Cross Bracing Protocol

The Cross-Bracing Protocol (CBP) is designed to improve ACL healing. During the first three weeks, it holds the knee at a right angle (90 degrees) where the torn ends of the ACL are close together so that new tissue can bridge the gap. After this, the amount you can move the knee is gradually increased. This protects the ligament as it remodels and regains strength. It is important to keep the knee at the instructed angle so that you do not over-stretch or pull on the healing ligament.

CBP phase goals:

• Help ligament healing

• Maintain strength and fitness

Potential benefits of CBP

CBP is thought to increase the chances of the ACL healing. This theory is currently being tested by the ENCORE study.

Healing your own ACL is thought to improve your chances of having a normal knee again and returning to sport. This is another theory currently being tested by the ENCORE study.

Potential challenges of CBP

• It is hard to keep your knee fixed at 90° for three weeks. This can be uncomfortable and make it hard to sleep.
• You cannot walk on your braced leg for at least five weeks and will need to use crutches.
• Depending on which leg you have injured and whether you drive a manual car, you may not be able to drive for the first six weeks.
• You are at increased risk of a blood clot when you do not use your leg normally. This is why we recommend you take medication to prevent blood clots while using the brace.
• Muscle wasting can occur from lack of use. Your physio will recommend working hard on your rehab while in the brace including exercises that put weight through your foot.
• Your skin may be irritated by the brace.
• Your knee joint can become stiff. This usually resolves with your post-brace rehab.