What happens when the ACL is torn?
What happens when the ACL is torn some people who rupture their ACL can recall the exact moment at which they felt it pop. This usually happens when changing direction quickly in pivoting or cutting sports like soccer, landing from a jump in sports such as basketball, or falling while skiing. Other than sports the common causes of ACL injury is fall of two wheelers in road traffic accident, dashboard injury, sudden twisting to knee by putting foot on uneven ground, pot hole or even falling from stairs.
The four “classic” symptoms that people may feel when they tear their ACL are:
- They hear a “pop” from inside the knee.
- They feel the knee give away at the time of injury.
- They develop a swollen knee immediately, or within a few hours
- The pain is bad enough that the player is unable to continue to play that day & others find difficulty to walk around even for their daily activities.
Typically X-ray show no bony injury. If all or most of the above is true than one should seriously consider a ligament injury in the knee. Secondly other structures in the may also be injured along with ACL like meniscus (cartilage),joint surface & other ligament like MCL, LCL, or PCL Examining an athlete immediately after they have had a knee injury can sometimes be difficult and it is often not possible to tell what structures, if any, have been injured. A better examination can usually be obtained after the swelling has gone down and the pain from the injury has subsided. Although accurate diagnosis of the exact injury can be difficult, it is relatively certain that an athlete who develops a swollen knee immediately after an injury should not return to play and should seek medical evaluation.
ACL injuries and women’s athletics
ACL injuries appear to be happening more frequently today than they did in the past. This is in part because most athletes demand much more from themselves as compared to a generation ago. As the speed and agility of athletes increases, so does the amount of force that is sent through the ligaments of the knee. Women appear to be particularly susceptible to ACL injuries, and there is an ongoing debate in the sports medicine community about why this may be the case. In 1995, an article was published in the American Journal of Sports Medicine that found that female basketball players tore their ACL’s four times more often than male basketball players. While research have shown that the increased rate of ACL injuries in women may be due to differences in ligament strength, anatomy of the knee, jumping ability, muscle strength and coordination. As ACL injuries have become more common, more and more research is being done on how to prevent them.
ACL injuries and children
ACL injuries do occur in children. If the child tears his or her ACL while playing sports or in an accident. The bones and joints of children are very different from the bones and joints of adults because children’s bones are still growing. This can make an ACL injury a bit more complicated for the children. The orthopaedic surgeon will want to find the best way to make sure that your child has a good knee that functions normally and does not hurt. This can be difficult because children are very active and it is hard to get them to slow down and avoid certain activities that may damage their knees. At the same time, ACL surgery for children is more difficult than it is in adults because there is the risk that the normal development of the bones can be changed by the surgery. There are some situations in which ACL injuries in children can cause enough looseness in the knee that participation in certain sports carries a very high risk of damaging the rest of the knee if the ACL is not fixed. These sports involve running, jumping, and changing direction quickly, like soccer, basketball, baseball, or skiing. In this situation, the child should either stop participating in these sports, or should get his/her ACL fixed. However, if the child does not play these sports, or if doctor believes that the child’s knee does not have a significant amount of looseness after the ACL has been torn, then the child may not need the surgery.
Currently, there are no solid recommendations for which surgical techniques are best for which age groups. Children who are close to maturity and generally more than about fourteen years old can have their ACL’s replaced safely with standard techniques. Children who are much younger may need to either wait until they are older, or if their knee is unstable enough they may need to have a different type of reconstruction that avoids drilling holes through the growth plate.
Different techniques for graft fixation can avoid drilling holes through the growth plates bone tunnels have been drilled through the growth plates
How your knee On field treatment of ACL/ knee injury
An ACL injury should be treated with a splint, ice, elevation of the joint , and pain relievers such as nonsteroidal anti-inflammatory drugs (like ibuprofen). The patient should not continue to play until evaluation and treatment has taken place.Some people may need crutches to walk until the swelling and pain has improved. Physical therapy may help regain joint motion and leg strength.
.DO NOT In the case of a serious knee injury, do not attempt to move the joint. A splint should be used to keep the knee straight until evaluation by trained medical personnel has been performed. Do not return to play until proper evaluation and treatment has taken place.
When to Contact a Medical Professional. Anyone with a serious knee injury should seek medical attention for x-rays and evaluation.
More important, if someone’s foot is cool and blue after a knee injury, they may have dislocated their knee and injured the blood vessels to the foot. This is a true medical emergency that requires immediate professional help.
