Search for more Articles

Printer Friendly Version


In This Article...
Anatomy of the Knee
How is the ACL Injured?
Signs and Symptoms
Treatment for ACL Injury
ACL Surgery
ACL Injury Prevention

ACL Injuries and Anterior Cruciate Ligament Rehabilitation

Prevent ACL injury and recover quickly with these prevention and treatment strategies.

ACL injury, or Anterior Cruciate Ligament injury, is another common problem that affects the knee joint. The ACL is damaged in about 70% of all serious knee injuries, which makes it the most common injury affecting the knee joint.

If you suffer from ACL injury or are seeking to prevent its occurrence it is important to follow the information in this article. In addition, making stretching a part of your fitness regime will have a significant impact. To get you started on a safe and effective stretching routine learn more about The Stretching Handbook and how it can improve your fitness.

Anatomy of the Knee
The anterior cruciate ligament is located within the capsule of the knee and connects the femur (thigh bone) to the tibia (shin bone).

The picture on the right is a front-on view of the bones, tendons and ligaments that make up the right knee. In the middle of the picture there is a ligament called the "Anterior Cruciate Ligament." It is this ligament, most commonly referred to as the ACL, which is damaged in an ACL injury.

The ACL is responsible for restraining excessive forward movement of the tibia and limiting rotational movement at the knee joint.

How is the ACL Injured?
As with any sprain, an ACL injury is the result of excessive stretching or tearing of the ligament. The severity of the injury can range from a slight stretching to a complete rupture. An ACL injury most commonly results from:

Athlete's involved in sports that require a lot of running and change of direction and speed; (especially contact sports) are most susceptible to ACL injury. Sports that involve the highest risk are football, soccer, basketball, skiing, hockey and gymnastics.

What are the Signs and Symptoms of an ACL Injury?
The severity of the symptoms tends to correlate with the severity of the injury. In other words, the worse the injury, the worse the symptoms. The most common symptom of an ACL injury is pain and swelling at the knee joint.

Treatment for ACL Injury
A minor ACL injury is just like any other soft tissue injury and should be treated accordingly. This involves the application of R.I.C.E.R. (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment. The following two points are of most importance.

How do you apply ice? Crushed ice in a plastic bag is usually best. However, blocks of ice, commercial cold packs and bags of frozen peas will all do fine. Even cold water from a tap is better than nothing at all.

When using ice, be careful not to apply it directly to the skin. This can cause "ice burns" and further skin damage. Wrapping the ice in a damp towel generally provides the best protection for the skin.

How long, how often? This is the point where few people agree. Let me give you some figures to use, as a rough guide, and then I will give you some advice from personal experience. The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours.

These figures are a good starting point, but remember they are only a guide. You must take into account that some people are more sensitive to cold than others are. Also, be aware that children and elderly people have a lower tolerance to ice and cold. Finally, people with circulatory problems are also more sensitive to ice. Remember to keep these things in mind when treating yourself or someone else with ice.

Personally, I recommend that people use their own judgement when applying ice to them self. For some people, 20 minutes is too much. For others, especially well conditioned athletes, they can leave ice on for up to an hour at a time. The individual should make the decision as to how long the ice should stay on.

My personal recommendation is that people should apply ice for as long as it is comfortable. Obviously, there will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it is time to remove the ice. It is much better to apply ice for 3 to 5 minutes a couple of time an hour, than not at all.

During the first 24 to 72 hours after an injury, be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spas, Jacuzzi's and saunas. Avoid all movement and massage of the injured area. Also, avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your injury. Avoid them at all costs.

ACL Surgery
For major ACL injuries, including a complete tear of the ligament, surgery will be necessary. The specific procedures for each surgery varies according to the degree of damage done, the age of the patient, the activity level of the patient and if there are any other injuries to the knee joint.

There are a number of tests your doctor or physical therapist can perform to help determine the extent of the damage of the ACL. Depending on certain factors your doctor may also choose to perform an x-ray and MRI, but these are not always necessary.

As it is not possible to repair the ACL by simply reconnecting the torn ends, in most cases, surgery will involve using a segment of another healthy ligament to replace the damaged ACL.

After surgery, expect to be on crutches for one to three weeks. Full recovery, using a comprehensive rehabilitation program will generally take about three to four months and athletes involved in high demand sports can be back on the field in about six to eight months.

For more detailed information on ACL tears and ACL surgery, visit the following sites.

ACL Injury Prevention
Although it is important to be able to treat ACL injury, prevention should be your first priority. So what are some of the things you can do to help prevent an ACL injury?

Stretching is one of the most under-utilized techniques for improving athletic performance and getting rid of those annoying sports injuries. Don't make the mistake of thinking that something as simple as stretching won't be effective.

And to help you improve your flexibility quickly and safely, you can't go past The Stretching Handbook & DVD. Together they include over 130 clear photographs and 40 videos of every possible stretching exercise, for every major muscle group in your body.

The Stretching Handbook & DVD will show you, step-by-step, how to perform each stretch EXACTLY! Plus, you'll learn the benefits of flexibility; the 7 critical rules for safe stretching; and how to stretch properly. Discover more about The Stretching Handbook & DVD here.

If you enjoyed this issue of The Stretching & Sports Injury Report, please feel free to forward it to others, make it available for download from your site or post it on forums for others to read. Please make sure the following paragraph and URL are included: