Do you ever ski? Or play football? Or follow contact sports? If so, you’ve probably heard of the ACL. It’s a key tendon in the knee that sometimes falls prey to nasty injuries.
So how does that happen – and what happens next? Here’s a quick explainer.
What does the ACL do?
ACL stands for anterior cruciate ligament, and it connects your thigh bone (femur) to your shinbone (tibia). One of its main purposes is to provide stability within the knee joint. It helps you to control the backwards and forwards movement of your leg, enables stability during rotation, and stops your knee from buckling outwards when you plant a foot on the ground.
How do people damage it?
Usually in a sporting accident. Most ACL injuries happen when the knee suffers a sudden stop, twist or impact. A classic scenario involves football studs catching in the turf. The foot stays rooted but the knee carries on moving – something that happened to one of our former patients, Robb, who tore his ligaments during a football match: “I just remember planting my foot on the ground and the knee suddenly twisting – and then I heard a huge crack,” he recalls.
What does an ACL tear feel like?
ACL tears come in different shapes and sizes. You could tear the ligament fibres partly. Or you could rupture the entire structure so that it comes fully away from the bone. The common result is moderate to severe pain. But ACL injuries aren’t always painful. Sometimes the main sensation is instability in the knee, followed by swelling. “[My injury] wasn’t painful so much as uncomfortable,” Robb explained. “There was immediate swelling, and then I found I couldn’t bend my knee.”
What are the potential fixes?
This varies. The first approach is conservative treatment. That means we’ll wait until the swelling settles, let you rest up, and see how your knee reacts to the tear over the next few weeks. We will also want to take a close look at scans to assess the damage to your ligament. That could be followed by a rehab programme and physiotherapy. By building up the surrounding muscles, you can do a lot to restore strength and stability to your knee, even if the ligament tear itself never fully heals.
The second approach is ACL reconstruction surgery. We only tend to recommend this procedure for specific reasons, such as:
- Major instability – serious, ongoing problems with a knee that keeps buckling
- Complete rupture – the ligament has torn completely away from the bone
- Concomitant damage – tears to other nearby structures, such as the meniscus
- Life, age and career – you’re an athlete, or highly active, and want to carry on doing the sport you love
The goal of an ACL reconstruction is to repair or replace the damaged ligament with a graft from another part of your body. It’s an operation that needs careful thought and discussion before going ahead, but many patients find it can make a huge difference to life post-injury.
Interested in finding out more about ACL reconstruction? Stay tuned for the next part of this blog! We’ll be unpacking the operation, what it feels like to go through it, and how best to prepare for the surgery.
In the meantime, for further reading…
Mythbuster: 6 big misconceptions about ACL injuries
Have you recently injured your ACL, or suffered other damage or instability to your knee? We can help you get to the bottom of what’s going on. Drop us a line, or book an appointment directly on the website, and help you to get the right diagnosis and treatment plan for your knee.
