Causes of ACL Injury
The anterior cruciate ligament (ACL) is one of the four major ligaments that stabilize the knee joint. The anterior and posterior cruciate ligaments are so named because they cross one another like an ‘X’ or a cross as they connect the femur (thigh bone) and the tibia (shin bone). Among other things, the ACL prevents the tibia from sliding forward relative to the femur. Injury to the ACL is one of the most common injuries related to sports and as the ligaments become weaker with age, ACL injuries can actually occur with just normal activities. ACL injuries include tears, sprains and rupture. They occur most commonly when the knee is bent backwards or twisted as may occur in sports like soccer, skiing, basketball and tennis which require jumping, pivoting or quick changes in direction or when the knee is hit with direct force as may occur in football.
Signs and Symptoms
The classic complaint after a severe ACL injury is hearing the sound or even having the ‘feeling’ of a loud popping at the time of the injury. There may be swelling and pain on the lateral (outside) and posterior (back) aspects of the knee. The swelling may develop over 6 to 24 hours. The knee joint may then be unstable and have limited movement. In addition to loss of full range of motion of the knee, there will be tenderness to palpation of the joint. With a minor injury, the patient may be able use the limb, but have the feeling that the knee is ‘giving way’ when bearing weight on it.
Treatment
While ACL injuries are among the most dreaded of sports injuries, there are now many treatment options as well as opportunities to prevent injury in the first place. Immediate treatment includes rest, ice, compression and elevation of the knee, known as the RICE protocol (which can be applied to other injuries as well). If not contraindicated, anti-inflammatory medications can help control pain and swelling. Definitive treatment ranges from physical therapy to surgery.
Prevention
It is important to be aware that girls are at greater risk of ACL injuries and all adolescents who suffer an ACL injury are at greater risk of developing degenerative knee osteoarthritis later in life. Young athletes can reduce their risk of sustaining a severe ACL injury by utilizing training programs that emphasize strengthening exercises and balance training. Your pediatrician, sports medicine physician, physical therapist or athletic trainer can provide you with more information about these helpful programs.
For More Information
For more information about Anterior Cruciate Ligament injuries and related topics, check out the excellent medical blog of sports medicine guru, Dr. David Geier.
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