ACL Injury Treatment and Rehabilitation
Anterior cruciate ligament (ACL) injuries are one of the most common forms of knee injuries. It accounts for more than half of all knee injuries. These injuries are common in both professional and recreational sports athletes. ACL injuries may be severe, with some ACL injuries requiring surgery. Surgery for ACL injuries tends to be expensive and requires a significant rehabilitation period with dedicated physiotherapy at least for 6 months after the surgery.
ACL Injury in Singapore
An ACL injury is a common sports injury in Singapore as well. In a study published in 2017, the prevalence of ACL tears within a sports setting was recorded to be 87.1% and 87.5% for males and females respectively. Soccer, basketball, racquet sports such as badminton and squash, and volleyball were the sports that resulted in the most amount of ACL tears. Non-sporting related ACL tears were attributed to falls, slips and traffic accidents.
What is an ACL Injury?
The ACL holds the thighbone, shinbone, and kneecap together, controlling the back-and-forth movement of the knees. ACL injuries can be a sprain or a partial/complete tear of the ACL. Most ACL injuries happen during sports due to the sudden stops or changes in direction involved. When an ACL injury happens, you may feel a “popping” sensation in the knee, followed by swelling of the knee.
ACL Injury Symptoms
Some people may not experience the “popping” sensation in the knee when they suffer an ACL injury. Other common ACL injury symptoms include:
- Pain. You may feel some pain along your injured knee. For minor ACL injuries, you may not feel pain but instead, feel soreness along the knee joint.
- Swelling. Your knee joint may swell up after your ACL injury.
- Difficulty walking. An ACL injury may make it difficult for you to walk. You may feel that your knee joint feels loose.
- Loss of range of motion. ACL injuries can cause your knee to lose its range of motion, being unable to bend and flex as much as you would be able to prior to the injury.
ACL Injury Risk Factors
The following factors can increase your risk of developing an ACL injury:
- Sex. Women are more prone to ACL injuries. The incidence of ACL injuries in women is 2 to 8 times greater than men.
- Participating in sports that involve sudden stopping and turns. Sports that require such quick, drastic movement can increase your risk of injuring your ACL. These include basketball, soccer and gymnastics.
- Poor conditioning. If your body is not well conditioned to withstand the intensity of your workout, you will be more prone to injuries such as an ACL injury.
- Improper movement. Poor movement patterns can increase your risk of ACL injuries. For example, moving your knees inward during a squat.
- Poor-fitting footwear. Proper footwear is key in protecting yourself from injuries, especially during sports. Having footwear that does not fit well can expose you to injuries such as an ACL injury.
Complications of ACL Injuries
ACL injuries can lead to health complications. These include:
- Increased risk of developing knee osteoarthritis in the long term
- Damage to your joint cartilage
- A loss in range of motion
Diagnosing ACL Injuries
Your doctor will assess the condition of your knee by conducting a physical examination, checking for swelling and tenderness. Any loss in your range of motion will also be checked for. Depending on the severity of your injury, additional imaging tests such as an X-ray, Magnetic Resonance Imaging (MRI) or ultrasound might be required to rule out other possible causes for your injury.
Preventing ACL Injuries
While sports injuries such as ACL injuries can sometimes be unavoidable, there are some steps that you can take to lower your risks of ACL injuries. Some ACL injury prevention tips for athletes include:
- Core strengthening exercises. Strengthening and conditioning your core can help you improve your balance and fix improper movements and posture due to muscle imbalances, such as moving your knees inwards during a squat.
- Leg strengthening exercises. Strengthening and conditioning your leg muscles can improve your overall balance in leg muscle strength.
- Train with proper technique in mind. When participating in sports that require a lot of jumping, landing with proper technique is key to avoiding ACL injuries.
- Improving your movement technique. When participating in sports that require a lot of sudden turns and pivoting, proper technique can help you reduce the risk of ACL injuries.
- Protective gear. Using the proper protective gear for your respective sport is essential in preventing injuries such as an ACL injury.
Treatment and Rehabilitation for ACL Injury
RICE Model of Self-care
Following the RICE model of self-care can help you to relieve pain and swelling immediately after an injury.
- Rest. Rest is essential to take off pressure from your injured knee and prevent further aggravation.
- Ice. Putting ice against your injured knee can help to relieve pain symptoms.
