ACL (LIGAMENT) TEAR
An ACL 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.
KNEE LIGAMENTS ANATOMY
A loud "pop" or a "popping" sensation in the knee
Severe pain and inability to continue activity
Loss of range of motion
A feeling of instability or "giving way" with weight bearing
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
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.
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:
General rest is necessary for healing and limits weight bearing on your knee.
When you're awake, try to ice your knee at least every two hours for 20 minutes at a time.
Wrap an elastic bandage or compression wrap around your knee.
Lie down with your knee propped up on pillows.
Medical treatment for an ACL injury begins with several weeks of rehabilitative therapy. A physical therapist will teach you how to do exercises that you will perform either with continued supervision or at home. You may also wear a brace to stabilize your knee and use crutches for a while to avoid putting weight on your knee.
The goal of rehabilitation is to reduce pain and swelling, restore your knee's full range of motion, and strengthen muscles. This course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees.
Your doctor may recommend surgery if:
You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
More than one ligament or the meniscus in your knee is also injured
The injury is causing your knee to buckle during everyday activities
During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon — tissue similar to a ligament that connects muscle to bone. This replacement tissue is called a graft.
Your surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor.
After surgery you'll resume another course of rehabilitative therapy. Successful ACL reconstruction paired with rigorous rehabilitation can usually restore stability and function to your knee.
There's no set time frame for athletes to return to play. Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years. A longer recovery period may reduce the risk of reinjury.
In general, it takes as long as a year or more before athletes can safely return to play. Doctors and physical therapists will perform tests to gauge your knee's stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. It's important to ensure that strength, stability and movement patterns are optimized before you return to an activity with a risk for ACL injury.
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