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The ACL is a major component of the knee structure which focuses on stabilisation. If you have played sport of any age or gender group Im sure you have been around or known someone to suffer some type of ACL injury.

These injuries range in severity from grade I-III which I will go into later in this post!

The main goal of the ACL is to help prevent the thigh bone (femur) from sliding too far forward on the shin bone (tibia). ACL injuries are typically caused by sudden changes in direction, a twisting motion, or a direct impact to the knee, such as a collision during a sport or activities of daily living. It definitely is not uncommon to suffer an ACL injury from a car or impact accident faced on your commute to work or when on a walk with friends!

Interestingly enough the ACL is a ligament that prevents rotation of the knee! So if your daily life or activities don't involve much rotation then you can go through life without needing one!!! However, if you are one that loves a twist and turn or play any sports that demand sharp or quick movements then you run the risk of low stability, possible increased damage of the knee and dislocation that can result in longer hospital stays and operations...

So you will always be posed the question when you undergo an ACL injury - do you need it or is it okay for you to go through life without doing much twisting and turning? That is for you to decide but for me personally I am going to twist, turn, jump and sprint throughout my days as a footballer or any of my other sports :)

Read further for more information on the ACL!!

Symptoms of an ACL injury include but are not limited to:

  • Knee pain

  • Swelling

  • Instability

  • Difficulty bearing weight on the affected knee

Could be a good idea to be weary and look out for these signs to ensure you are not veering towards dangerous territories with your sport or daily life tasks!

ACL injuries are typically diagnosed through physical examination and imaging tests, such as an MRI. There are a few tests which are undertaken by physiotherapists or other allied health professionals to test the strength and ability of the ACL to sustain differing levels of force. One of my favourites is the lachmann's test where you would be placing force down on the tibia essentially displacing it under the femur... Doesn't sound so good but if your knee is able to stay rigid and does not move too much it could be a positive sign that you have a pretty stable joint capsule

Treatment options include physical therapy, bracing, and surgery. Surgery is only undertaken in a later grade (III) where the ACL has completely ruptured and will not return to its normal state it was previous to the rupture. Most people can live normal lives in the absence of an ACL however will face the decision to not participate in sports that would place demand upon the knee to stabilise or change direction/planes mid motion.

ACL injuries are graded in accordance to their respective damage levels post injury! There are three main grades of ACL injury:

  1. Grade 1: A mild sprain, in which the fibres of the ACL are stretched or slightly torn. With this injury the ACL has not ruptured and will be able to return to its previous position after some rehabilitation methods have been undertaken. Symptoms may include mild pain and swelling, and the knee may feel slightly unstable.

  2. Grade 2: A moderate sprain, in which the fibres of the ACL are partially torn. A partial tear would involve some damage that would lengthen the process of rehabilitation if the goal is to return the structure to a stable form for return to sport protocals. Symptoms may include moderate pain, swelling, and instability, and the knee may be difficult to bear weight on. Rehabilitation within this phase will include a period of bracing to prevent movement in the repair phase.

  3. Grade 3: A complete tear of the ACL. With a complete tear you will be experiencing some slight misfortune as an athlete as you will be facing at least up to a year in sporting absence. Even with a return to play protocol the individual may need to rebuild to a state of fitness to be able to keep the joint up to a state that will prevent future injury!! With a complete rupture it is very common for athletes to be elected for surgery to reattach the ACL as the ACL will not be able to reattach itself even with all the rehab exercises + bracing being done in the background. Periods of bracing will still be required to ensure the joint is able to ease into weight bearing which will be painful. Symptoms may include severe pain, swelling, and instability, and the knee may be unable to bear weight.

It's important to note that grading of an ACL injury can be subjective and can also vary among physicians. Additionally, an ACL tear may also be associated with injury to other structures in the knee such as meniscus, cartilage or other ligaments. This is important to note as having multiple structural damage to the knee will result in a longer process of phase 1-2 which means longer periods of bracing and immobility to ensure the structure is able to return to a strengthening phase, reduced pain and inflammation so extra work can be undertaken.

Basically, do you pistol squats and if you can't do them build yourself towards them through mobility training. If you have a joint that is more flexible but also strong from bottom to top you are providing your mind and body with the confidence that it will be difficult for an injury to stop you from movement. No injury is completely preventable but we can work everyday to prevent pain and minor injuries that may put most people out for periods at a time!!

Stay safe, stay mobile!


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