Take A Knee: How To Keep Your ACL Kicking Both Before and After Injury
By George Sutherland, MD, as published in the September/October 2014 edition of Coastal Sport & Wellness
Athletes and fans alike will tell you that there’s nothing worse then a promising season lost to injury. The seemingly most prominent of those season ending injuries, is the torn Anterior Cruciate Ligament (ACL). For a small ligament known best by its abbreviation, it has become one of the most common injuries amongst professional athletes and amateurs alike. During the 2013-2014 NFL season, sixty-three NFL players on the Injured List suffered from a torn ACL; nationwide the injury occurs roughly 150,000 times a year.
Located inside the knee joint behind the kneecap (patella), the ACL creates knee stability by connecting the thighbone (femur) to the shinbone (tibia), as part of the four primary ligaments. Additionally, the ACL prevents the tibia from moving forward and away from the femur.
As the adage goes, an ounce of prevention is worth a pound of cure. That is why I advise all of the athletes I treat to follow these simple steps before and after exercise:
- Warm-up: Warming up the muscles before any sport significantly reduces the risk of injury.
- Pursue Strength Training: Increasing leg strength will lend to an overall stronger knee joint.
- Work On Your Agility: Agility exercises vary from sport to sport but overall are used to keep players dynamic and stable.
- Don’t Forget Stretches: After every exercise, stretching helps decrease the risk of injury, soreness, and stiffness in the joints.
Identifying an Injury
As the ACL is surrounded by other sensitive structures, an injury to the ACL typically involves damage to the surrounding cartilage, meniscus, and ligaments. When an injury occurs, a loud “popping” noise can often be heard and your knee will feel unstable. Pain, swelling, discomfort, and tenderness are commonly experienced following the tear.
What Are Possible Treatments?
If you are unfortunate enough to have experienced an ACL injury, it’s important that you understand what your options are.
For people who maintain a low level of activity and for whom the knee is stable, your doctor may recommend a brace to protect the knee from further instability without having to endure further risks or complications that can be associated with surgery.
Physical therapy and significant rehab will gradually strengthen the leg muscles while simultaneously restoring the knee’s function
Performed using an arthroscope and a small incision, surgery can repair and reconstruct the ligament using tissue grafts obtained from tendons in the kneecap, hamstring, quadriceps, thighs, or cadavers.
What to expect after surgery
Following the surgery, rest and rehabilitation are crucial to the healing process. Physical therapy will focus on restoring the motion in the knee joint, strengthening the surrounding muscles, and stabilizing the knee joint to protect the knee from further injury. The most important thing at this stage will be patient adherence to your rehab schedule.
With enough time and rehab, you’ll be ready to return to the game in no time!