- Compression. Use an elastic band or compression wrap to support your injured knee.
- Elevation. Elevating your knee will improve blood circulation.
Medications
Anti-inflammatory pain-relieving drugs can help you alleviate symptoms of pain and swelling. Depending on the intensity of your pain, you may get prescriptions for stronger drugs, or even get a steroid injection into your knee for pain relief.
Knee Brace
For minor ACL injuries, the use of a knee brace while participating in sports can provide sufficient support for the injured knee.
Surgery
For more severe ACL injuries, such as a complete ACL tear, ACL tear surgery may be necessary. The damaged ACL is either repaired or replaced with a graft (usually taken from the patient’s own tendon). After the surgery, physiotherapy will be required to help you complete your rehabilitation and get back into shape. This rehabilitation period may take six months to a year.
Physiotherapy and Rehabilitation
Physiotherapy and rehabilitation are important for recovering lost range of motion, knee stability and function following an ACL injury. This is especially important if you are an athlete suffering from an ACL injury and wish to get back to competing as soon as possible. The duration of the rehabilitation period can range from 6 to 12 months, depending on the severity of your ACL injury, or your age. It is of utmost importance that a patient who undergoes surgery also be counselled on the importance of rehabilitation post-surgery. If a patient is not compliant, the patient will have a high chance of ending up with a stiff knee with reduced range of motion.
Generally, the first part of the rehabilitation process aims to recover your knee’s range of motion. After this is complete, you will move on to strengthening exercises, with a gradual and progressive increase in intensity. This will allow your knee to regain strength and stability. Finally, once you are ready, the last phase of the rehabilitation process will have you practice exercises and movements that are specific to the sport you participate in, to get your body ready to return to your respective sport. Your physiotherapist will supervise your progress throughout the rehabilitation process, ensuring that you carry out the program safely to optimise your recovery.
Manage ACL Injuries at Regis Wellness
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“ACL Injury.” ACL Injury - Diagnosis and Treatment, Mayo Foundation for Medical Education and Research, 10 Mar. 2021, https://www.mayoclinic.org/diseases-conditions/acl-injury/diagnosis-treatment/drc-20350744.
“ACL Injury.” ACL Injury - Symptoms and Causes, Mayo Foundation for Medical Education and Research, 10 Mar. 2021, https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738#:~:text=An%20ACL%20injury%20is%20a,to%20your%20shinbone%20(tibia).
ACL Tear: Symptoms, Complications, and Treatment, Practo Health Wiki, https://www.practo.com/health-wiki/acl-tear-symptoms-complications-and-treatment/265/article#6.
“Anterior Cruciate Ligament (ACL) Injuries.” Anterior Cruciate Ligament (ACL) Injuries - Orthoinfo - Aaos, OrthoInfo, Mar. 2014, https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/.
Kvist, Joanna. “Rehabilitation following anterior cruciate ligament injury: current recommendations for sports participation.” Sports medicine (Auckland, N.Z.) vol. 34,4, 2004. 269-80. doi:10.2165/00007256-200434040-00006
Ma, Benjamin. “Anterior Cruciate Ligament (ACL) Injury.” Anterior Cruciate Ligament (ACL) Injury: Medlineplus Medical Encyclopedia, MedlinePlus, 7 Aug. 2020, https://medlineplus.gov/ency/article/001074.htm.
Sayampanathan, Andrew Arjun et al. “Epidemiology of surgically managed anterior cruciate ligament ruptures in a sports surgery practice.” Journal of orthopaedic surgery (Hong Kong) vol. 25,1, 2017. : 2309499016684289. doi:10.1177/2309499016684289
“The female ACL: Why is it more prone to injury?.” Journal of orthopaedics vol. 13,2 A1-4. 24 Mar. 2016, doi:10.1016/S0972-978X(16)00023-4
Wheeler, Tyler. “ACL Injury: What to Know.” Anterior Cruciate Ligament (ACL) Injuries: Symptoms, Treatment, & Recovery, WebMD, 18 Dec. 2020, https://www.webmd.com/pain-management/knee-pain/acl-injury-what-to-know.
Zippelius, Karl. “The integrative TCM treatment of cruciate ligament injury.” Journal of Chinese Medicine. 2017. 5-14.
