ACL TEAR

Made By
Rashmi Jain
A1106616090
Subjective Information
Name: Shilpi Yadav
Age: 30 years

Gender: Female
Occupation: Housewife
IP No.- P233623
Objective Information
Chief complaint: Patient feels pain and weakness in
the left leg while walking
History:
 Present History: Patient experienced pain in left leg
since 1-2 days due to fast walking.
 Past History: History of road traffic accident on 7th
November 2020
 Medical History: N/A
 Surgical History: History of lower section caesarean
section 6 years back
 History of Abortion in 2018 and March 2020

Medications: Vitamin sachet

 Tab. Covalium D3
 Tab. Signoflam

Pain history
 Onset: since 1-2 days
 Site: Medial side of knee

Aggravating factor: prolonged walking

Relieving factor: rest
NPRS: 6
Observation-
 Body build: Mesomorphic
 Oedema: Absent
 Any scar: Absent
 Gait: Limping gait
 Deformities: Absent
 Posture: Mild flexion of knee

On palpation:
 Tenderness: Present over medial side of knee
 Temperature of skin: Normal
On examination
 Range of motion:

Knee Flexion/Extension : 130º -135º

 Manual muscle testing:

Knee Flexors 3+/5

Extensors 3+/5
Investigations – MRI suggestive of suspicious
subchondral fracture of tibial plateau with total ACL
tear.(Nov’ 20)
Special tests-
 Lachman test – Positive
 Anterior drawer test- Positive
 Valgus/varus stress test : Negative
Provisional diagnosis- Chronic Left ACL tear
( Nov’20) 
Treatment-
Short term goal: To reduce pain
 
Long term goal: To strengthen muscles
To be able to do ADLs
Electrotherapy Modalities:
 Hot water fermentation x left knee x 15 minutes
 IFT x Classical Interferential x left knee x 15.8 mA x
80 Hz x 15 minutes
Exercise programme:
Ankle toe pumps x 10 repetitions
Isometric Quadriceps exercise x 10 repetitions
Vastus Medialis Oblique exercise x 10 repetitions
SLR x 10 repetitions
Dynamic Quads x 10 repetitions
 
After 2 days
Isometric Quadriceps exercise x 1 kg weight x 10
repetitions
Vastus Medialis Oblique exercise x 1 kg weight x 7
repetitions
SLR x 1 kg weight x 7 repetitions
Dynamic Quads x 10 repetitions

Next Week
Chief Complaint: Pain is reduced in the left knee and is
able to perform some ADLs without any problem.
Observation and Palpation:
Gait: Normal
Oedema: Absent
Tenderness: Mild
Temperature: Normal
NPRS: 4
Examination:
MMT: Knee Flexors 4/5
Extensors 4/5
PT Advice:
Isometric Quadriceps exercise x 2 kg weight x 10
repetitions
Vastus Medialis Oblique exercise x 2 kg weight x 10
repetitions
SLR x 2 kg weight x 10 repetitions
Dynamic Quads x 1 kg weight x 10 repetitions
Addition of Exercises
Hamstring curls x 1 kg weight x 10 repetitions
Prone SLR x 1 kg weight x 10 repetitions
Side SLR x 1kg wt. x 10 repetitions

After 2 days
Continuation of above exercises
Partial lunges x 10 repetitions
Wobble board exercises (lateral and anterior
direction) with support
Step ups and step downs
Wall slides x 10 repetitions
Next week
Observation and Palpation:
 Gait: Normal
 Oedema: Absent
 Temperature: Normal

NPRS: 2
 
Examination:
MMT: Knee Flexors 4+/5
Extensors 4+/5
PT Advice:
Hamstring curls x 2 kg x 10 repetitions
Dynamic Quadriceps x 2kg x 10 repetitions
Prone SLR x 2kg x 5 repetitions
Side SLR x 2kg x 7 repetitions
Wall slides x 15 repetitions
Single leg standing
Step ups and step downs with 1 kg weight x 15 reps
Static cycling
 
THANK YOU