How ACL injury can be prevented?

The knee joint has three main bones attached to it:  thigh bone, the femur, shin bone, and the knee cap. There are several ligaments attached to the femur and the shin bone providing the joint with the strength and stability. One of the many joints is, the anterior cruciate ligament (ACL), which is in the center of the knee and limits rotation and the forward movement of the tibia. The recent studies show that every year nearly 250,000 ACL injuries happen in the United States.

The ACL ligament is often stretched or torn by an abrupt rotating motion–for example, your feet are in one direction and your knees turn into another. ACL can also be torn by quickly changing the direction of movement; by putting the brakes on too quickly when running; or, when landing from a jump. A woman’s body structure and hormones cause more force on the ligaments, increasing the likelihood of injury during sports and athletic activities.

Recognizing an ACL injury

People who play basketball, volleyball, soccer, or football, or who ski are most likely to injure their ACLs when they slow down, pivot or land after a jump.

If you injure yours, you may not feel any pain immediately. You might hear a popping noise and feel your knee give out from under you.

Within a few hours, you’ll notice swelling at the knee. The knee will often hurt when you try to stand on it. It’s important to keep weight off the knee until you can see your health care provider, or you may injure the knee cartilage. You should use an ice pack to reduce swelling and keep the leg elevated. If needed, use a pain reliever. If you must walk, use crutches and be sure to see a doctor right away to have your knee evaluated.

Diagnosis

Your doctor may conduct physical tests and take X-rays and obtain an MRI to determine the extent of your ACL damage. If the ACL is only partially torn, your doctor may prescribe an exercise program to strengthen surrounding muscles and a brace to protect the knee during activity. You may or may not need surgery. Surgery can be performed to reconstruct the torn ligament from a piece (graft) of strong, healthy tissue taken from another area near the knee (autograft) or from a cadaver (allograft). If the ACL is completely torn, it may need to be replaced surgically.

Successful surgery tightens your knee and restores its stability, which helps you avoid further injury.

After ACL reconstruction, you’ll need to do rehabilitation exercises to gradually return your knee to full flexibility and stability.

You also may need a knee brace temporarily and will probably have to stay out of sports for about six months to a year after the surgery.

Prevention

Many ACL injuries can be prevented if the muscles that surround the knees are strong and flexible.

Prevention focuses on the proper nerve and muscle control of the knee. Exercises aim to increase muscle power, balance, and improve core strength and stability.

The following training tips can reduce the risk of an ACL injury:

• Always warm up before playing. Get blood circulating to your muscles and joint before you start your game or practice.
• Stretch. Being flexible enough to move freely can help you maintain the ideal form. Include stretches for your thighs, calves, and hips, and pay particular attention to any areas that are especially tight.
• Strengthen. Having adequate strength in your hips and thighs is key to providing support for your knees and preventing ACL injuries. Squats and lunges are just a couple of exercises that can build strength.
• Balance. Many injuries occur when an athlete is off-balance. Like anything, balance gets better with practice. Your gains in stability will pay off on the playing field.
• Agility-Changing Direction:
  • Run to a line or cone, plant your outside foot without letting your knee collapse inward to change direction.
  • Move in patterns that take you front to back, side to side and diagonally. Start by running slowly so you can concentrate on good position.
• Jumping and Landing Safely:
  • Jump straight upward several times. Spring up, then land with your feet and knees pointing straight ahead. No knock knees! Let your knees bend softly each time you land. Practice these jumps facing a teammate and ask him/her to watch your form. Practice proper landing technique until it becomes second nature. Keep your knees bent, your chest high, your buttocks back, and land softly.

• Train and condition year round.
• Practice proper landing technique after jumps.
• When you pivot, crouch and bend at the knees and hips. This reduces stress on the ACL.
• Strengthen your hamstring and quadriceps muscles. The hamstring muscle is at the back of the thigh; the quadriceps muscle is at the front. The muscles work together to bend or straighten the leg. Strengthening both muscles can better protect the leg against knee injuries.