Your ACL or anterior cruciate ligament is one of four knee ligaments that are critical for the stability of your knee joint. Your ACL is made of tough fibrous material and functions to prevent excessive anterior (forward) movement of the tibia off of the femur, as well as hyperextension of the knee. One of the most common problems involving the knee joint is an anterior cruciate ligament injury or ACL tear.
What Causes an ACL Injury?
An ACL injury is usually a sports-related knee injury. About 80% of sports-related ACL tears are “non-contact” injuries. Most often ACL tears occur when pivoting or landing from a jump. Your knee gives out from under you once you tear your ACL.
Female athletes are known to have a higher risk of an ACL tear while participating in competitive sports. Unfortunately, understanding why women are more prone to ACL injury is unclear. There are some suggestions it is biomechanical, strength and hormonally related. In truth, it is probably a factor of all three.
What Sports have a High Incidence of ACL Injuries?
Many sports require a functioning ACL to perform common manoeuvres such as cutting, pivoting, and sudden turns.
The high directional demands of sports include football, rugby, netball, touch, basketball, tennis, volleyball, hockey, dance and gymnastics
You may be able to function in your normal daily activities without a normal ACL, but high-demand multi-directional sports may prove difficult.
What are the Symptoms of an ACL Injury?
The diagnosis of an ACL tear is made by several methods. Patients who have an ACL tear commonly sustain a sports-related knee injury.
They may have felt or heard a “pop” in their knee, and the knee usually gives out from under them. ACL tears cause significant knee swelling and pain.
How is an ACL Injury Diagnosed?
On clinical knee examination, your Podiatrist will look for signs of ACL ligament instability. These special ACL tests place stress on the anterior cruciate ligament and can detect an ACL tear or rupture.
An MRI may also be used to determine if you have an ACL tear. It will also look for signs of any associated injuries in the knee, such as bone bruising or meniscus damage, that regularly occur in combination with an ACL tear.
X-rays are of little clinical value in diagnosing an ACL tear.
How is an ACL Injury Treated?
Many patients with an ACL tear start to feel better within a few days or weeks of an ACL injury. These individuals may feel as though their knee is normal again because their swelling has started to settle. However, this is when your problems with knee instability and giving way may start or worsen.
ACL tears do not necessarily require ACL reconstruction surgery. There are several important factors to consider before deciding to undergo ACL reconstruction surgery.
Do you regularly perform sports or activities that normally require a functional ACL?
Do you experience knee instability?
What are your plans for the future?
If you don’t participate in a multi-directional sport that requires a patent ACL, and you don’t have an unstable knee, then you may not need ACL surgery.
Rehabilitation and ACL Exercises
Your best way to avoid ACL reconstructive surgery is to undertake a comprehensive ACL-Deficient Knee Rehabilitation Program that involves leg strengthening, proprioception and high-level balance retraining, plus sport-specific agility and functional enhancement. Your sports physiotherapist is an expert in the prescription of ACL tear exercises.
PhysioWorks has developed a specific ACL Deficient Knee Rehabilitation Program to address ACL injuries for the patient who wishes to avoid or delay ACL reconstructive surgery.
Management will aim to:
- Reduce pain and inflammation.
- Normalise your joint range of motion.
- Strengthen muscles supporting your knee: Quadriceps (especially VMO) and Hamstrings.
- Strengthen your lower limb: Calves, Hip and Pelvis muscles.
- Improve patellofemoral (kneecap) alignment
- Normalise your muscle lengths (muscles tighten post acute injury)
- Improve your proprioception, agility and balance
- Improve your technique and function eg walking, running, squatting, hopping and landing.
- Minimise your chance of re-injury.
- Refer as required for surgical review
At Rural Health our team are skilled in the assessment and management of recent and old knee injuries. Call us today to book an assessment on 02 5963 2707.