ACL is commonly known as Anterior Cruciate Ligament which is the major ligaments in our knee. So ACL Injury is a sprain or tear of the anterior cruciate ligament. If you are a sports man, who involve in sudden stops or change in direction and jumping and landing; such as soccer or basketball or football or volleyball and downhill skiing then be aware. You are in a high risk zone of ACL injury.
Anatomy
The knee is made up of four main things. Bones, Cartilage, Tendons and Ligament. Three bones meet to form our knee joint. Femur or thighbone, Tibia or shinbone and Patella or kneecap. Kneecap sits in front of the joint to provide few protections. Bones are connected to other bones by ligaments. There are four primary ligaments in our knee. They act like strong ropes to hold the bones and keep our knee stable. Cruciate Ligaments are found inside our knee joint. They cross each other to form “X” with the anterior Cruciate Ligament in front and the posterior Cruciate Ligament in back. The cruciate ligaments control the back and forth motion of our knee. The anterior Cruciate Ligament runs diagonally in the middle of the knee. It prevents the Tibia from sliding out in front of the femur and provides rotational stability to the knee.
Injury Description
Almost half of all injuries to the anterior Cruciate Ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.
Injured ligaments are considered “sprains” and are graded on a severity scale as follows:
Grade 1 Sprains: The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable.
Grade 2 Sprains: A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament.
Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.
Partial tears of the anterior Cruciate Ligament are rare; most ACL injuries are complete or near complete tears.
Causes
Ligaments are strong bands of tissue which connect one bone to another. ACL injuries often happen during sports and fitness activities that can put stress on the knee. The anterior Cruciate Ligament can be injured in several ways:
- Suddenly slowing down and changing direction (cutting)
- Pivoting with your foot firmly planted
- Landing awkwardly from a jump
- Stopping suddenly
- Slowing down while running
- Receiving a direct blow to the knee or collision, such as a football tackle
When the ligament is damaged, there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact.
Several studies have shown that female athletes have a higher incidence of ACL injury than male athletes in certain sports. It has been proposed that this is due to differences in physical conditioning, muscular strength, and neuromuscular control. Other suggested causes include differences in pelvis and lower extremity (leg) alignment, increased looseness in ligaments, and the effects of estrogen on ligament properties.
Symptoms
When anterior Cruciate Ligament is injure, there is a possibility to might hear a “popping” noise and you may feel your knee give out from under you. Other typical symptoms are:
- A loud “pop” or a “popping” sensation in the knee
- Loss of full range of motion
- Tenderness along the joint line
- Discomfort while walking
- Severe pain and inability to continue activity
- Rapid swelling
- Loss of range of motion
- A feeling of instability or “giving way” with weight bearing
- Pain with swelling.
Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. However, if you attempt to return to sports, your knee will probably be unstable and you risk causing further damage to the cushioning cartilage (meniscus) of your knee.
Risk Factors
Several factors are exists to increase the risk of ACL injuries:
- Females are in high risk of ACL injury due to differences of anatomy, muscle strength and other hormonal influences.
- Participating in certain sports like soccer, football, volleyball, basketball, gymnastics and downhill skiing.
- Poor conditioning.
- Wearing such kind of footwear that doesn’t fit properly.
- Using poorly maintained sports equipment, such as ski bindings that are nott adjusted properly.
- Playing on artificial turf surfaces
Complications
An ACL injury sufferer are at higher risk of developing osteoarthritis in the knee. Arthritis may occur even if you have surgery to reconstruct the ligament.
Multiple factors likely influence the risk of arthritis, such as the severity of the original injury, the presence of related injuries in the knee joint or the level of activity after treatment.
Treatment
The knee joint is a complex structure of bones, ligaments, tendons and other tissues that work together. It’s important to get a prompt and accurate diagnosis to determine the severity of the injury and get proper treatment.
A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, your doctor may recommend simple, nonsurgical options. Doctor may recommend a brace to protect knee from instability. For further protection crutches may be given. Specific exercises will restore function to your knee and strengthen the leg muscles that support it.
Most ACL tears cannot be stitched back together. To surgically repair the ACL and restore knee stability, the ligament must be reconstructed. Doctor will replace torn ligament with a tissue graft. This graft acts as scaffolding for a new ligament to grow on. So seek immediate care if any injury to your knee causes signs or symptoms of an ACL injury.
Prevention is better than Cure
The sports medicine physician, physical therapist, athletic trainer or other specialist in sports medicine can provide assessment; instruction and feedback which can help to reduce risks. Accurate training and exercise is the key element to reduce the risk of ACL injury. Following programs can reduce ACL injury:
- Exercises that strengthen leg muscles particularly hamstring exercises, to ensure an overall balance in leg muscle strength.
- Exercises to strengthen the core, including the hips, pelvis and lower abdomen.
- Training and exercise emphasizing proper technique and knee position when jumping and landing from jumps.
- Training to improve technique when performing pivoting and cutting movements.
- Training to strengthen muscles of the legs, hips and core — as well as training to improve jumping and landing techniques — may help to reduce the higher ACL
- injury risk associated with women athletes.
Take a good protection by wearing footwear and padding that is appropriate for sport to help prevent injury and get a proper guidance by a trained professional.
