Treatments Classes

ACL Injury

The ACL is an internal knee ligament that provides key structure and stability to the knee joint. It is most commonly injured during sporting activities that require pivoting movements such as football, basketball, skiing and gymnastics. Injuries can occur as a result of direct contact or more commonly during a period of non-contact while performing a wrong movement such as a cut and plant movement or jumping and landing. Injury severity can vary from a minor sprain to a complete rupture. Woman tend to have a higher incidence of injury; this can be due to biomechanical and hormonal differences in the body.

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Symptoms

1. Occurs after a cutting manoeuvre, landing or jumping
2. Pain immediately after injury
3. There may be an audible pop or crack at the time of injury
4. Swelling of the knee that is usually immediate
5. A feeling of instability or episodes of giving way
6. Restricted movement of the knee, especially trying to fully straighten the knee

Treatments

Initial treatment usually begins with restoring range of movement and strength of the surrounding muscles in a controlled manner [1]. Once stability improves, more advanced strengthening exercises can begin [2]. Balance and proprioception exercises are also fundamental to restoring full function to the knee with more advanced plyometrics being brought in for later stage rehabilitation [1] [3]. Taping can be used to provide some stability to the knee initially and reduce swelling [4] while massage and stretching can be used as an effective complimentary treatment to reduce any spasms in the surrounding muscles [5]. ACL knee bracing has been shown to reduce injury rates in Skiers who have deficient and reconstructed ACL [6], but there is limited evidence to suggest that bracing improves outcomes after ACL injury.

References

1.https://www.jospt.org/doi/full/10.2519/jospt.2010.3345 EItzEn, I., Moksnes, H., Snyder-Mackler, L. and Risberg, M.A., 2010. A progressive 5-week exercise therapy program leads to significant improvement in knee function early after anterior cruciate ligament injury. journal of orthopaedic & sports physical therapy, 40(11), pp.705-721.

2.http://ejhm.journals.ekb.eg/article_13019_ea8fb230c6fbf437e1bf587f379c2378.pdf Awad, O.B., Alqarni, S.A.M., Alkhalaf, H.M., Alnemer, F.A., Alahmari, K.A.A., Alshahrani, S.M.S., Alahmari, S.A.T., Ahad, M.A.M.A., Habtar, H.S.A., Almousa, M.A.S. and Alarabi, A.A.M., 2017. A Systematic Review of ACL Reconstruction Rehabilitation. Egyptian Journal of Hospital Medicine, 68(1).

3.https://link.springer.com/article/10.1007/s00167-009-1027-2 Van Grinsven, S., Van Cingel, R.E.H., Holla, C.J.M. and Van Loon, C.J.M., 2010. Evidence-based rehabilitation following anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 18(8), pp.1128-1144.

4.https://www.sciencedirect.com/science/article/pii/S1017995X1630222X Balki, S., Göktaş, H.E. and Öztemur, Z., 2016. Kinesio taping as a treatment method in the acute phase of ACL reconstruction: a double-blind, placebo-controlled study. Acta orthopaedica et traumatologica turcica, 50(6), pp.628-634.

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091451/ Zalta, J., 2008. Massage Therapy Protocol for Post–Anterior Cruciate Ligament Reconstruction Patellofemoral Pain Syndrome: A Case Report. International journal of therapeutic massage & bodywork, 1(2), p.11.

6 S. D. Smith, R. F. LaPrade, K. S. Jansson, A. Årøen, and C. A. Wijdicks, “Functional bracing of ACL injuries: Current state and future directions,” