「acl tear no surgery」タグアーカイブ

Case 43: Natural Healing of a Complete Anterior Cruciate Ligament Rupture (Ihara II, ACLOAS 1)

注目

投稿日時: 投稿者:
返信

This page presents Case 43: a 50-year-old Greek woman living in the Netherlands who sustained a complete rupture of the left anterior cruciate ligament while skiing. She did not undergo surgery. With Evo-Devo Exercises she restored ligament continuity, and the follow-up MRI demonstrated a native anterior cruciate ligament ACLOAS score of 1.

ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient information:

  • Profile: Female, 50 years old; Greek, residing in the Netherlands
  • Date of injury: March 2, 2023
  • Mechanism: While getting off a ski lift, the skis crossed on landing; the knees fell into a “snowplow” (valgus) position and the left knee twisted. She was transported to the hotel by snowmobile.
  • Initial care: About 3 hours post-injury she visited a hospital. X-ray: no fracture. Manual test: Lachman positive.

Initial assessment and plan:

  • First MRI: March 22, 2023. Local report: “injury of the left anterior cruciate ligament; partial tear cannot be excluded.”
  • Local physiotherapy (before switch): From Mar 2 to Mar 17: leg press, knee extension exercises, jump drills, stair climbing.
  • Switch to our protocol: From March 17, online care with Jun Matsumoto Clinic, starting Evo-Devo Exercises. The previous regimen (full knee extension work, jumping, etc.) was discontinued.

Treatment details:

  • Brace management: Knee brace for 3 months with 0–30° extension limitation (avoid full extension).
  • Activity restriction: Walking limited to ≤1,000 steps/day.
  • Exercise therapy: Home-basedEvo-Devo Exercises 3 times/day.
  • Late phase: After 3 months the brace was removed; gradual re-introduction of full extension range and strength training.

First MRI and Ihara classification:

Three independent imaging specialists re-read the first MRI: Ihara classification “Type II in two readers, Type III in one.”

[Ihara classification notes] I: linear tear; II: curved tear (simple complete rupture); III: tear with displaced stumps; IV: indistinct/unclear stumps.

Initial MRI (2023-03-22)

Follow-up MRI (~3 months) and ACLOAS:

After 3 months of Naturalization Therapy (Evo-Devo Exercises), a follow-up MRI was obtained. All three readers rated the native anterior cruciate ligament as ACLOAS score 1.

[ACLOAS (native anterior cruciate ligament) notes] 0 = normal (low signal, regular thickness and continuity) / 1 = thickened and/or intraligament high signal, but shape and continuity are normal / 2 = thinned or elongated but continuity preserved / 3 = defect or complete loss of continuity.

Follow-up MRI (~3 months)

Clinical course:

Because the pre-switch program included full-extension drills, jumping and stair training, deterioration was initially a concern. However, with extension limitation, brace management and Naturalization Therapy (Evo-Devo Exercises), imaging achieved ACLOAS 1 (best-tier natural healing). Daily activities were comfortable, and subjective stability improved.

Discussion:

This case likely benefited from a predominantly Ihara Type II (simple complete rupture) pattern and a relatively early switch to our protocol, leading to a favorable endpoint of ACLOAS 1. High-load early exercises can hinder stump apposition; an early shift to 0–30° extension limitation with brace control and continued Evo-Devo Exercises likely promoted restoration of ligament continuity.

Summary:

  • 50-year-old Greek woman living in the Netherlands with a complete rupture of the left anterior cruciate ligament.
  • Ihara classification: Type II (two readers) / Type III (one reader); pattern favored a simple complete rupture.
  • Three months of 0–30° extension limitation + brace management + Evo-Devo Exercises.
  • Follow-up MRI: all readers ACLOAS 1—a best-tier natural healing finding.

References:

Case 41 Report: A 33-Year-Old Hungarian Male’s ACL Rupture Healed Through Evo-Devo Exercises

注目

投稿日時: 投稿者:
返信

This page presents a case of a 33-year-old Hungarian male who completely ruptured his right anterior cruciate ligament (ACL) while playing soccer and aimed for spontaneous healing through Evo-Devo Exercises without undergoing surgery.

ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

  • Age / Sex / Nationality: 33 years old / Male / Hungarian
  • Date of Injury: March 20, 2023
  • Mechanism of Injury: Twisting injury to the knee after being kicked during soccer; audible pop and collapse
  • Date of Initial Consultation: March 21, 2023 (Positive Lachman test and MRI performed)
  • Diagnosis: Complete rupture of the right ACL

Treatment:

  • Start Date: March 22, 2023
  • Therapy: Online Evo-Devo Exercises
  • Brace: Worn with 0–30° extension restriction
  • Activity Restriction: Walking allowed within 3,000 steps/day
  • Treatment Duration: Approx. 3 months

Pre-Treatment MRI Evaluation: March 21, 2023

Three independent radiologists evaluated the images using the Ihara classification system.

