If you have a few spare moments scroll through the Rugby League Week “Casualty Ward” page and sandwiched in-between the shattered limbs and dislocations you will find no fewer than 13 season ending ACL injuries. So what is the ACL and why is damage to this structure the cause of so much grief for the professional or amateur athlete. The ACL is one of the main ligamentous stabilisers of the knee – it prevents excessive movement of the joint particularly as it relates to pivoting or rotational movement. Without a functioning ACL the footballer, netballer or tennis player is generally unable to change directions or pivot at speed and hence are incapable of competing at a high level.
Risk Factors / Causes
In the majority of cases an athlete experiences a ‘non-contact’ rupture of the ACL where the ACL ruptures because it is unable to cope with the shearing and rotational forces generated during a high speed change of direction not because of an external force applied during a tackle. Athletes with a previous history of ACL rupture, even of the opposite leg, are at a higher risk of ACL injury, as are females competing in competitive sport.
This is where it gets interesting. If your work or sport requires a reliably stable knee or you are experiencing episodes of knee instability in everyday life then a surgical reconstruction is the best management strategy. For many people, adopting a conservative (non-surgical) approach involving extensive rehabilitation of the injured knee will suffice. Anecdotally we have seen some evidence of increased osteoarthritic (OA) complications in the conservatively managed knee however this may be attributable to injuries sustained to the cartilage and bony tissue at the time of ACL rupture and not the rupture and associated instability itself. Plenty of people opt for a surgical ‘wash out’ of the knee without undergoing the full ACL repair and this does seem to address the OA concerns.
In either a surgical or conservative case the aims of physiotherapy are much the same: manage pain; restore range of movement; develop power, agility, balance and endurance.
Think you’ve ruptured your ACL or are post-ACL reconstruction and need some help with your rehab then come and see one of our highly qualified physios today [ Click here to Request an Appointment ]