ACL Injury

1 What is ACL Injury?

Anterior cruciate ligament (ACL) injury refers to a tear in one of the four ligaments that connects the thigh bone with the shin bone. ACL provides stability to the knee and aids in its flexing and extending.

Injury of the ACL may be mild, with a partial tear, or severe, with a complete rupture of the ligament. If left untreated, movement of the knee is affected.

Lack of treatment may result in the bones rubbing each other. Tearing of the ligament causes swelling and pain in the knees.

This injury is common in sports that involve sudden direction changes, like soccer, basketball and skiing.

Treatment of ACL injuries focus on regaining the strength and stability of the knees. Rehabilitation is also an important part of the treatment in order to enable the patient to get back to his/her normal routine.

2 Symptoms

Some of the early symptoms of ACL injury include:

  • A characteristic snap at the time of injury
  • Swelling of the knee within few hours of injury
  • Pain that increases when trying to put pressure on the knee

Bleeding at the joint causes swelling and this makes it difficult to straighten the knee after injury.

Pain and swelling will continue and makes walking and climbing hard. Knee may feel unstable and movement may be limited.

3 Causes

Excess strain on the knee is the most common cause of an ACL injury. Sports activities that include sudden stopping is a culprit as it puts strain on the knee ligaments.

Sports with sudden change in direction such as basketball, football, and skiing increase the risk of injury to ligaments.

Other causes of ACL injury include:

  • Twisting of the knee when the foot is planted firmly
  • A blow or hit to one side of the knee
  • Suddenly stopping while moving
  • Landing from a jump

Many sports that involve the above-mentioned movements increase the chances of ligament injury.

4 Making a Diagnosis

Physical examination and patient history are the best diagnostic measures for an ACL injury.

Physical examination reveals swelling and deformity, if any, in the knee. The doctor may note the area of tenderness in the affected knee.

To assess the stability of the knee, tests like the Lachman test, the pivot-shift test, and the anterior drawer test are conducted.

Severity of the ligament injury is assessed using imaging techniques including X-ray, MRI and Ultrasound.

X-rays help to differentiate bone fractures from ligament tears.

MRI shows the extent of the injury clearly.

Ultrasound images are also useful in identifying the type and extent of damage to the ACL.

5 Treatment

Treatment of an ACL injury focuses on stabilizing and strengthening the knees. It also helps to reduce further damage to the knees. First aid for an ACL injury is the RICE method. This includes:

  • R - Rest the affected leg and avoid putting weight on it
  • I - Apply ice pads on the affected region for 20-30 minutes for two to three days
  • C - Compress the lower parts of the leg using an elastic bandage to reduce swelling 
  • E - Raise or elevate the leg while resting

Surgery is often recommended in the case of individuals involved in agility sports, so that they can return to sports as soon as possible.

Non-surgical methods are useful for older and less active individuals.

Non-surgical treatment options include:

  • Bracing – braces are ideal for stabilizing the affected knee. Crutches are suggested to avoid putting weight on the knees
  • Physical therapy – this therapy is useful once swelling resolves. Physical therapy exercises help to restore strength in the muscles and knees.

With the surgical method, the ligament is reconstructed using arthroscopy. The torn ligament is replaced with a tissue graft.

Stability and functioning of the damaged area is restored by a rehabilitation program.

Non-steroidal, anti-inflammatory medications are used to relieve pain and swelling.

6 Prevention

Stretching and strengthening the muscles of the thighs is the best way to prevent an ACL injury.

Joints and muscles can be protected by warming up and cooling down during physical activity.

Plyometric exercises are also suggested to improve power and speed with minimal injury to the joints.

7 Alternative and Homeopathic Remedies

There are several alternative and homeopathic remedies used for ACL Injury.

Rhus tox is the primary prescribed homeopathic medication for ACL injuries.

Arnica, Argent Met, Hypericum, and Ruta are also used for ligament tears.

Prolotherapy is a non-surgical alternative therapy for treating muscular pain and instability.

Physical therapy is the most common method for controlling further damage.

8 Lifestyle and Coping

There are different ways to adapt your lifestyle in coping with ACL injury.

R.I.C.E are simple home methods that help to reduce pain and swelling in the knee due to a ligament tear.

Rehabilitation exercise programs are also important in coping with the injury.

9 Risks and Complications

Sports activities that involve sudden changes in direction, abrupt stopping and twisting movements of the knee increase the risk and affect complications of ACL injury

Other risk factors of ligament injury include age, disability, improper muscle strength, and previous ACL injuries.

ACL injuries may also increase the chance of osteoarthritis.