  • Ihara Grade 3: All three doctors diagnosed complete rupture with stump displacement

Follow-Up MRI: July 31, 2023

Three radiology specialists reevaluated the images based on the ACLOAS score.

ACLOAS Score Definition:

  • Score 0: Normal ACL (shape and signal)
  • Score 1: Thickened/high signal ligament but normal shape and continuity
  • Score 2: Thinned/elongated but with preserved continuity
  • Score 3: Complete rupture, discontinuity

Evaluation Result in This Case:

  • Score 2: All 3 radiologists agreed

Discussion:

Ihara Grade 3 indicates stump displacement and is considered challenging to heal spontaneously. However, in this case, proper early extension restriction and consistent Evo-Devo Exercises resulted in all three radiologists rating the ligament as Score 2 (with continuity). This suggests the possibility of spontaneous healing of the ACL.

References:

[Case Report] Case 40: Natural Healing of Anterior Cruciate Ligament (ACL) Rupture in a 49-Year-Old Singaporean Woman

注目

投稿日時: 投稿者:
返信

This page introduces a case in which a 49-year-old woman with a complete anterior cruciate ligament (ACL) rupture achieved natural healing without surgery through Evo-Devo Exercises.

ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

On March 6, 2023, while performing a martial arts jump kick, the patient felt a popping sensation in her left knee and fell upon landing. An MRI was performed on March 17, revealing the following findings:

March 17, 2023: ACL Rupture (Ihara Grade IV)

After the injury, the patient performed several sessions of knee extension exercises under the guidance of a physical therapist. Knee buckling occurred for about 10 days. From March 28, she began Naturalization Therapy through Jun Matsumoto’s online rehabilitation program. No brace was used, and walking was limited to under 3,000 steps per day. During a trip to Japan in April, she used a wheelchair and minimized walking.

July 29, 2023: ACLOAS score 2

ACLOAS Score Evaluation:
Score 2 (Posterolateral fibers healed / Anteromedial fibers not healed)

Discussion:

This case involved a complex tear categorized as Ihara Grade IV, with frayed ligament stumps, making natural healing typically difficult. Inappropriate activity restrictions in the early stage and the absence of bracing may have influenced healing. Follow-up interviews revealed no major issues in daily life, but the patient felt knee instability during high-impact or pivoting movements. Full functional and muscular recovery required more than one year of rehabilitation.

References:

[Case 39] A 36-Year-Old Male Skier with a Complete ACL Tear Who Achieved Natural Healing through Evo-Devo Exercises: A Case Report

注目

投稿日時: 投稿者:
返信

This page presents a case report of a 36-year-old male with a complete anterior cruciate ligament (ACL) tear who achieved natural healing without surgery through Evo-Devo Exercises.

ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

  • Age / Gender: 36-year-old Japanese male
  • Date of Injury: February 4, 2023
  • Injury Situation: Fell while skiing and twisted his left knee
  • Initial Response: X-ray, joint aspiration, emergency bracing

MRI performed on February 7, 2023, diagnosed a complete ACL tear. Three radiologists independently evaluated the image and all rated it as Ihara Classification Grade 4 (ruptured, horizontally oriented, or indistinct).

MRI on Feb 7, 2023
▲ February 7, 2023: ACL tear image diagnosed as Ihara Grade 4

Treatment Summary:

  • Start of Therapy: February 14, 2023
  • Brace: Not used (early mobilization allowed with slight knee flexion)
  • Exercise Therapy: Evo-Devo Exercises, 3 times daily
  • Duration: About 4 months

Manual Tests (May 2, 2023):

TestResult
Lachman Test± (slightly loose)
Pivot Shift TestNegative
Lever Arm TestNegative

MRI Re-evaluation (June 16, 2023):

Three radiologists assessed the ACL healing using the ACLOAS score system.

ACLOAS Score Definitions:

  • Score 0: Normal ACL (normal shape and signal)
  • Score 1: Thickened ligament or high intraligament signal, but normal continuity
  • Score 2: Thinned or elongated ligament, continuity preserved
  • Score 3: Discontinuous ACL, ruptured

Case Result:

  • Score 1: 2 radiologists
  • Score 2: 1 radiologist
MRI on June 16, 2023
▲ June 16, 2023: Restored ACL continuity and structure

Discussion:

Despite being classified as Ihara Grade 4 (a complex and severe tear), this case showed notable ACL healing through consistent Evo-Devo Exercises. With 2 radiologists rating the ligament as Score 1 and 1 as Score 2, and with clinical stability confirmed, this case demonstrates the potential of non-surgical natural healing of ACL tears.

