Treatment for ACL injuries

The treatment required for ACL injuries depend on the severity of your injury. Treatment methods range from resting at home to having to undergo surgery to replace the torn ACL.

A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, your doctor may recommend simple, nonsurgical options.

Less Serious Cases

In less serious cases, such as Grade 1 sprains, resting for a few days and not participating in any vigorous activities can allow the ACL to heal. Receiving immediate first-aid care can help to reduce the pain and any swelling.

In the next few days following the injury, do adopt the R.I.C.E. method to speed up recovery:

  • Rest: Avoid any vigorous activities for a few days
  • Ice: Aim to ice your knee once every two to four hours daily, not exceeding 20 minutes each time to prevent frost bites.
  • Compress: Your doctor will usually wrap an elastic bandage around the knee, and be sure to change it as instructed.
  • Elevate: Whenever you are sitting or lying down, elevate your knee with pillows to around your chest level.
RICE method for injuries
Image 5.1: RICE method for injuries Source: https://www.pathtomom.com/rice-method-for-injuries/

In certain cases that are more serious, your doctor may recommend having a temporary brace on your knee to increase stability. Clutches may also be issued to prevent putting weight on the injured knee, to prevent further aggravation.

Knee braces and crutches for patient who tore her ACL
Image 5.2: Knee braces and crutches for patient who tore her ACL Source: https://www.theodysseyonline.com/10-things-that-happen-when-you-tear-your-acl

After the swelling goes down, physiotherapy is very important to allow your ACL to heal completely. Specific exercises for ACL injuries will be taught to allow your leg muscles to strengthen, and for your knees to return to its original strength.

Serious Cases

Surgery

In serious cases where the ACL is torn, surgery is usually the only method to treat the injury. Most torn ACLs can no longer be stitched back together, and need to be reconstructed instead.

To reconstruct the ACL, the damaged ACL is removed, and replaces it with a tissue graft that connects the muscle to bone. The graft acts as a scaffolding to allow a new ligament to grow on.

Grafts can come from several sources, usually from another part of your own knee. Hamstring tendons found at the back of the thigh are a commonly used as grafts. In certain cases, the tendon of a deceased donor may also be used.

ACL surgery
Image 5.3: ACL surgery Source: https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=zm2375

After the surgery, patients may take from six months, up to a year to fully recover. This is because time is needed for the ACL to regrow. Studies have also shown that up to one-third of athletes who previously suffered from an ACL tear end up with another tear in the ACL within two years. Hence, a longer recovery period is recommended to reduce the risk of reinjury.

Physical Therapy

Apart from surgeries, physical therapy also plays a very big part in the recovery from ACL injuries.

After the surgery, physical therapy helps in strengthening the knee and regaining its full range of motion.

In the first phase, physical therapy will focus on regaining motion to the knee and its surrounding muscles. In the next phase, a strengthening program for the muscles and knees will be introduced, in order to protect the new ligament. The final phase aims to allow the athlete to smoothly and safely return to his or her sport.

Doctors and physical therapists will perform various tests throughout the physical therapy period to gain an estimate of the knee’s rate of recovery. They will test for the knee’s strength, stability, function as well as how ready is the athlete to return to their sport, especially those playing at a competitive level.

ACL injuries rehabilitation exercises
Image 5.4: ACL injuries rehabilitation exercises Source:https://www.summitmedicalgroup.com/library/adult_health/sma_anterior_cruciate_ligament_sprain_exercises/

Prevention of ACL injuries

Prevention is better than cure. This is especially true for injuries as serious as tearing the ACL, as recovery takes a very long time, and a full recovery is also very hard, not to mention the increased chances of reinjury.

Programs to prevent ACL injury include:

  • A proper training program consisting of proper warm-ups, stretches and cool down
  • Progressive training plans that build up the muscles and the other parts of the body.
  • Training the proper technique and knee position for jumps and landing to minimize the risk of injury. Take note never to land on a fully extended leg.
  • Agility drills that emphasise on safe techniques when pivoting, making sudden changes in directions and cutting movements
  • Exercises that aim to strengthen leg muscles as well as maintain their strength and flexibility.
  • Hamstring exercises to ensure there is a balance in leg muscle strength
  • Core exercises including the lower abdomen, hips and pelvis

Apart from training programs, the shoes you used in your sport is also very important. Ensure that you are wear suitable footwear and padding both for your leg size as well as the sport you are playing.

For athletes participating in winter sports like skiing and snowboarding, make sure that the bindings on your board are adjusted correctly by a professional to ensure that the boards will not injure you when you fall.

Adjusting bind on snowboard
Image 6.1: Adjusting bind on snowboard Source: https://www.wikihow.com/images/thumb/0/01/Mount-Bindings-to-a-Snowboard-Step-2-preview-Version-2.jpg/550px-nowatermark-Mount-Bindings-to-a-Snowboard-Step-2-preview-Version-2.jpg

 

Causes & Symptoms of ACL Injuries

Written By: Lim Jun Tian

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