Is it my ACL? At Village Physiotherapy Shellharbour, one of the most common questions we get asked is in regards to one of the most commonly injured ligaments in the knee. It seems like this is a sports persons most dreaded injury especially those participating in high risk activities such as basketball, football, skiing and soccer.
The funny thing is injury to your ACL occurs mainly with no contact with other players. All to often it happens during cutting/pivoting/sidestepping maneuvers, whilst landing or in awkward play.
Having experienced 2 ACL injuries, learning that women have a higher incidence than males was intriguing. It seems there are many theories around this, however no clear cut reason. Theories include:
- Differences in physical conditioning, muscular strength and neuromuscular control
- Differences in pelvic and leg alignment
- Increased liagmentous laxity
- Effects of estrogen on ligament properties.
So what occurs with an ACL injury?
In a nutshell the ligament tears (fully or partially) with associated damage to the bones (bruising), meniscus, cartilage and/or ligaments. Generally following the injury there is a high amount of swelling, pain, and reduction in movement due to inflammation (a normal part of the injury). If the injury has occurred during sport, it is common for players to cease playing the remainder of the game.
Can a physio diagnose ACL injury?
Physiotherapists have the ability to assess and diagnose ACL injury. MRI scanning will confirm the diagnosis. Referral to an orthopaedic surgeon is recommended in most cases, especially for those who are aiming to continue playing sport. With the assistance of physio, it is possible to recover from a full or partial ACL tear without surgical intervention, however there are a few considerations:
- No instability of the knee
- Willingness to give up high demands sports
- Light manual work or sedentary lifestyle
- Young children whose growth plates are still open
What can physio do for me?
Recovering from an ACL injury is not a short journey with most people looking at 6-9months. Physiotherapy has a strong focus on rehabilitation both with and without knee surgery. This involves:
- Regaining knee range of motion (reducing swelling)
- Improving and maintaining muscle strength
- Balance training
- Functional movement re-training
- Sports conditioning
- Advice, education and re-assurance throughout.