✅ Summary:

Age / Gender36-year-old male
Injury TypeIhara Grade 4 ACL tear
TreatmentNon-surgical (Evo-Devo Exercises, no brace)
DurationApprox. 4 months
MRI ResultsACLOAS Score 1 (2), Score 2 (1)
Manual TestLachman ±, Pivot −, Lever −
ConclusionProves possibility of natural healing even in complex tears

References:

Natural Healing of a Re-ruptured ACL After Reconstruction

注目

投稿日時: 投稿者:
返信

ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

40-year-old, Indian, male

Mechanism of Injury:

In 2004, the patient tore the left ACL and underwent reconstruction surgery in 2008. On October 13, 2022, he twisted his left knee after falling down stairs. An MRI taken on October 17 revealed the following:

Rupture of the reconstructed ACL

Post-Injury Course:

Online therapy began on November 24, 2022. A brace was worn for 3 months with extension limited to 0–30 degrees. Walking was limited to 3,000 steps per day. The patient performed an exercise therapy based on evolutionary developmental movement three times daily for 3 months. In the fourth month, the brace was removed and full range of motion gradually restored. A follow-up MRI was taken on June 6, 2023.

MRI Findings:

The radiologist’s report from India noted:
・Mild damage to the reconstructed ACL and PCL
・Grade 3 tear in the posterior horn of the medial meniscus

Clinical Outcome:

The re-ruptured ACL was judged to have regained sufficient continuity. The patient was instructed to continue rehabilitation toward returning to daily activities.

Discussion:

This is the first reported case in which a re-ruptured reconstructed ACL spontaneously healed through Evo-Devo Exercises. If the graft is fused and fixed within the bone tunnel, appropriate mechanical stress and dynamic movement therapy may allow for spontaneous repair. Accumulation and analysis of further cases is needed.

References:

Natural Healing of ACL Tear -case 37- Be careful of the opposite knee!

注目

投稿日時: 投稿者:
返信

ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

44 years old, Male, Croatian

Mechanism of Injury:

On November 5, 2022, during a tennis match, he twisted his left knee. An MRI was performed on November 9, leading to the following diagnosis:

ACL Tear (Simple Complete Tear (Ihara Classification II))

Progress After Injury:

After the injury, he did not undergo physical therapy and rested. Starting from November 13, he began an online therapy program with our clinic and continued “Evo-Devo Exercises” at home for three months. On February 14, 2023, a second MRI was performed.

MRI Results:

The torn ACL had regained continuity. However, on the MRI, the ligament appeared pale and had not fully regained its thickness. He continued the “Evo-Devo Exercises,” and a third MRI was performed three months later.

MRI Results:

The ACL appeared darker and thicker compared to the previous MRI.

Subsequent Progress:

The ACL was deemed sufficiently healed, and the patient was cleared to return to sports. He gradually increased his activity levels and eventually played tennis at the same level as before the injury. However, around August 2024, he felt discomfort in his opposite (right) knee during tennis. He rested for a week, but the discomfort persisted even after resuming tennis. An MRI was conducted on October 1, 2024.

MRI Results:

The MRI showed a partial tear in the right ACL but retained continuity overall.

Discussion:

The initially injured left ACL healed naturally, and the patient returned to sports successfully. However, he subsequently injured the opposite ACL. Research suggests a significant likelihood of injuring the contralateral ACL after an initial ACL tear. This case underscores the importance of maintaining balance and minimizing asymmetry to prevent future injuries. Ongoing training to stabilize and balance the body is recommended.

References:

Natural Healing of an ACL Tear: Case Study of a 30-Year-Old Chinese Businessman

注目

投稿日時: 投稿者:
返信

ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

30 years old, male, Chinese-Australian

Mechanism of Injury:

On February 19, 2023, he twisted his left knee while skiing. X-ray at the hospital showed no abnormalities. On March 2, MRI was performed, and the following diagnosis was made:

ACL Tear (curved and continuous fiber (Ihara Classification II))

Post-Injury Progression:

After the injury, he wore a brace for only one day and then engaged in rehabilitation, including knee extension exercises. From March 10, he began our online treatment and performed Evo-Devo Exercises three times a day for two months. During this period, all other rehabilitation exercises were strictly prohibited. On May 4, a follow-up MRI was conducted.

MRI Results:

The torn ACL had regained continuity with sufficient thickness (ACLOAS Score 1).

