Integrated efriction method and injury level evaluation strategy for effective ACL knee injury recovery

Introduction: Knee injuries, particularly following anterior cruciate ligament (ACL) surgery, are common among athletes and carry a high risk of recurrence when rehabilitation is incomplete. Many rehabilitation programs prioritize short-term recovery while overlooking long-term functional support. Objective: This study aimed to evaluate the effectiveness of effleurage massage combined with self-directed exercise education in improving recovery outcomes and reducing recurrence risk in athletes with post-ACL knee injuries. Methodology: A mixed-methods design was applied using purposive sampling of 30 athletes treated at the MCO Arif Clinic. Knee injuries were confirmed through X-rays, MRI, and medical records. Participants received 30-minute effleurage massage sessions over three weeks, alongside structured self-training education. Pre- and post-intervention assessments measured pain, range of motion (ROM), muscle strength, edema, balance, and functional activity. Results: The intervention significantly reduced pain and knee edema while improving flexion-extension ROM and muscle strength. Statistical analysis showed a significant decrease in edema (mean difference = 3.79 cm; t(29) = 111.96; p < .001). Participants who received exercise education demonstrated additional improvements in balance and functional movement, indicating enhanced rehabilitation outcomes. Discussion: The findings support previous evidence that manual therapy enhances circulation and reduces swelling, and suggest that combining massage with structured exercise produces synergistic benefits for joint stability and function. Conclusions: An integrated rehabilitation approach using effleurage massage and self-directed exercise effectively improves recovery and functional performance in athletes after ACL surgery while potentially reducing recurrence risk.