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Torn Anterior Cruciate Ligament
Causes: A torn ACL is a relatively common knee injury amongst sports people. The injury usually occurs through a twisting force being applied to the knee whilst the foot is firmly planted on the ground or upon landing. A torn ACL can also result from a direct blow to the knee, usually the outside, as may occur during a football or rugby tackle.
Symptoms: There may be an audible pop or crack at the time of injury. Feeling of initial instability, may be masked later by extensive swelling. This injury is extremely painful, in particular immediately after sustaining the injury. Swelling of the knee- usually immediate and extensive, but can be minimal or delayed. Restricted movement, especially an inability to fully straighten the leg. Possible widespread mild tenderness. Positive signs in the anterior drawer test and Lachman's test. Tenderness at the medial side of the joint- this may indicate meniscal damage.
Treatment: Immediately stop play or competition. Apply RICE (Rest, Ice, Compression, Elevation) immediately. Seek medical attention immediately. Surgery is not always essential when the ACL is ruptured. But in the case of a young sportsman looking to return to sport as soon as possible, it will be. A middle aged or older person could recover without going under the surgeon's knife. However, it is believed that repairing the ligament can reduce the risk of getting arthritis in the joint later in life. Surgeon's will usually graft tissue from either the patella or hamstring tendons to repair the ACL. Basically the new tendon replaces the ACL and is usually attached to the bones above and below the knee by screws. The success rate for such operations is high and while the injured person can soon be up and walking, running and twisting are some months further down the line.
Phase one (0-2 weeks after surgery): The knee will be swollen after the operation, so the first job is to reduce the swelling. After that, the physio will make the patient do a few light exercises like isometric contractions - keeping the leg still but moving the muscles around the knee.
Phase two (2-6 weeks after surgery): The swelling should have disappeared, but the graft usually weakens around this time. The physio may have to back off from the rehabilitation programme until the ligament is up to more exercises. The patient should be walking normally by then.
Phase three (6-12 weeks after surgery): By this stage, the knee should be getting stronger and able to take more strain. The patient should be able to go swimming and use a road bike to get the knee back on track, as well as doing more strength exercises.
Phase three (3-6 months): The patient will have their full range of movement and strength back, so they can start running properly once more. They should be able to get back to specific drills and training.
Phase four (6-12 months): The patient should be able to return to playing sport with their surgeon's approval.
Causes: A torn ACL is a relatively common knee injury amongst sports people. The injury usually occurs through a twisting force being applied to the knee whilst the foot is firmly planted on the ground or upon landing. A torn ACL can also result from a direct blow to the knee, usually the outside, as may occur during a football or rugby tackle.
Symptoms: There may be an audible pop or crack at the time of injury. Feeling of initial instability, may be masked later by extensive swelling. This injury is extremely painful, in particular immediately after sustaining the injury. Swelling of the knee- usually immediate and extensive, but can be minimal or delayed. Restricted movement, especially an inability to fully straighten the leg. Possible widespread mild tenderness. Positive signs in the anterior drawer test and Lachman's test. Tenderness at the medial side of the joint- this may indicate meniscal damage.
Treatment: Immediately stop play or competition. Apply RICE (Rest, Ice, Compression, Elevation) immediately. Seek medical attention immediately. Surgery is not always essential when the ACL is ruptured. But in the case of a young sportsman looking to return to sport as soon as possible, it will be. A middle aged or older person could recover without going under the surgeon's knife. However, it is believed that repairing the ligament can reduce the risk of getting arthritis in the joint later in life. Surgeon's will usually graft tissue from either the patella or hamstring tendons to repair the ACL. Basically the new tendon replaces the ACL and is usually attached to the bones above and below the knee by screws. The success rate for such operations is high and while the injured person can soon be up and walking, running and twisting are some months further down the line.
Phase one (0-2 weeks after surgery): The knee will be swollen after the operation, so the first job is to reduce the swelling. After that, the physio will make the patient do a few light exercises like isometric contractions - keeping the leg still but moving the muscles around the knee.
Phase two (2-6 weeks after surgery): The swelling should have disappeared, but the graft usually weakens around this time. The physio may have to back off from the rehabilitation programme until the ligament is up to more exercises. The patient should be walking normally by then.
Phase three (6-12 weeks after surgery): By this stage, the knee should be getting stronger and able to take more strain. The patient should be able to go swimming and use a road bike to get the knee back on track, as well as doing more strength exercises.
Phase three (3-6 months): The patient will have their full range of movement and strength back, so they can start running properly once more. They should be able to get back to specific drills and training.
Phase four (6-12 months): The patient should be able to return to playing sport with their surgeon's approval.
