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If you play most any kind of sport, chances are you or someone you know has experienced an ACL tear. This common athletic injury cannot only be debilitating and immobilizing, but may require surgery and months of physical therapy too.
What Is The ACL?
The anterior cruciate ligament is one of four main connective fibrous bands of tissue which help stabilize the knee and keep the bones of the joint in place including the femur (thigh bone), tibia (shin bone) and the patella (knee cap). The ACL runs diagonally right in the center of the knee and is responsible for stabilizing the motion of the knee joint when you turn or plant your leg.
What Are Risk Factors for ACL Tears?
While ACL tears are quite common among athletes, over 200,000 injury cases reported annually, there are some factors that put players at higher risk, including:
- Playing high impact sports like soccer, rugby, or football
- Gender, girls are at higher risk than boys
- Specific bone structures of knee joint more susceptible to injury including decreased femoral notch size and increased anterior-posterior knee laxity
- Tight and or weak muscles and ligaments in and around the knee, especially quadriceps and hamstrings
- Wearing cleats with high rotational tractional value when playing sports (cleats with many large, teeth or rubbery nodules along the outside of the sole)
- Wearing high heels regularly
What Causes an ACL to Tear?
Most often an ACL tear results as an athlete decelerates in speed while at the same time pivoting, cutting, sidestepping, or landing at an awkward angle. Causal body positions include:
- Flat footed landing form when jumping
- Overextending the knee joint
- Rapid speed or direction changes when running
- Knee joint gets bent side to side
What Are the Symptoms of an ACL Tear?
Most often an athlete will hear or feel a pop in their knee at the moment of injury, followed by moderate to severe pain on the outside and back of the knee, swelling, and tenderness. In addition, the knee will feel “out of place” as in it is wobbly or buckles with pressure, and bearing weight will be difficult to impossible depending on severity of the injury.
You may be able to walk after an ACL tear, however, your movement and range of motion will be limited by the pain and swelling you experience.
A physical exam will be conducted by a doctor to diagnose an ACL tear as well as imaging scans including x-rays and potentially MRIs to evaluate the extent of the damage and any other potential issues with other ligaments and bones. Occasionally a CT will be performed to if your treating doctor has concerns about bone fractures.
How is an ACL Tear Treated?
Immediately, rest, ice, and elevation will always be the priority for an ACL tear, especially if you have to wait to see a doctor. Avoiding bearing weight on the affected leg will also help prevent you from exacerbating the injury.
While some minor ACL tears may heal overtime on their own, for athletes looking to resume regular play, more invasive procedures including surgery may be required. Physical therapy accompanied by wrapping the knee or wearing an orthotic brace can also aid recovery. Click here to see knee braces for torn ACLs.
Chances of reinjuring the knee increase after an ACL tear so it is critical that athletes learn how to stretch and strengthen leg muscles to help prevent future injury. Reducing pressure on the knee joint may also come in the form of learning better technique for running and landing when playing sports.