An ACL injury is a sprain or tear to the Anterior Cruciate Ligament of the knee. They most commonly occur in individuals who play sports involving pivoting such as: basketball, netball, football, rugby, gymnastics and skiing. Women are three times more likely to have ACL injuries than men, due to anatomical differences such as a wider pelvis and greater ligament laxity.
ACL injuries can vary in severity from a small sprain/tear to severe (ligament full tear/rupture). Injuries to the ACL can sometimes also involve damage to other structures of the knee including the meniscus, other ligaments and articular cartilage.
This ligament is crucial for knee stability and is one of four ligaments that connects from the shin bone (tibia) to the thigh bone (femur). There are two cruciate ligaments and two collateral ligaments. The cruciate ligaments are found inside the knee joint, where the ACL is found at the front and the posterior cruciate ligament (PCL) is at the back. The ACL prevents the shin (tibia) from moving in front of the thigh bone (femur).
It is reported that approximately 70% of ACL injuries are non-contact injuries and 30% are direct contact. Examples of these include:
Suddenly slowing down and changing direction
Landing awkwardly from a jump
Receiving direct contact or collision to the knee
Pivoting with your foot firmly planted and twisting
Signs and Symptoms of an ACL injury:
You may hear a “popping” noise and your knee giving way from under you
Significant swelling and pain within 24 hours
Loss of movement in knee
Pain while walking
Feeling of instability or “giving way” with weight bearing
It is important to get an accurate and prompt diagnosis in order to get proper treatment and also determine the severity of the injury. A Physiotherapist can do a number of different tests to determine this. Often diagnosis can be made with getting a detailed history around your injury and a physical examination, however further imaging may be required if appropriate .
Management of ACL injuries start with reducing the acute swelling after injury using the R.I.C.E principle. This involves: rest, ice, compression and elevation. Following this management will involve reducing pain, effusion, muscle strength, function and movement patterns.
During this process surgical and non-surgical options will be considered. A physiotherapist can help you decide whether surgical or non-surgical management is an option best suited to you and may refer on to a specialist if required. ACL tears do not necessarily require ACL reconstruction surgery and there are many important factors to consider before deciding to undergo this surgery.
These factors to consider include: Age, type of sport and level of competition, degree of instability, plans and goals for the future.
Regardless of surgical or non-surgical management; exercises that improve knee range of motion, strength, balance and stability are vital for maximising recovery, and restoring function back into the knee.
For more information, please call to book in for advice and management from your physiotherapist.
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