August is here, and that means… the return of football. (It hardly seems to have gone away, does it?!)
Like all sports, football carries a heightened risk of certain injuries, and one of the most common is the dreaded ACL tear.
ACL stands for Anterior Cruciate Ligament. That’s the tough band of tissue that sits at the front of the knee joint, connecting the thighbone (femur) to the shinbone (tibia). It provides control and stability to the knee. And sometimes, during a heavy impact, it can tear.
There are several common misconceptions about ACL injuries, however. So I thought this might be a good time to address them.
Myth #1: ACL injuries are always caused by tackles…
While tackles certainly can cause ACL tears, a more common reason is some kind of twist or pivot. This often happens when the foot ‘plants’ on the grass and, as the studs sink in, the knee joint carries on moving. Result: an overstretched ligament. Sudden stops, changes of direction and, yes, sudden tackles can also cause the ACL to rupture.
Myth #2: it’s excruciating…
Not necessarily. An ACL injury can be relatively painless. Some people twist their knees, hear a ‘pop’ as the ligament tears, and get plenty of swelling – but little discomfort. So it’s possible to rupture your ACL and not be doubled-up in agony. On the other hand, they can sometimes be very painful. And persistent pain may indicate an additional problem, such as damaged cartilage.
Myth #3: the whole ligament snaps…
ACL injuries actually vary in degree, from a partial tear of the ligament fibre to a complete rupture. Even then, the symptoms that follow can vary widely – from serious instability to virtually no signs of instability (although this is quite rare). Which leads to the next myth…
Myth #4: you can’t walk after an ACL tear…
Again, not necessarily. Even with a complete ACL tear, most people are able to achieve enough functionality to walk on their injured leg (mainly because there are three other major ligaments in the knee joint to compensate). I have even treated people who tore their ACLs while skiing, but were able to clamber back onto their skis and make it to the bottom of the mountain.
Myth #5: men and women are equally at risk of injuring their ACLs…
Women are actually more likely to suffer an ACL injury than men. This might be due to differences in muscular and bone strength. Or it could be due to greater laxity (looseness) in the tissues, which may allow the joints to rotate or sublux further, and therefore be more susceptible to overstretching. Various theories have been proposed but, in general, women do seem to be at greater risk of injuring their ACLs than men.
Myth #6: Surgery is the only solution…
Untrue. Most ACL treatment starts conservatively. We discuss what happened, examine the knee and analyse scans. Then we usually recommend physiotherapy, to encourage range of movement and muscle strength as the healing begins. We also usually recommend rest for several weeks, to see how that healing develops. Surgery is normally only considered if the knee is very unstable, if there is persistent pain, or if there is a concomitant injury – such as torn meniscus, or damage to the lining cartilage.
Struggling with an ACL injury? We are always happy to meet and talk through the options. Click here to book an appointment.
