Painful ACL Injuries
Anterior cruciate ligaments (ACL) in the knee are very common injuries. There are between 100,00 to 200,00 ACL ruptures annually in the United States, primarily in younger people. In the general population there are approximately 1 in 3500, but due to unreported injuries the number could be greater. The greatest number of these injuries happen while playing football.
A large number of these injuries also occur due to a fall at a high school level girls soccer game, followed by boys football, girls and boys basketball, gymnastics and lacrosse.
Types of ACL Injuries
ACL injuries occur when the anterior cruciate ligament is partially torn, stretched or completely torn. The complete tear is the most common injury.
The symptoms of an ACL injury include:
- Popping sound during injury
- Knee instability
- Swelling of the knee within two hours
Additional structural damage occurs approximately 50% of the time, which includes ligaments, cartilage or in the meniscus. Magnetic resonance imaging (MRI) is often used for the diagnosis, but an ultrasound or x-ray may also be used. A physical exam will reveal tenderness, a reduced range of motion and looseness in the knee joint. This physical exam may be adequate for a diagnosis.
ACL injuries tend to happen with a rapid change in direction, a sudden stop, direct knee contact or landing too hard after a jump. It is much more common in athletes. The injuries happen in American football, alpine skiing and basketball to adults and teenagers.
ACL Injuries | Q&A with Dr. Jay Lee
Treatment for ACL Injury
For care at home the Mayo Clinic suggests using the RICE mode, which means:
- Rest - limit weight bearing
- Ice - use ice for twenty minutes every two hours
- Compression - use an elastic bandage or compression wrap around your knee
- Elevate - Lie down with the knee elevated on a pillow
People with an ACL tear have a 30% chance of tearing it a second time or tearing the other knee within two years. Therefore, doctors are using a patient’s own biologics, which means their cells, blood components, growth factors and other natural substances to promote healing. According to the Cleveland Clinic this will promote healing, plus it decreases inflammation. This is a new technique called a bridge-enhanced ACL repair (BEAR). Their hope is an improved long-term result.
Surgery may be required if:
- More than one ligament or the meniscus is injured
- The injury is causing your knee to buckle during your normal everyday activities
- You are a very active athlete and want to continue your sport
The surgeon will remove and replace your damaged ligament with a tendon segment from a similar tissue, which is called a graph. This would be a ligament that connects the muscle to the bone. The surgeon uses a piece of tendon from another area of your knee or one from a deceased donor.
Rehabilitative therapy will be useful following the treatment for an ACL tear. There is not a set timeframe for athletes to return to play. Before a person returns to their sport it is important to check the knee for stability, strength and movement patterns. A longer recovery time helps prevent a re-injury.
ACL Injury Prevention
The best way to prevent this injury is by core strengthening and neuromuscular training. Neuromuscular training is often done with a professional trainer, which is recognized by the American Medical Association. The most qualified trainers belong to the National Athletic Trainers’ Association (NATA).
ACL Rehab Phase 1 Exercises
Professional and teenage athletes can help prevent ACL injuries or any injury by strengthening exercises and with a great deal of training. Improving your core strength is also helpful. A professional athlete may benefit greatly by using a NATA trainer.
Fortunately there are new treatments for the injuries that may provide a better long term result. It still may take up to one year for the knee to heal. Physical therapists and doctors can perform tests to assess the stability of the knee, the strength and the general readiness for them to return to their sports activities.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2020 Pamela Oglesby