Anterior Cruciate Ligament (ACL) Injury

Ligament tears, primarily of the anterior cruciate ligament (ACL), are commonly the season ending injuries we hear about in sports. Although male athletes make the headlines, women experience ACL tears 7-8 times more frequently than men due to hormonal and anatomical differences. ACL injuries account for more than two-thirds of all knee injuries in skiers and are common in other sports such as volleyball, football, soccer, basketball, and racket sports. To prevent ACL injury it is important to have strong quadriceps and hamstrings.

Anatomy

The knee has 2 collateral (parallel) ligaments and 2 cruciate (crossing) ligaments. The medial collateral ligament (MCL) and the lateral collateral ligament (LCL) provide support to the knee by limiting the sideways motion of the joint. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) bond the upper and lower parts of the leg together and stabilize the knee by limiting the rotation and the forward and backward movement of the joint.

An ACL injury normally occurs when the knee is locked with the foot planted and the knee is twisted quickly. Minor tears may go unnoticed immediately and will appear a few hours later with pain and swelling. More serious ACL tears are accompanied by severe pain and often a popping sound. The knee may feel as though something has snapped and walking or bending the knee is usually impossible.

A ruptured ACL is typically diagnosed by a doctor - an MRI exam is advisable, as this can also identify whether the meniscus (cartilage in the knee that provides cushioning) is damaged as well. If your meniscus is damaged, you should definitely avoid exercises that could aggravate this condition. There are occasions where surgery is not necessary, or not worth the potential for further damage, as the ACL is not always crucial for people that do not exercise heavily. As with all recommendations for surgery, it is usually advised to get a second opinion.

Treatment

Treatment will differ depending on the degree of instability and the patient's activity level. Many ligament injuries heal with ice, rest, ultrasound and heat followed by physical therapy to build muscle strength around the knee.

RICE (Rest Ice Compression Elevation)

Knee Cold Wrap

Administering ice and compression immediately following an ACL tear reduces pain and swelling. Our cold compression wraps allow you to actively treat yourself using the RICE method. They work because they interrupt and slow nerve and cell function in the damaged area. Once blood vessels are damaged they can no longer carry oxygenated blood to the damaged tissue and therefore cells begin to break-down. The deep cold provided by our cold/warm compression wraps slows cell function thereby reducing cellular break-down. Furthermore, because the cold wraps serve to numb the nerves the wraps also reduce pain! Our wraps keep the ice off the skin preventing frostbite and keep the cold in the area that you need it.

Ultrasound

If you suffer from mild inflammation or pain in your knee after certain activities or movements, use ultrasound therapy when you complete the activity and then rest. The heating and massaging effects of MendMeShop Ultrasound have two primary benefits. First, it increases blood flow in the treated area which speeds the healing process. Second, it reduces swelling and edema which are the main sources of pain. Typically, ligament injuries are slow to heal and because people continue to try to use the injured body part, the injury is repeatedly stressed. Regular applications of ultrasound over the duration of the healing period will significantly reduce pain and the time to heal.

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.

We recommend you check with your doctor before using ultrasound to ensure it is a proper course of treatment for you.

Blood Flow Stimulation Therapy™

A knee Inferno Wrap™ is one of the most helpful tools for an ACL injury. With Blood Flow Stimulation Therapy™ tissues are safely and gently heated - increasing blood flow within the treated area. Your body’s natural response to this increased temperature is to try to maintain a condition of homeostasis — a balanced environment or state of equilibrium throughout the body. To do this, your body responds with a rapid increase in blood flow to the area (this is known as vasodilation), increasing the supply of nutrients to injured cells and flushing out toxins (including lactic acid, commonly found in trigger points) to promote healing. An Inferno Wrap provides effective, non-invasive, non-addictive pain relief with no side effects.

Surgery and Recovery

If an injured ligament does not strengthen appropriately or an athlete continues to experience the knee giving way, arthroscopic surgery and ligament reconstruction may be necessary.

If you have chosen to have ACL reconstructive surgery, remember that proper post-surgery rehabilitation is very important, perhaps even more important than the surgery itself. Activities should set out to promote healing, increase flexibility in the knee and strengthen surrounding muscles. Your physical therapist will probably set up a "passive range of motion" program, and put you in a hinged knee brace for a month or two to prevent hyperextension or hyperflexion in the knee. An important point for ACL patients to remember after surgery is that every effort must be made to increase range of motion and flexibility at the knee. Weakness in the knee can usually be eliminated by extra strengthening exercises, but increased stiffness can sometimes be permanent if not corrected by further surgery.

Not only will ultrasound reduce the pain and inflammation in your knee, but will help increase the range of motion in your joint, reduce post operative scar tissue and increase flexibility in the surrounding muscles, tendons and ligaments. Ask your physical therapist about ultrasound and if it’s right for your reconstructed ACL! As with all medical devices, make sure your physician is aware of any treatment plan you decide to take.