There are few more devastating injuries in sport than tearing the Anterior Cruciate Ligament (ACL).
The ACL plays a critical role in providing stability and control with sideways and pivoting movements in your knee. Along with the Posterior Cruciate Ligament (PCL), and the medial and lateral collateral ligaments, the knee relies upon these strong ligaments to control and limit movement.
Why are ACL injuries so common?
Unfortunately, Australians see a lot of ACL injuries, as they have a very high occurrence in many sports popular in Australia. This is especially the case with AFL (Australian Rules Football) and netball, but also rugby union and league, soccer (football), and basketball.
This is due to both the sudden changes in direction that you see in all of these sports, as well as physical contact and tackling.
Skiing is also a sport with a very high frequency of ACL injuries. This is due to the very high forces exerted on the knee, especially in falls and when the skis force twisting motions in the knee.
Diagnosis and assessment
Diagnosis of ACL injuries by a highly skilled physiotherapist and/or sports medicine doctor is usually possible without scans, as the mechanism of injury, the severe initial pain, and the swelling and instability seen on examination are highly indicative of this injury.
However, scans are regularly ordered to determine the extent of the injury and, critically, whether other structures are injured. If other ligaments and/or the meniscus (cartilage) are also damaged, this creates additional complications when compared with an isolated ACL tear.
Treatment and rehabilitation
Initial treatment should consist of physiotherapy and include preventing further damage and minimising the swelling as much as possible.
It is then important to work with your physiotherapist, sports doctor, and surgeon to determine the best approach for rehabilitating your injury. This may include surgery and an ACL reconstruction, especially if you intend to return to sports or activities that are higher risk, if other structures are damaged or injured, and/or if you have noted instability on testing.
However, a guided physiotherapy-led strength and control exercise rehabilitation program may be the best approach for some individuals who have fewer risk factors.
There are currently studies underway looking at the effect of highly specific knee bracing to assist the ACL in repairing without surgery, and these may provide an additional option for some individuals.
Early action is key
So, the important thing is to act early, get the injury properly assessed and treated, and then work with a team of physiotherapists, sports doctors, and surgeons to come up with the best option for you and your particular injury and circumstances.
For more information, see your local Lifecare practitioner. Click here to find your closest Lifecare clinic.
