Anterior Cruciate Ligament - Injury and Rehabilitation

An ACl tear may be confirmed with the Anterior Drawer Test.
The Anterior Drawer Test is used to help determine if you may have an ACL sprain. Brett Sears, PT, 2013

The ACL or anterior cruciate ligament is a strong ligament located in the anterior, or front, portion of the knee. It runs from the femur (thigh bone) to the tibia (leg bone) connecting these two bones together.

Anterior Cruciate Ligament Function

The purpose of the ACL is to control the movement of the knee joint. It acts to limit the amount of motion of your shin bone underneath your thigh bone. It keeps your shin from sliding forward too far, and it also helps to stabilize you knee against rotational forces when your foot is planted on the ground.

ACL injuries are among the most common sport related knee injuries. Approximately 100,000 to 200,000 people in the United States acquire a torn or ruptured ACL every year. These injuries often occur during athletic activities such as soccer, football, and skiing when one stops suddenly with the foot planted firmly on the ground. This action causes an over extension of the knee with the tibia (shin bone) moving too far forward on the femur. This stresses the ACL beyond its normal limits causing a tear of the ligament.

Diagnosis of an ACL Tear

A physician can usually diagnose an ACL injury through a physical exam, although an MRI is often used to assist in the diagnosis. If you suspect you have an ACL tear, check in with your doctor right away. The anterior drawer test is a simple method to determine if your ACL may be torn.

If the tear is severe enough, an orthopedic surgeon may need to repair the ligament by performing arthroscopic knee surgery.

By using a small camera and special instruments, the ACL can be replaced or repaired with special anchors guided by this surgical technique.

Rehab after ACL Tear

Guidelines for rehabilitation after ACL tear or repair will be made by the managing physician. Your doctor may refer you to physical therapy to start to work on regaining normal mobility after an ACL sprain.

Some patients are able to fully recover without the need to surgery. If you do require surgery to repair your torn ACL, your doctor may recommend a specific protocol to follow for rehab after ACL surgery.  Your physical therapist can help guide you through your ACL rehab. He or she may use modalities to help contorl the pain and swelling in your knee, or electrical stimulation to improve the way your muscles around your knee work.

Exercise is one of the most important things you can do after an ACL tear or surgery. Common exercises after ACL injury and/or repair include:

Your physical therapist can help you progress through your ACL rehab properly, and he or she can teach you balance and plyometric exercises to help you return to full function after an ACL tear or surgery.

One of the most important things you can do with your PT is to learn how to prevent ACL injuries. This may entail working to keep your hips strong and learning to jump and land properly when participating in sports.

An ACL sprain can be a devastating injury and may result in significant lost time at work or in your sport.

If you have suffered an ACL tear, check in with your doctor, and then visit your physical therapist to learn how to properly rehab your injury so you can quickly and safely return to your prior level of function.

Edited by Brett Sears, PT.

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