Description

An acl injury is a tear or sprain of the anterior cruciate (KROO-she-ate) ligament (ACL) — one of the strong bands of tissue that connect the thigh bone (femur) to your shin bone (tibia). 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 listen to pop or feel a "popping" sensation in the knee when an acl injury occurs. The 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 can help to reduce the risk of an acl injury.

Symptoms

The signs and symptoms of an acl injury usually include:

  • A loud pop or a "popping" sensation in the knee
  • Severe pain and inability to continue activity
  • Rapid swelling
  • The loss of range of motion
  • A feeling of instability or "giving way" with weight bearing

When to see a doctor

Seek immediate medical attention if any injury to your knee that produces signs or symptoms of an acl injury. The knee joint is a complex structure of bones, ligaments, tendons, and other tissues that work together. It is important to get a prompt and accurate diagnosis to determine the severity of the injury and get the appropriate treatment.

Causes

Ligaments are strong bands of tissue that connect one bone to another. The ACL , one of the two ligaments that cross in the center of the knee, connecting the femur with the tibia and helps to stabilize the knee joint.

Acl injuries often occur 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
  • Stopping suddenly
  • Receiving a direct blow to the knee or a collision, such as a football tackle

When the ligament is damaged, there is usually a partial or complete tear of the tissues. A mild injury can stretch the ligament, but leave it intact.

Risk factors

There are a number of factors that increase the risk of an acl injury, including:

  • The fact of being a woman, possibly due to differences in anatomy, muscle strength and hormonal influence
  • Participation in certain sports, such as football, soccer, basketball, gymnastics and skiing downhill
  • Poor conditioning
  • The use of patterns of movement have defective, such as the movement of the knees inward during a squat
  • With shoes that do not fit properly
  • Using the poor maintenance of the equipment of sports, such as ski bindings that do not fit properly
  • Play on artificial turf

Complications

People who suffer from an acl injury have a higher risk of developing osteoarthritis in the knee. Arthritis can occur even if you have the surgery to reconstruct the ligament.

Multiple factors may influence the risk of arthritis, such as the severity of the original injury, the presence of injuries related to the knee joint or the level of activity after the treatment.

Prevention

Proper training and exercise can help to reduce the risk of acl injury. A sports medicine physician, physical therapist, sports coach or other specialist in sports medicine can provide the assessment, teaching and feedback that can help reduce the risks.

Programs to reduce acl injury include:

  • Exercises to strengthen your core — including the hips, the pelvis and the lower part of the abdomen — with a goal of training the athletes to avoid the movement of the knee inward during a squat
  • Exercises to strengthen the muscles of the leg, especially hamstring exercises, to ensure an overall balance in the muscle strength of the leg
  • The training and exercise with emphasis on proper technique and the knee when the position of the jump and the landing of jumps
  • Training to improve the technique when making turns and movements of court

Training to strengthen the muscles of the legs, hips and core, as well as training to improve the jump and the landing, and techniques to prevent the inward movement of the knee may help reduce the increased risk of acl injury in female athletes.

Gear

The use of footwear, and the filler is suitable for sports to help prevent injuries. If you alpine ski, make sure your ski bindings are adjusted correctly by a trained professional, to release the ski properly if you fall.

Use a knee brace doesn't seem to prevent acl injury or reduce the risk of recurrence of the lesion after surgery.

Diagnosis

During the physical exam, your doctor will check your knee for swelling and tenderness — the comparison of his injury in the knee of your injured knee. He or she can also move your knee in a variety of positions to assess the range of movement and joint function.

Often, the diagnosis can be made on the basis of a physical exam alone, but you may need tests to rule out other causes, and to determine the severity of the injury. These tests may include:

  • The x-rays. X-rays may be needed to rule out a bone fracture. However, X-rays do not show soft tissues, such as ligaments and tendons.
  • Magnetic resonance imaging (MRI). A magnetic resonance imaging (MRI uses radio waves and a strong magnetic field to create images of both soft and hard tissues in your body. An mri can show the extent of the injury of the acl and signs of damage to other tissues in the knee joint, including the cartilage.
  • Ultrasound. Using sound waves to visualize internal structures, ultrasound can be used to detect injuries to ligaments, tendons, and muscles of the knee.

Treatment

Prompt first aid can reduce the pain and swelling immediately after an injury to his knee. Follow the R. I. C. E. model of self-care in the home:

  • Rest. General of rest is necessary for the healing and the limits of the weight load on the knee.
  • Of ice. When you are awake, try to ice your knee, at least every two hours for 20 minutes to an hour.
  • Compression. Wrap an elastic bandage or compression wrap it around your knee.
  • Elevation. Lie down with the knee resting on the pillows.

Rehabilitation

The medical treatment for an acl injury begins with several weeks of rehabilitation therapy. A physical therapist will teach you exercises that are done with the supervision or at home. You can also use a brace to stabilize the knee, and the use of crutches for a while to avoid putting weight on the knee.

The goal of rehabilitation is to reduce the swelling and the pain, restore the knee's full range of motion and strengthen the muscles. This course of physical therapy can successfully treat an acl injury for individuals who are relatively inactive, moderate exercise and recreational activities, or play sports that put less stress on the knees.

Surgery

Your doctor may recommend surgery if:

  • You are an athlete and want to continue in the sport, especially if the sport involves jumping, cutting, or pivot
  • More of a ligament or fibrous cartilage in the knee, is also injured
  • The injury is the cause of your knee to buckle during daily activities

During acl reconstruction, the surgeon removes the damaged ligament and replaces it with a piece of tendon tissue similar to a ligament that connects the muscle to the bone. This replacement tissue is called a skin graft.

The surgeon will use a piece of tendon from another part of the knee joint or a tendon from a deceased donor.

After the surgery is going to resume the course of rehabilitation therapy. The success of ACL reconstruction paired with rigorous rehabilitation can restore the stability and function of the knee.

There is No set time period for athletes to return to play. Recent research indicates that up to one-third of the athletes sustain another tear in the same or opposite knee in the term of two years. A longer recovery period, can reduce the risk of a new injury.

In general, it takes a year or more before athletes can safely return to play. Doctors and physical therapists perform tests to measure knee stability, strength, function, and ready to return to sports activities at various intervals during their rehabilitation. It is important to ensure that the strength, stability, and movement patterns are optimized before return to an activity with a risk of acl injury.

Preparing for your appointment

The pain and disability associated with an acl injury prompt many people to seek immediate medical attention. Others may make an appointment with their family doctors. Depending on the severity of your injury, you may be referred to a doctor specializing in sports medicine or a specialist in bone and joint surgery (orthopedic surgeon).

What you can do

Before an appointment, be prepared to answer the following questions:

  • When did the injury occur?
  • What were you doing at that time?
  • Did you hear a loud pop or feel a "popping" sensation?
  • There was a lot of swelling after?
  • You've injured your knee before?
  • The symptoms been continuous or occasional?
  • Do any specific movements seem to improve or worsen your symptoms?
  • Does your knee always "lock" or feel blocked when you are trying to move it?
  • Do you ever feel that your knee is unstable, or unable to bear his weight?
Symptoms and treatment of acl injury