ACL Knee Problems

The ACL (Anterior Cruciate Ligament) connects the shin bone to the thigh bone. A healthy ACL stabilizes the knee and the leg and is critical to humans' ability to do everything from sprint to kick a soccer ball. Due to the ACL's prominent position in the knee and the manner in which it connects the upper and lower parts of the leg, injuries to the ACL are quite common, especially in sports. ACL injuries range from mild strains to complete ligament tears. Prognosis is tied to the severity of the ACL tear and the exact location where the tear occurs.

Causes

• The ACL, like other ligaments, is like a rubber band. If you were to take a rubber band and stretch it or twist it, it would be fine. But if you stretch that rubber band too far it can snap. The ACL works the same way. ACLs have a normal range of elasticity. If the ACL is twisted, bent or stretched beyond that acceptable range, tears can occur. While it's possible to tear the ACL from mild activities such as walking, ACL injuries are much more likely to occur during strenuous activity. High-contact sports increase the risk of ACL injury because the chances of landing on your leg in such a way that the ACL is twisted at an awkward angle with force and velocity is much higher than with more leisurely sports like bowling.

Symptoms

• The most obvious symptom of an ACL tear is a loud pop emanating from the knee. After the pop, the knee usually swells. The severity of the knee injury depends on how fast the knee swells and how much it swells. Bruising, knee pain and internal bleeding are also possible. A torn ACL will result in a severely limited ability to walk and use the knee. Less severe ACL injuries may produce slight buckling while walking and other impairments of leg functioning.

Treatments

• Since ACL injuries mimic other leg injuries, the initial treatment will focus on reduction of the swelling through icing and safe transport to a medical facility. Once the doctor examines your leg, an MRI may be ordered to determine the nature of the injury and how severe the tear is. With mild ACL strains, physical therapy, icing of the knee and medication to reduce the swelling may be all that's required. However, due to the anatomy of the knee, more severe tears will not heal naturally. In cases such as this, surgery is required to repair the ACL and/or reattach it to the bones from which it was severed.

Prognosis

• Overall prognosis depends on the severity of the ACL injury. In cases where surgery is required, factors such as age, history of prior ACL injuries and overall health impact whether or not a doctor can fully repair the injured ACL. Often, other knee ligaments are also torn when then ACL is torn. The location and severity of additional tears also influences recovery time and whether or not the knee will return to full functionality.
  After surgery, patients must undergo physical therapy. Depending on the physical therapy program, the nature of the injury and how much you adhere to your therapist's instructions, recovery from ACL injury can take anywhere from a few months to a year.

Prevention

• For most people, preventing ACL injuries is a simple matter of not engaging in activities that will test your ACL's elasticity. However, for those who compete in sports, ACL injury is often unpreventable. Proper conditioning can increase your ligaments' elasticity and prevent future tears from occurring. Nonetheless, even with the best conditioning, athletes can still suffer ACL injuries if the knee bends too far a certain way.