Discussion:

Although the MRI was taken relatively early at the patient’s request—two months into treatment—the ACL’s continuity was sufficiently confirmed. The simple complete tear (Type II) of the ACL may have been a factor in the early healing observed. Despite including knee extension exercises in the rehabilitation, there was no adverse effect on natural healing in this case.

References:

A Panamanian gentleman’s Natural Healing of ACL Tear -case 34

注目

投稿日時: 投稿者:
返信

Natural Healing of ACL Tear

ACL Tear Natural Healing Case Studies

Patient Information:

32 years old, male, Panamanian

Mechanism of Injury:

On August 21, 2022, during a basketball game, he felt a popping sound in his left knee when he jumped off his left foot. He could not move and was transported to the hospital. An MRI was performed the same day, leading to the following diagnosis. The Lachman test was positive.

ACL Tear (unclear stump (Ihara Classification IV))

Post-Injury Progress:

From September 13, 2022, he began Natural Therapy with Jun Matsumoto through online treatment. He continued with online therapy and Evo-Devo Exercises at home, and after four months of treatment, a follow-up MRI was performed.

MRI Results:

Although the torn ACL did not regain enough tension, its continuity had recovered. Fibers near the femoral attachment were thin, but the distal part was sufficiently thick. (Ihara’s Healing Classification B)

Discussion:

This ACL tear had an unclear stump, a type of tear considered difficult to heal naturally (Ihara’s classification). Contrary to expectations, MRI taken five months after the injury showed that the continuity had been restored, yielding relatively favorable results. After continued rehabilitation, he recovered enough to perform daily activities without issues and could engage in light exercises like jogging.

References:

A high school Skateboarder’s Natural Healing of ACL tear -case 33

注目

投稿日時: 投稿者:
返信

Patient Information:

17 years old, male, American

Mechanism of Injury:

On June 11, 2022, he twisted his right knee after a failed landing from a skateboard jump. An MRI was performed on June 25, and the following diagnosis was obtained:

ACL Tear (unclear tear ends (Ihara Classification IV))
Lateral Collateral Ligament sprain

Post-Injury Progress:

Starting August 3, 2022, he began Jun Matsumoto’s natural therapy through the online sessions. He continued with online treatment and at-home Evo-Devo Exercises, and an MRI was performed five months after the start of treatment. The patient did not use any functional braces.

MRI Results:

The torn ACL had recovered its continuity with a thick and tense form (Ihara Healing Classification A).

Discussion:

ACL tears in younger individuals often have unclear tear ends due to the softness of their fibers. This case also had unclear tear ends, making natural healing seem difficult. Additionally, the treatment started eight weeks after the injury, which also reduced the likelihood of successful natural healing. However, contrary to expectations, the ACL naturally healed with a thick and tense form. According to the Ihara Healing Classification, this is the highest grade, A. Unfortunately, during the treatment period, the patient sustained mild injuries to the medial and lateral meniscus. The patient was not wearing any functional braces, and I had not instructed him to do so. Considering such cases, starting from 2023, I have instructed all patients to wear braces.

References:

A Professional Footballer’s Natural Healing of ACL Tear -case 32

注目

投稿日時: 投稿者:
返信

ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

38-year-old male, Japanese

Mechanism of Injury:

On September 11, 2022, during a soccer match, an opponent collided with him from the left. At that time, he twisted his right knee unnaturally when he braced with his right foot. He went to the hospital the same day and had an MRI the next day, receiving the following diagnosis:

ACL tear (mid-section tear with retracted ends (Ihara Classification III)

Post-Injury Progress:

On September 15, he visited another hospital. The Lachman test was positive. On September 19, joint fluid was extracted through joint aspiration. After that, there was no swelling, and the knee could flex up to 90 degrees.

On October 3, he visited our clinic. Lachman test was positive, lever arm test was positive, and pivot shift was negative. He started Evo-Devo exercise therapy and continued it daily at home. Another MRI was performed on October 18.

Natural healing of the torn anterior cruciate ligament was confirmed. He continued the naturalization exercises, and MRIs were performed again on December 15 and January 19 of the following year.

The continuity of the anterior cruciate ligament was sufficiently confirmed, and the looseness was also improved.

Discussion:

The patient was a former top athlete in the Japanese national beach soccer team. He wished to continue playing soccer at a competitive level and frequently had MRI scans to closely monitor the healing process. Despite recommendations for surgery from doctors and all related soccer personnel, he chose natural healing, which was a bold decision. The healing level as per imaging diagnosis was Grade II four months post-injury. Although there were concerns about his return to high-level soccer, he underwent rehabilitation and returned to soccer after several months.

References: