Cross Bracing Protocol for ACL Tears: The Game-Changing Protocol Showing that ACL Tears Can Heal Without Surgery

ACL injuries are a significant concern in Australia, particularly for young athletes and active individuals with around 200,000 cases annually, making it one of the most frequently occurring knee injuries.The Anterior Cruciate Ligament (ACL) is one of 4 ligaments in the knee, with the main role being to provide stability. 

An injury to the ACL can require prolonged recovery periods, substantial healthcare costs, and a significant impact on an individual’s quality of life. The financial burden of ACL injuries is substantial. The cost of ACL reconstruction surgery in Australia is an average of $15,000 per patient, depending on various factors such as hospital fees, surgeon fees, and rehabilitation costs. This does not include the indirect costs related to lost productivity and long-term healthcare needs, which can further escalate the economic impact.

It has been believed for many years that the only solution to an ACL tear is surgery, through an ACL Reconstruction. 

Exciting research into ACL injuries over the last decade are now repeatedly showing that the ACL can in fact heal without surgery. One of the more recent non-surgical protocols developed and researched is the Cross Bracing Protocol, demonstrating an astounding 90% healing rate in torn ACL’s, within 3 months. This is a promosing alternative to traditional surgical treatments.

What is the Cross Bracing Protocol?

The Cross Bracing Protocol was developed by Dr Tom Cross (Sports and Exercise Physician) and his late father, Dr Mervyn Cross (Orthopaedic Surgeon) in Sydney, Australia. They have since braced over 700 ACL patients around the world, with 90% of participants showing successful healing.

They designed this protocol, after having patients present with a torn ACL, that did not want to have surgery. The theory was based on a protocol used in earlier years by Mervyn, where they used to plaster to hold an ACL deficient knee at a 90 degree angle to allow the ACL to heal.

Other injuries, such as a displaced fracture (a broken bone where the bone has moved out of position), are immediately put back into position, and either via surgery or plaster, held in place, to allow the bone to heal. A significant cut in the skin is stitched back together to allow the skin to heal. So why should the ACL also not be placed in a position to allow a chance to heal?

What does the Cross Bracing Protocol include?

The best outcomes are achieved when the knee is braced 5-6 days after injury, however, can commence as late as 3 weeks post-surgery.

After a suspected ACL Injury, the patient will visit either a physiotherapist or Sports Doctor and get referred for a MRI scan of the knee. This scan will confirm the extent of the injury, and any other associated injuries in the knee. 

There will be a decision making process between the doctor, physio and patient as to whether they will be a suitable candidate for the Cross Bracing Protocol, based on how the injury occurred, the results of the MRI, the patient goals and preferences.

If the patient is eligible for the Cross Bracing Protocol, the physiotherapist trained in this procedure will fit the patient up for a brace and lock the brace at 90 degrees for 4 weeks.The patient will be provided with crutches, or other mobility aids such as a knee scooter, or I-Walker, to help get around. Between week 4-12, the angle of the brace is changed weekly, to gradually increase the range of movement allowed in the knee. Throughout the protocol, the physio will provide the patient with a range of exercises (both at-home and gym-based), to maintain muscle strength. 

After 12 weeks, the patient is removed from the brace, and a repeat MRI is performed to review healing of the ACL. The patient then follows an ACL rehab program from their physio, to safely return them back to sport or activities.

Is this the right option for me?

If you have recently injured your ACL, or know someone who has, then non-surgical treatment should be considered as a first-line treatment option. Surgery may not always be a viable option for everyone, especially for people that do not have private health, do not want to have surgery and do not want to return to elite level sport. Knowing that the ACL can heal without surgery, at rates of up to 90%, makes for a promising alternative.

Our team at ECP Physiotherapy are one of the first clinics in Adelaide, South Australia, to offer the Cross Bracing Protocol as a part of our ACL Perform Program. This decision is made in conjunction with our excellent team of Sports Doctors, Radiographers and Orthopaedic Surgeons in Adelaide and Sydney, to ensure that the best decision to give you the greatest success after your ACL injury is provided for you.

If you would like to talk to us first and find out more, or are ready to book an appointment, we would love to hear from you and help you get back to the activities you love as soon as possible.

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ACL Tear | ACL Rupture | ACL Injury | ACL Reconstruction 

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