Injury to the anterior cruciate ligament (ACL) in the knee: Recognizing symptoms, available treatments, and expected recuperation duration
An ACL (anterior cruciate ligament) injury is a significant knee injury that commonly occurs during sports or activities involving sudden stops, quick changes in direction, jumping, or landing. These activities include soccer, basketball, football, and skiing. The injury can range from a mild sprain to a complete tear of the ligament that stabilises the knee by connecting the thigh bone to the shin bone [2][4].
Common causes of ACL injuries include sudden pivoting or cutting motions in sports, jumping or landing awkwardly, direct trauma to the knee, and rapid deceleration or changes in direction [2][3]. Typical symptoms of an ACL injury include a noticeable "popping" sensation at the time of injury, immediate swelling of the knee, pain that impedes weight bearing on the affected leg, and a feeling of instability or the knee "giving way" [2][4].
Treatment for an ACL injury depends on its severity. For mild sprains, physical therapy focusing on strength, flexibility, and balance may suffice. More severe injuries may require bracing, surgical reconstruction, or even regenerative medicine techniques like stem cell therapy [2][4][5].
Recovery from an ACL injury is a multi-stage process, with typical milestones including regaining range of motion, reducing swelling, restoring quadriceps control, starting closed-chain strengthening and balance training, introducing sport-specific drills, light jogging, and plyometrics, and finally, returning to pivoting or contact sports [1][3]. Most athletes require 6 to 12 months to fully recover, with the exact duration depending on factors such as age, physical condition, rehabilitation compliance, psychological readiness, and the nature of their sport [1][3].
Sports involving cutting and pivoting movements tend to require longer recovery due to a higher re-injury risk. Psychological readiness plays a crucial role, as fear of re-injury can delay return to play. Studies show that delaying return until 9–12 months and achieving good neuromuscular control significantly reduce re-injury rates, which remain around 20–30% in young athletes returning to pivoting sports [1][3].
In the event of surgery, a surgeon may remove the damaged portion of the ACL and graft a new ligament into place, which can come from the injured individual's body, a donor, or be synthetic. Recovery from an ACL injury can take 7-9 months or more for people who play sports, and may require using crutches or a knee brace [1].
To reduce the risk of future ACL injuries, strengthening the leg muscles, core, hips, and pelvis can be beneficial. Additionally, engaging in physical therapy, strength training, and neuromuscular training in jumping and turning can further help [1]. It's important to note that ACL injuries are more common in females than males, even among those who play the same sport [1].
Physicians will assess the extent of the injury, evaluate the range of motion of the affected knee, and may use X-rays or MRI to diagnose an ACL injury. With the right treatment and follow-up care, most people are able to return to their regular activities after an ACL injury [1].
Sources: [1] Mayo Clinic. (2021). ACL injury. https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20355677 [2] American Orthopaedic Society for Sports Medicine. (2021). ACL Injury. https://www.sportsmed.org/injuries-and-conditions/acl-injury [3] American Academy of Orthopaedic Surgeons. (2021). ACL Injury. https://orthoinfo.aaos.org/en/diseases--conditions/acl-injury [4] American Family Physician. (2016). Anterior Cruciate Ligament Injuries in the Knee. https://www.aafp.org/pubs/afp/issues/2016/0215/p391.html [5] OrthoInfo. (2021). Regenerative Medicine. https://orthoinfo.aaos.org/en/treatment/regenerative-medicine/
- An individual with chronic knee pain due to an ACL injury might benefit from medical-condition resources related to sports, fitness-and-exercise, and health-and-wellness.
- The recovery timeline for an ACL injury may extend to 12 months if the person engages in sports, especially those involving chronic-conditions like respiratory-conditions, chronic-kidney-disease, or mental-health concerns.
- Nutrition plays a crucial part in rehabilitation from an ACL injury, ensuring proper strength, endurance, and recovery.
- With a focus on strength, flexibility, and balance, physical therapy can help manage chronic diseases and other medical-conditions that may arise from accidental falls and ACL injuries.
- The scientific community is exploring regenerative medicine techniques, like stem cell therapy, to potentially alleviate the recovery process for severe ACL injuries.
- ACL injuries are more prevalent among females than males, suggesting a need for sport-specific research and resources to address mental-health issues, nutritional requirements, and fitness training for female athletes.
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