What you should know about ACL injury
with advice from
Bobby Horn, PT, DPT, CSCS, Cert. MDT
Unless you’re Marcus Lattimore, who famously — or infamously? — injured all four knee ligaments in a college football game in 2012, the anterior cruciate ligament (ACL) is the knee ligament you’re most likely to injure. All of us can take steps to reduce the risk, but if you do suffer an ACL tear, your physical therapist can help you on the road to recovery.
An ACL tear is usually caused by a traumatic event, says Bobby Horn, a physical therapist and clinical director at Strive Physical Therapy (a Physiquality network member with several locations across New Jersey). While some tears occur during vehicle collisions or during a fall, most are sports-related and occur without contact from anyone or anything else. These “non-contact” injuries can be caused by quick changes in direction with a misstep, a bad landing after a jump (especially in basketball) or even simply turning the body while slowing down.
Many people that have experienced an ACL tear say that the injury creates a very loud popping sound; one mother, whose son recently tore his ACL, described it this way: “The resulting pop reputedly resounded like gunfire through the facility.” Bobby says that symptoms following an ACL injury might include noticeable swelling, pain either in the front or back of the knee, and instability in the joint (often referred to as “giving out”). If you hear such a sound, and have any of these symptoms, he says, it’s time to see a doctor. Most likely, she’ll order an MRI to confirm or rule out an ACL tear.
An ACL injury or tear does not necessarily mean surgery, but it will necessitate rehabilitation and physical therapy. Rehabilitation after an ACL injury should focus on reducing or eliminating swelling, restoring complete range of motion, and regaining strength and functionality. Visits to physical therapy will feature a variety of treatment methods, including exercises, hands-on stretches and massage, and a home exercise program.
Rule number one in this (and any) rehabilitation program: Listen to your body. It is essential to move at your own pace; your physical therapist will tailor your rehabilitation to what you could accomplish before the injury, as well as what you hope to return to after you have completely healed. Bobby notes that PT can last anywhere from 6 to 24 weeks, and it can take up to a year to return to your previous level of activity. Some athletes post-injury may wear a stabilizing brace during activity, to help avoid further injury.
Bobby explains that a good physical therapy provider will create a return-to-sport program specific for that patient, and test the patient thoroughly to allow her physician to properly determine if she is ready to return to sporting activities. In addition, he says, “Upon discharge, the patient should be given an extensive home exercise program to continue to work on proximal hip strength, core strength, proprioceptive awareness, and hamstring/quad strength.” (And be aware: one of the biggest risks for ACL injury is previous ACL injury, so even after you’re released from the doctor or physical therapist, you should take precautions against another ACL injury.)
||Bobby Horn, PT, DPT, CSCS, Cert. MDT, is a physical therapist and the clinical director of the Tower Commons location of Strive Physical Therapy, a Physiquality member with seven locations throughout New Jersey. Certified as a Strength and Conditioning Specialist, Bobby’s especially interested in treating the hip and knee, and working with throwing athletes.
For further information, look through our selection of articles on ACL and knee injury, in addition to the below links:
Reynolds, Gretchen. New York Times.
Lentz, Trevor A., Giorgia Zeppieri, Jr., Susan M. Tillman, et al. Return to preinjury sports participation following anterior cruciate ligament reconstruction: contributions of demographic, knee impairment, and self-report measures. The Journal of Sports and Orthopedic Physical Therapy, November 2012.
Rehab timeline expectations. Emory Healthcare.
Kyed, Doug. Marcus Lattimore injured ‘several ligaments,’ Steve Spurrier says he can make comeback (video). New England Sports Network, October 28, 2012.
FreeStyleFitnessTV. Lower body balance and proprioception exercises. YouTube.com, January 12, 2012.
American Physical Therapy Association. Physical therapist’s guide to anterior cruciate ligament (ACL) tear. MoveForwardPT.com, September 6, 2011.
Preventing ACL injury. Physiquality, August 15, 2011.
Anterior cruciate ligament (ACL) injury. U.S. National Library of Medicine, August 14, 2011.
Fell, James S. An injured ACL isn’t a death knell for athletes anymore. Los Angeles Times, July 11, 2011.
Myer, Gregory D., Kevin R. Ford and Timothy E. Hewett. New method to identify athletes at high risk of ACL injury using clinic-based measurements and freeware computer analysis. British Journal of Sports Medicine, April 2011.
Brophy, Robert H., Holly J. Silvers, and Bert R. Mandelbaum. Anterior cruciate ligament injuries: Etiology and prevention. Sports Medicine and Arthroscopy Review, March 2010.
Hip conditioning program. American Academy of Orthopedic Surgeons.