17 May 2023

The ACL, anterior cruciate ligament, is a strong band of tissue that connects the thigh bone to the shin.  It crosses with another ligament to give the knee stability.  It is vulnerable to sprains and tearing especially in movements that require sudden stops or changes in direction, like skiing, basketball, or moving boxes, the construction industry, or even office workers.

Symptoms include the feeling of something popping in the knee followed by severe pain and an inability to continue with the activity.  There is usually swelling and loss of range of motion.  See a medical professional immediately.  The knee is quite complex and prompt treatment can help prevent complications.

Like most things, there are some factors that can increase the risk of an ACL injury.  Top on the list is being female, which comes from physical anatomy, musculature, and hormonal differences from males.  Wearing improper footwear for the activities, or equipment that is not adjusted correctly or is falling apart or inferior.  Poor physical conditioning or performing the activity incorrectly will also be cause for concern.  Lastly, and most obviously, the type of activity pursued.

Prevention is always a good road to try.  That includes an appointment with a professional trainer or therapist who can offer exercises.  As you might expect, there are movements to strengthen the leg muscles to increase flexibility.  In addition, core work is essential to almost any activity.  That includes the hips, pelvis and lower abdomen that will give the entire body support.  Always be sure you are fully warmed up before you start moving.  Wearing appropriate footwear is another positive.  Studies show that wearing a knee brace does not seem to prevent an ACL injury.

When you have made an appointment with a doctor, there is some preliminary work you can do to be able to answer all the questions as thoroughly as possible.  Write the information down, so that you won’t forget.

  • Date of the injury
  • What were you doing?
  • Did you hear or feel a pop?
  • Previous injuries, including feeling as though the joint is unable to support your weight
  • Swelling
  • Are the symptoms occasional or continuous, do certain movements help or hinder?

During the visit the doctor will manipulate your knee to determine the degree of tenderness or pain and assess the overall range of motion.  Part of this is comparing it to the “good” knee.  Post visit, you may need to have additional tests like an x-ray to rule out a fracture.  For the soft tissue like the ACL, you may need an ultrasound.  Another tests is frequently an MRI (magnetic resonance imaging).  This uses strong radio waves and magnetic power to provide images of the knee, both the hard and soft tissues, including the cartilage.

The first line of treatment is R.I.C.E., rest, ice, compression, and elevation.  If more extensive treatment is required, it will usually start with rehabilitation.  A physical therapist will develop a plan of exercises and teach them to you.  They will take place at the therapist’s office and then you will be instructed which to do on your own at home.  The aim is to reduce the swelling and pain and restore as much of the range of motion as possible.

Surgery can be an option if the knee is unstable and can cause you to fall, there are extensive injuries like more than one ligament or the cartilage, if it impacts your employment, or if you want to continue the sports activity.  The surgery will involve removing the damaged tissue and replacing it with a graft of a tendon, either from another area of your body or from donated tissue.  Following the surgery will be another round of rehab to restore as much function as possible.

Each individual is different and there are no guarantees about the amount of time it will take or that you will recoup the full range of motion and use.

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