Sports Injuries Part 2

Condition: Anterior Cruciate Ligament (ACL)Tear

 
By Phillip McShane B.Sc. Physiotherapy (Curtin), APAM.

 

Phillip works from our Manning practice Monday to Saturday.

Background: The Anterior Cruciate Ligament (ACL) connects the shin bone to the thigh bone, at the knee joint. Its role is to restrain the shin from shifting forwards on the thigh, and vice-versa. Injury to the ACL most frequently occurs during sport and males between the age of 18 and 25 are most at risk. 

Symptoms: An audible pop or crack is often heard at the time of injury, as well as sharp pain initially. Swelling often occurs following a tear, but this is not always the case. Instability and episodes of knee buckling or “giving way” can be key signs of an ACL rupture.

Cause: The ACL is commonly ruptured during sport, in particular high-impact sports and sudden changes of direction. 70% of ACL ruptures occur without contact, often twisting or pivoting on a single planted foot.

Treatment: Grade III (complete) ACL tears are traditionally treated with an ACL reconstruction surgical procedure, where a section of hamstring or quadricep tendon is grafted and used to replace the ACL. A synthetic ligament (LARS) is also sometimes used as an alternative replacement. This is followed by a thorough rehabilitation program with a physiotherapist in order to regain strength, stability and function, with resumption of running usually around 3 months post-op and return to sport between 6 and 12 months.

References:

  •  Management of Anterior Cruciate Ligament: What’s In and What’s Out? Raines BT, NAclerio E, Sherman SL. Indian J Orthop. 2017 Sep-Oct; 51 (5): 563-575. DOI: 10.4103/ortho.IJOrtho_245_17. PMCID: PMC5609378 PMID: 28966380

Current Concepts for Anterior Cruciate Ligament Reconstruction: A Criterion-Based Rehabilitation Progression. Adams D, Logerstedt D, Hunter-Giordano A, Axe MJ, Snyder-Mackler L. J Orthop Sports Phys Ther. 2012 Jul; 42 (7) 601-614. Doi: 10.2519/jospt.2012.3871. PMID 22402434 PMCID: PMC357689