How Do ACL Injuries Occur?
Why does the ACL suddenly tear?
Roughly 70% of all ACL injuries are as a result of a noncontact mechanism of injury and usually occur as an individual is cutting, jumping or planting. Lower extremity movement patterns during these activities play a critical role in injury mechanism because they influence the load and forces on ligaments, meniscus/cartilage, and bone (DiStefano, L.J., 2009). ACL injuries occur most frequently in field sports involving landing from jumps, side-stepping, turning sharply and decelerating, e.g GAA, soccer , rugby, basketball.
The ACL is one of the two cruciate ligaments. It is named in relation to its attachment to the tibia.
The two cruciates- ACL and PCL are crucial in providing knee stability. It is essential in controlling
pivoting movements. If the ACL is not functional the tibia may rotate under the femur when a
person attempts to land from a jump, pivot, or stop suddenly.
The ACL has two primary functions:
It prevents forward movement of the tibia under the femur
It controls rotational movement of the tibia under the femur
Intrinsic Risk Factors:
Female have a wider pelvis and slightly knocked knee
Body mass index
Anatomy of the bones
Dynamic risk factors
How we move/ jump/ land
Extrinsic Risk Factors:
The level of exposure to risk factors
Uneven / Even
Point of no Return:
Non-contact ACL injuries often exhibit a common body posture that involves a valgus collapse of the knee joint (knee falls inwards/ medially), with the knee near full extension (between 0 and 30 degrees), external tibial rotation with the foot planted during a deceleration manoeuvre. Approximately 85% of the knee joint’s total restraint to anterior tibial translation is provided by the ACL and as studies have shown that sagittal plane knee angles near full extension and large quadriceps muscle forces increase ACL loading (Quatman, 2009).
Sign & Symptoms of ACL Tear:
A description of valgus knee position at time of injury, a landing, cutting maneuver.
Patient can hear a ‘pop’ or ‘click’ or something ‘going out of place and then going back’.
Most tears are extremely painful.
Players are usually unable to continue playing.
There can be relatively immediate swelling (2hrs)
Patients experience a feeling of instability in the knee.
Sometimes we need to reduce certain exercises that may be aggravating our symptoms only to add them back in with time.
Grades of Ligament Tears:
A tear occurs when the force placed on the ligament is too much for the ligament to control.
Grade 1: Mildly Damaged
Grade 2: Partial Tear
Grade3: Complete Rupture
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