Miss M is a young patient presented with complete ACL tear due to injury during her dancing. She was presented with swelling, pain and difficulty walking initially. She had also had consultation from specialist to receive surgery to repair her ACL and was referred for physiotherapy for prehabilitation. Standard ACL protocol was provided for this patient including the following:

Pain and swelling control
Passive and active assisted knee flexion in closed kinetic chain
Isometric knee extension
Gait retraining +/- assistive aid use
Progressive strengthening in weightbearing position
Balance training

During her rehabilitation in our clinic, ultrasound was used for pain and swelling control. Shockwave therapy was adopted to provide higher intensity ultrasound wave to promote blood flow, tissue healing and pain relief. ROM and strengthening exercises were prescribed in closed kinetic chain to avoid further shearing forces induced at the knee. The patient is having significant improvement in pain after the use of shockwave therapy. Her knee ROM and strength are also gradually improving which can help to optimize her function and independence after the surgery to assist her return to her sports.