ACL stands for Anterior Cruciate Ligaments, one of the four knee ligaments that support the knee and prevents rotation of the Femur(thigh bone) on the Tibia (shin bone). This ligament is critical in giving stability to knees, and any injury can cause serious damage to this ligament. Mostly, the injury is caused in sports, also vehicle collisions fall and work-related injuries. 80% of ACL tear injury is caused in sports, mostly in football and other sports where one athlete contacts with another. The knee “gives out” and it is a sign that ACL is torn.
How ACL tears occur
The irony of ACL tears is only 30% of injuries occur due to direct blow or contact, and 70% occur when the athlete does a wrong landing. So, there is a big question on how to reduce the risk of this type of injury when there is no direct contact.
Risk Factors of ACL Tears
Anatomic risk factors
The risk depends on the individual anatomical structure, for example, females are more prone to injury than males. There are anatomical structures such as:
- Women are more prone to ACL tears than men.
- Women have different body anatomical structure include a large “Q angle”, meaning the hips are larger the width between knees. This results in more stress on knee joints.
- Women have more mobility than men.
- The “notch” factor also affects ACL tears. The notch is a part of the femur where it joins the knee, so ACL ligament connects in the notch. So, if the width of the notch is small, ligament flexibility is likely to be less.
Hormonal risk factors
The area is still in research field how hormone can effect the ACL. Some researchers claim the during menstrual cycle, the ACL tends to be weakened.
ACL tears can also happen due to neuromuscular control, meaning nerve controls over muscles. This is an involuntary process that occurs in the body, and some researchers speculate that it can deem risk factors for ACL tears.
Signs of ACL Tears
Hearing a “pop”
Most of the time when ACL tears happen, a surprisingly loud pop sound is heard. Even bystanders can hear the sound, it mostly happens in football or soccer game when athletes can understand injury has been taken place. Sometimes you don’t hear the pop but a sudden shift of joint will be felt in the joint.
“Giving out” the knee
Giving-out is a common sign of ACL tears because when the ligament supports the knee joint and when an ACL tear happens, the knee joints have a tendency to give out. This instability makes it difficult even to walk or simple movements.
Swelling and pain
Swelling and sharp pain is the common sign with a large lump of swelling within a few minutes. The swelling is a sign of blood accumulation in the knee joint.
How can a physical therapist helps in ACL tears
The shortcut method to recover from ACL tears is surgery, but you can also try to manage your recovery without surgery. A physical therapist can help to restore your muscle strength, endurance and coordination, though it will be time is taken, more permanent and holistic. Physical therapy helps to learn how to maintain a balance of the body, giving minimum stress to your knee.
Treatment without surgery
Surgery is the primary necessary in ACL tears, but in some cases, patients do not need surgery to recover. Nevertheless, the patient needs special attention of a physical therapist for recovery. The physical therapist identifies the problems according to various parameters such as anatomical, age and others, and then design a special program. The program also includes special electrical stimulation, cardiovascular strengthening, muscle training etc.
Treatment after surgery
After surgery, the patient also needs physical therapist to recover the strength in muscles. There are many steps such as:
Bearing weight: After surgery, a patient needs to walk on crutches. The physical therapist guides the rehabilitation program how much weight you put on your legs, and how long you should walk daily for recovery.
Icing and compression: After surgery, the swelling and pain give discomfort, so the physical therapist works on the cold application and control your pain.
Bracing: After surgery patients need to wear a brace to limit the knee movement. A physical therapist will teach how to use the brace.
Exercise regime: A physical therapist will design the exercise regime and focuses on the movement on the knee.
Physical rehabilitation training will be:
Coordination and agility training (for competitive athletes).