ACL Reconstruction

Once you have been diagnosed with a partial or complete ACL tear, there are both non-surgical and surgical options.  If the overall stability of the knee is intact, non-surgical options may be advised, including the use of a brace and physical therapy for a balance training and muscle strengthening program.  The avoidance of cutting and pivoting movements is recommended.  If these methods don't relieve symptoms, surgery may be necessary.  Open and arthroscopic surgery may be performed, followed by rehabilitation program to address strength and mobility.

Patients usually take part in formal physical therapy after ACL reconstruction. The first few physical therapy treatments are designed to help control the pain and swelling from the surgery.  The goal is to help you regain full knee extension as soon as possible.
The physical therapist will choose treatments to get the thigh muscles toned and active again.  Patients are cautioned about overworking their hamstrings in the first six weeks after surgery.  They are often shown how to do isometric exercises for the hamstrings.  Isometrics work the muscles but keep the joint in one position.  At Northern Michigan Sports Medicine Center, we utilize aquatic therapy in the early stages of rehabilitation.   This allows you to advance your progress more quickly and with less pain while allowing your new ligament to heal.
As the rehabilitation program evolves, more challenging exercises are chosen to safely advance the knee's strength and function.  Specialized balance exercises are used to help the muscles respond quickly and without thinking.  This part of treatment is called neuromuscular training.  If you need to stop suddenly, your muscles must react with just the right amount of speed, control, and direction.  After ACL surgery, this ability doesn't come back completely without exercise.
Neuromuscular training includes exercises to improve balance, joint control, muscle strength and power, and agility.  Agility makes it possible to change directions quickly, go faster or slower, and improve starting and stopping.  These are important skills for walking, running, and jumping, and especially for sports performance.
When you get full knee movement, your knee isn't swelling and your strength and muscles control are improving, you'll be able to gradually go back to your work and sport activities.  Some surgeons prescribe a functional brace for athletes who intend to return quickly to their sport.
Ideally, you'll be able to resume your previous lifestyle activities.  However, athletes are usually advised to wait at least six months before returning to their sports.  Most patients are encouraged to modify their activity choices.
You will probably be involved in a progressive rehabilitation program for four to six months after surgery to ensure the best results from your ACL reconstruction.  In the first six weeks following surgery, expect to see your physical therapist two to three times a week.  If your surgery and rehabilitation go as planned, you may only need to do a home program and see your therapist every few weeks over the four to six month period.
Northern Michigan Sports Medicine Center specializes in the complete recovery of people returning to sports.


Rotator Cuff Repair

After your physician has diagnosed you with a rotator cuff tear, there are two treatment options; non-surgical and surgical.  The non-surgical options would include rest and limited overhead motions, use of a sling, anti-inflammatory medication, steroid injuection(s), and physical therapy to strengthen the shoulder.

The second option would be surgery. This would occur if previous treatments have failed to relieve symptoms, it is a fairly new and large tear, or if the tendon is torn away from the bone.  There are three major types of repairs: open, mini-open, and arthroscopic repairs.

Rehabilitation after rotator cuff surgery can be a slow process.  You will probably need to attend therapy sessions for two to three months, and you should expect full recovery to take up to six months.  Getting the shoulder moving as soon as possible is important.  However, this must be balanced with the need to protect the healing tissues.

Your surgeon will most likely have you wear a sling to support and protect the shoulder for several weeks (generally four to six weeks) after surgery.  Ice and electrical stimulation treatments may be used during your first few therapy sessions to help control pain and swelling from the surgery.  Your therapist may also use massage and other types of hands-on treatments to ease muscle spasm and pain.

Therapy can progress quickly after arthroscopic procedures.  Treatments start out with range-of-motion exercises and gradually work into active stretching and strengthening.  You just need to be careful about doing too much, too quickly.

Therapy goes slower after surgeries where the front shoulder muscles have been cut.  Exercises begin with passive movements.  During passive exercises, your shoulder joint is moved, but your muscles stay relaxed.  Your therapist gently moves your joint and gradually stretches your arm.  You may be taught how to do passive exercises at home.

Active therapy usually starts 6 weeks after surgery.  You use your own muscle power in active range-of-motion exercises.  You may begin with light isometric strengthening exercises.  These exercises work the muscles without straining the healing tissues.  At Northern Michigan Sports Medicine Center, we utilize aquatic therapy to allow you to initiate active motion without stressing your repaired rotator cuff tendon.  Formal strengthening exercises will be delayed until 12 weeks.

Exercises focus on improving the strength and control of the rotator cuff muscles and the muscles around the shoulder blade.  Your therapist will help you retain these muscles to keep the ball of the humerus firmly in the socket.  This helps your shoulder move smoothly during all your activities.

Some of the exercises you'll do are designed to get your shoulder working in ways that are similar to your work tasks and sport activities.  Your therapist will help you find ways to do your tasks that don't put too much stress on your shoulder.  Before your therapy sessions end, your therapist will teach you a number of ways to avoid future problems.


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Home office Petoskey West Clinic
Phone (231) 347-9300        Email
Petoskey East (231) 348-7950
Harbor Springs (231) 348-7002
Charlevoix (231) 547-0380
Boyne City (231) 459-4750
Indian River (231) 238-4880
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Petoskey, Petoskey East & Boyne City

Our Petoskey clinic is located within the Bay Street Orthopedic building, 4048 Cedar Bluff Drive. 231-347-9300 [map]

Our Petoskey East clinic is located on the corner of Mitchell & Division, 345 N. Division 231-348-7950.[map]

Our Boyne City Clinic is located in the SOBO district, 210 S Lake Street 231-459-4750 map

Charlevoix & Cheboygan

Our Charlevoix clinic is located in the Kmart Plaza, at 06510 M-66, 231-547-0380 [map] 

Our Cheboygan clinic is located south of town, 9445 N Straits Hwy, 231-627-7201 [map]

Harbor Springs & Indian River

Our Harbor Springs clinic is located next the Harbor Springs airport, 8452 M-119 Harbor Plaza, 231-348-7002. [map]                                        

Our Indian River clinic is right in the heart of downtown, 3805 South Straits Hwy, 231-238-4880. [map]