What Everybody Ought to Know About ACL Injuries
Athletes who twist their knees in sports like basketball, netball, soccer and badminton often complain of having a sense of the knee ‘giving way’ or ‘locking’. The sensation of ‘giving way’ is an indication that you might have an Anterior Cruciate Ligament (ACL) tear, while the ‘locking’ sensation is an indication of a possible meniscus tear.
The ACL is a fairly strong ligament found between the knee-joint. Its main role is to limit the forward movement (anterior translation) of the leg bone (tibia) o the thigh bone (femur).
When athletes change direction speedily during their games, they twist their knee inwards. This increased strain on the ACL places the ligament at risk of tearing. The ACL tears when the knee is forced downwards and inwards beyond the ligament’s ability to hold. As it happens, many describe the tear to be accompanied by a ‘pop’ sound.
Unfortunately, the ACL is very rarely the only ligament involved in this kind of injury. It is typically accompanied with a slight tear in the Medial Collateral Ligament (MCL) and either a medial or lateral meniscus (cartilage) tear. These 3 tears are commonly known as the ‘Unhappy Triad’ or ‘Terrible Triad’.
The meniscus, a crescent-shaped cartilage between the knee, acts as a cushion to absorb the impact between the leg and thigh bones. The meniscus is better at handling stress from an up and down motion, but does not do as well under a twisting motion, especially when compressed. This motion can cause a tear in the meniscus. When the torn part of the meniscus blocks the movement of the knee, the knee is often described to feel ‘locked’.
Immediate swelling and severe pain in the knee are common signs of the Triad injury. However, there are instances where there will be a delay in the onset of swelling or even the absence of swelling entirely. It would help your Doctor of Physiotherapist in diagnosing this problem if you can recount how you injured your knee.
Solving the Problem
Unfortunately, the ACL does not heal on its own due to poor blood supply to the ligament. The torn ACL will need to be surgically reconstructed by using either your hamstring tendon or patella tendon.
Athletes who undergo the surgery would need another 6-9 months of rehabilitation before they will be able to go back to proper training.
However, there are about 20% of people with ACL tears who are able to go about their day-to-day activities without having to surgically reconstruct their ACL. To cope without surgery, the Hamstring, Quadricep (thigh), Gluteus Medius and Gastrocnemius (calf) muscles need to have good strength and control.
Other than doing strengthening exercises, slowly getting back into specific sports training is essential. This is to condition your muscles to develop an anticipatory reaction (feed-forward mechanism) to prevent future injury.
Furthermore, sports taping of the knee to support the ACL and MCL can also be done as a temporary measure for the athlete to cope with the injury until the end of the season.