For those of us that are involved in sport, either through participation or from the comfort of our sofas, the term ACL will be a very familiar phrase. One that no doubt conjures up images of discomfort.
We hear about it, we read about it, but what exactly is the ACL?
ACL is an abbreviation of Anterior Cruciate Ligament. It is a 38mm long band of fibrous tissue that connects the femur (thigh bone) to the tibia (shin bone). Its job is to control stability when performing twisting actions. The cruciate ligament is usually not required for normal daily living activities, however, it is essential in controlling the rotation forces developed during side stepping, pivoting and landing from a jump.
The ACL is commonly injured whilst playing ball sports or skiing when attempting any of the above actions.
When the ACL is stretched beyond its stabilising function, it snaps. Swelling commonly occurs within the hour. Frequently pain is felt on the outer aspect of the knee. The medial ligament of the knee joint may also be disrupted resulting in severe pain and swelling about the inner side of the joint.
Historically this snap would have meant end of the career for an athlete. Thankfully medical and technological advancements mean that diagnosis is made quicker, increasing the chances of full recovery. Improvements in MRI, magnetic resonance imaging, have also helped with the identification of issues with the ACL.
However, while medical improvements have led to better treatments becoming available, the increased weight training and conditioning programmes aimed at making modern day athletes bigger, stronger and faster have increased the risk of ACL injuries.
Prevention is always better than the cure and sometimes making small changes to warm up routines can have a very measurable impact.
Studies have discovered that different use of the quadriceps and hamstrings when landing means that women are 4 to 6 times more likely to suffer an ACL injury. A simple warm up routine centred on jumping and landing has shown significant results in preventing ACL injuries in women’s sports
Prevention, however, is not always possible and there are times when surgery is required. A repair of the ACL is one way of getting the athlete back on track however the most effective way is often a replacement, known more commonly as anterior reconstruction.
For a reconstruction, the surgeon will use a portion of a tendon, typically from the Hamstring areas as a direct replacement for the ACL.
This has the same effect as it is good, strong and very stable, ensuring that the athlete, especially younger ones, return to peak condition. Strength, balance and physiotherapy play a large part in the recovery process. The modern day recovery times for ACL injuries range from six to 12 months.