General info
Summary
Data about the condition
An ACL (Anterior Cruciate Ligament) injury is a tear or sprain of the anterior cruciate (KROO-she-ate) ligament (ACL) — one of the major ligaments in your knee. ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing — such as soccer, basketball, football and downhill skiing.
Many people hear or feel a “pop” in the knee when an ACL injury occurs. Your knee may swell, feel unstable and become too painful to bear weight.
Depending on the severity of your ACL injury, treatment may include rest and rehabilitation exercises to help you regain strength and stability or surgery to replace the torn ligament followed by rehabilitation. A proper training program may help reduce the risk of an ACL injury.
Simptomes
- A loud “pop” or a “popping” sensation in the knee
- Severe pain and inability to continue activity
- Rapid swelling
- Loss of range of motion
- A feeling of instability or “giving way” with weight bearing
Causes
Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects your thighbone (femur) to your shinbone (tibia) and helps stabilize your knee joint.
ACL injuries often happen during sports and fitness activities that can put stress on the knee:
- Suddenly slowing down and changing direction (cutting)
- Pivoting with your foot firmly planted
- Landing awkwardly from a jump
- Stopping suddenly
- 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.
Treatment
Prompt first-aid care can reduce pain and swelling immediately after an injury to your knee. Follow the R.I.C.E. model of self-care at home:
- Rest. General rest is necessary for healing and limits weight bearing on your knee.
- Ice. When you’re awake, try to ice your knee at least every two hours for 20 minutes at a time.
- Compression. Wrap an elastic bandage or compression wrap around your knee.
- Elevation. Lie down with your knee propped up on pillows.
The objectives of the Recovery Program
- Pain relief
- Restoring the range of motion
- resumption of walking
- Increased muscle strength and endurance
The content of the Recovery Program
Heel slides – involve the extension of the knee without bearing any weight:
- Start by sitting on the floor with your legs outstretched.
- Slowly bend the injured knee while sliding your heel across the floor toward you. Slowly slide the foot back into the starting position.
- Repeat 10 times.
Isometric Quad Contractions – isometric contractions of the quads are also done seated:
- Sit on the floor with your injured leg extended and your other leg bent.
- Slowly contract the quadriceps of the injured knee without moving the leg.
- Hold for 10 seconds.
- Relax.
- Repeat 10 times.
Prone knee flexion – involves lying on your stomach:
- Lie on your stomach with your legs straight.
- Now bend your injured knee and bring your heel toward your buttocks.
- Hold 5 seconds.
- Relax.
- Repeat 10 times.
Passive knee extensions – require two chairs of equal height. Place the chairs facing each other at a distance slightly shorter than the length of your leg:
- Sit in one chair and place your heel on the seat of the other.
- Relax your leg and allow your knee to straighten.
- Rest in this position 1 to 2 minutes several times a day to gradually stretch out the hamstrings.
Heel raises – are done while standing:
- Start by placing one hand on the back of a chair for balance.
- Now slowly lift the heel of your injured leg up, standing on your tiptoes.
- Stay there for 5 to 10 seconds.
- Slowly lower your heels.
- Repeat 10 times.
Half squats – are done standing while holding a sturdy table with both hands:
- Placing your feet a shoulder’s width apart, slowly bend your knees and lower your hips into a half squat.
- Hold for 10 seconds and then slowly return to a standing position.
- Repeat 10 times.
Knee extensions – require either a TheraBand or a length of an exercise band:
- To begin, loop one end of Theraband around the leg of the table and the other around the ankle of your injured leg. (Alternately, tie both ends of the exercise band around the table leg and insert the ankle of your injured leg into the looped end.)
- Facing the table, slowly bend your knee about 45 degrees against the resistance of the tubing.
- Hold for a few seconds and slowly return to a standing position.
- Repeat 10 times.
Standing on One Leg – is a great way to build and evaluate your strength and balance:
- Stand up on both feet.
- Lift the uninjured leg and standing unassisted on the injured leg for 10 seconds.
This exercise may not be so easy at first, but, with time and patience, you should able to do so while a few weeks.
Methodical Indications
- Long-term warm-up before physical exertion
- Avoiding knee hyperextension
- Avoiding sudden movements
Did you know?
A loud “pop” or a “popping’ sensation may be heard or felt in the knee. It is the 1st symptom that may indicate an ACL injury.
The anterior cruciate ligament (ACL) is the most commonly injured knee ligament.
The most common sports in which ACL injuries occur include football, basketball, rugby and more.
You can also read about Knee osteoarthritis.
Refrences
- Nagano Y, Ida H, Akai M, Fukubayashi T. Biomechanical characteristics of the knee joint in female athletes during tasks associated with anterior cruciate ligament injury. The Knee. 2009 Mar 1;16(2):153-8.
- Jump up↑Arendt E,Dick R. Knee injuries patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med 995;23:694-701
- Jump up↑Arendt EA, Agel J,Dick R.Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Train 1999;34:86-92.
- Jump up↑Garrick JG, Requa RK. Anterior cruciate ligament injuries in men and women: how common are they? In: Griffin LY, ed. Prevention of noncontact ACL injuries. Rosemont,IL:American Academy Orthopaedic Surgeons,2001:1-10.
- Jump up↑Agel J, Arendt E, Bershadsky B.Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: a 13 year review.Am J Sports Med 2005;33(4):524-30.
- Jump up↑Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE. Treatment of anterior cruciate ligament injuries, part I. The American journal of sports medicine. 2005 Oct;33(10):1579-602.
- Jump up↑Matsumoto, H., Suda, Y., Otani, T., Niki, Y., Seedhom, B. B., Fujikawa, K. (2001). Roles of the anterior cruciate ligament and the medial collateral ligament in preventing valgus instability. J Orthop Sci, 6(1), 28-32.
- Jump up↑Mark L. Purnell, Andrew I. Larson, and William Clancy. Anterior Cruciate Ligament Insertions on the Tibia and Femur and Their Relationships to Critical Bony Landmarks Using High-Resolution Volume-Rendering Computed Tomography. Am J Sports Med November 2008 vol. 36 no. 11 2083-2090
- Jump up↑Girgis, F. G., Marshall, J. L., Monajem, A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res(106),1975 216-231.
- Jump up↑Singh JK, Verma A. PREVENTION OF ANTERIOR CRUCIATE LIGAMENT (ACL) INJURY AND ENHANCE PERFORMANCE PROGRAM. IJRAR-International Journal of Research and Analytical Reviews (IJRAR). 2020 Feb;7(1):715-27.
- Jump up↑Shultz SJ, Griffin LY, American Orthopaedic Society for Sports Medicine. Understanding and preventing noncontact ACL injuries. Hewett TE, editor. Champaign, IL: Human Kinetics; 2007.
- ↑ Jump up to:012.1 Wetters N, Weber AE, Wuerz TH, Schub DL, Mandelbaum BR. Mechanism of Injury and Risk Factors for Anterior Cruciate Ligament Injury. Operative Techniques in Sports Medicine. 2015 Oct 17.
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