ANTERIOR CRUCIATE LIGAMENT (ACL) INJURIES
There are four main ligaments that support the knee. Probably one of the most important is the ACL because it controls the back of the thigh bone (femur) to the front of the shin (tibia). If you damage the ACL you will feel quite unstable. Active lifestyles involving sports like basketball, running and hockey that involve acceleration, deceleration and changing direction require a strong, intact ACL. It is interesting to note that women playing contact sports such as soccer and football are significantly more vulnerable to these types of ACL injuries because of their specific anatomy of the knee. ACL injuries commonly occur when the foot is planted on the ground and the body rotates over the knee. This is common in a tackle, sharp cuts or change in direction.
Often you will have an incident where you experience:
- A click or a pop
- A feeling of instability
- Extensive swelling
- Immediate pain
- Difficulty straightening the leg
The grade or degree of the ACL tear will determine the type of treatment neccessary. For low grade tears you may need to wear a supportive knee brace to provide stability followed by a physiotherapy program to regain full range, address muscle spasm and decrease swelling. You will progress to a graded strengthening program before returning to sport.
(Source: Texas Spine and Joint Hospital)
If the tear is more severe surgery may be neccessary. In this case it is often good to undergo a pre-surgery physio program to minimise swelling, optimise range and strength to enable best outcomes. After surgery, initial goals are to decrease inflammation and regain full range of movement. You will often find you lose strength quite quickly and the muscles around the knee will decrease in size. It is important to control swelling and decrease muscle tightness to allow early activation of specific muscle groups. You will quickly progress to walking, swimming or cycling to maintain physical fitness before increasing to a sports specifics strength program.
Once you are back at full strength it is important to manage your knee so you stay fit for life. Make sure you start to understand your own body, ensuring to keep strength in key areas like gluteals as well as quadriceps etc. Your physio will help you learn specific home techniques.
Also be aware of warning signs in the knee, twinges, catches, weakness, tightness. They can be a precursor to injury. One hint to optimising strength and function long term is to make sure your physio teaches
you how to self release the muscles around the knee so you can always nip ACL problems in the bud.