Prevention use proper techniques when playing sports or exercising. Several women’s collegiate sports programs have reduced ACL tears through a training program that teaches athletes how to minimize the stress they place on their ACL.
Although the issue is controversial, the use of knee braces during aggressive athletic activity, such as football, has not been shown to decrease the incidence of knee injuries and may give the player a false sense of security.
Diagnosing a torn ACL
To diagnose a torn ACL, doctor at A+ Center first wants to know as much as possible about how the injury occurred. Be prepared to describe:
- How the injury felt and whether you heard or felt your knee pop.
- Whether the injury swelled immediately afterward.
- If you were unable to continue being physically activ
All of these are signs and symptoms of a possible ACL tear. Knee examination next, doctor at A+ Center examines your knee to determine if the ACL is torn. Commonly used exams are the Lachman’s test and the pivot shift test.Next, doctor at A+ Center examines your knee to determine if the ACL is torn. Commonly used exams are the Lachman’s test and the pivot shift test.
- Lachman’s test. In this test, while lying on your back with your knee bent at a 30-degree angle and your foot flat on the table, doctor gently moves your lower leg forward at the knee. If your leg moves forward freely without reaching a firm endpoint, your ACL is torn.
- Pivot shift test. In this test, doctor extends your knee and rotates your foot inward while applying pressure to the outside of your knee and slowly bending it.Doctor is checking for signs of instability indicated by a shifting of the shinbone on the thighbone. If the movement in your knee is restricted by swelling or by contraction of the muscles in the back of your upper leg, doctor may not be able to detect a torn ACL with these tests.
If doctor at A+ Center is able to examine your knee adequately, imaging studies may be unnecessary. ACL tears don’t show up on X-rays, although certain types of shin fractures associated with ACL tears may be visible. In diagnosing a torn ACL, some studies show that magnetic resonance imaging (MRI) has the same accuracy as a careful history and physical exam. Depending on the nature of the injury and other exam findings, however, an MRI is sometimes helpful in identifying damage to other structures in the knee treatment
Diagnosing a torn ACL
You and doctor at A+ Center may choose nonsurgical rehabilitation if:
- Your knee is stable during typical daily activities.
- Your knee cartilage hasn’t been damaged.
- You have no desire to paticipate in high risk activities involving jumping ,cutting, & pivoting.
Nonsurgical rehabilitation may also be appropriate for a child or an adolescent with a torn ACL. If your child has no damage to the knee other than to the ACL and can avoid high-risk activities, the doctor may recommend postponing surgery until your child’s bones have finished growing, although with current techniques, ACL reconstruction is generally possible without damaging the growth plate in growing children.
As with all treatment options, you’ll want to consider the trade-offs before deciding if nonsurgical rehabilitation is the best choice for you.
Physical therapy: what to expect
The goal of physical therapy is to strengthen the muscles around your knee to make up for the absence of an intact ACL. Training focuses on the:
- Muscles in the back of the thigh (hamstrings)
- Muscles in the front of the thigh (quadriceps)
Some exercises can be done at home. Others require the use of weight machines, exercise bicycles or treadmills, which may require visits to A+ Orthopedic & Sports Med Center.
In the early stages of rehab, you work on re-establishing full range of motion in your knee. Then you progress to knee, hip and ankle-strengthening exercises combined with training to improve your stability and balance. Finally, you work on training specific to your sport or work activities, including exercises to help you prevent further injury, such as learning how to land properly from a jump.
Estimated recovery time
A nonoperative rehabilitation program may be easier and less painful than the physical therapy needed after surgery. You can usually expect to be back to your normal daily activities within a month. However, physical therapy can be time-consuming, especially in the first few months after your ACL injury. To maintain maximum knee stability, your doctor will probably recommend lifelong strength and stability exercises for your legs.
Changing activities to protect your knee
You’ll need to change your activities to avoid high-risk sports that could further damage your knee. Avoid activities that include jumping, cutting, pivoting, and sudden slowing down or stopping (deceleration), such as basketball, football and soccer. You’ll likely be able to do other activities, such as jogging, swimming and bicycling, without difficulty.
When paired with strength and stability exercises, activity modification reduces the risk of future knee problems. However, people who continue to participate in sports or activities that involve cutting, pivoting or sudden deceleration may find their knee “gives way.” Before you decide on a course of treatment, ask yourself if you’re willing to change your activities and give up those that may further damage your knee.