so that the injured area is raised above the level of the heart. Two pillows may be required.
The RICE (rest, ice, compression, elevation) method will help to decrease symptoms. Once the pain and swelling has decreased, your physician may recommend a thorough rehabilitation program that consists of range of motion exercises, active motion, strengthening, and stretching. Depending on the patient’s activity goals, your physician may prescribe a knee brace to protect the knee from further injury.