What is the ACL?
The Anterior Cruciate Ligament (ACL) is one of the four main ligaments in the knee. It runs from the lateral condyle of the femur to the tibial plateau. These attachments allow the ACL to resist anterior translation and medial rotation of the tibia in relation to the femur.
How do ACL injuries happen?
ACL injuries can occur in multiple ways. The most common injuries to the ACL are partial and complete tears. These require extensive rehab to return the knee to a somewhat normal state. Typically, these injuries occur in athletes who participate in sports where abrupt changes in direction are performed. For instance, football, basketball and soccer are the most common sports were ACL injuries result from the constant sharp turns and maneuvers these sports demand. The key movement that causes an ACL tear is when the feet are planted one way and the knees are turned in another direction.
Other factors that may lead to ACL injuries are the type of surface one might run on and the choice of footwear while performing activities.
Women are said to be at more of a risk for ACL injuries as compared to men. Some theories as to why include that women have less muscle strength in proportion to bone size, difference in hormone levels, ligament strength, biomechanics and the Q-Angle of the knee.
What should you do if you have an ACL injury?
If you have fully torn your ACL you have two options.
1. Surgical: ACL reconstruction
2. Non-Surgical: physiotherapy, strengthening exercises and custom bracing to improve knee stability
Most individuals who plan to return to their high impact sports and highly active lifestyles will opt to have surgery so that they can feel confident in their knee once again. Surgery is a huge commitment because the rehabilitation process before and after surgery can be extensive if you want the best outcome. Your physiotherapist will help you achieve full range of mobility, teach you exercises to improve your strength, balance, coordination and agility so that you can return to sport when the time is right. Your registered massage therapist will also be involved in the rehabilitation process by helping to release and mobilize tight muscles and fascia so that your leg can return to it’s normal state once again.
Tips for ACL Prevention
Athletes can decrease the risk of ACL injuries by performing training drills that require strength, balance, power and agility. Furthermore, plyometric exercises such as jumping and balance drills will help improve neuromuscular conditioning and muscular reactions. Evidence shows this can decrease the risk of ACL injury.
To find out more about how you can prevent ACL sport-related injuries, please read Part 2: Prevention of ACL Injuries in Athletes.
Written By: Giuliano Calleri, RMT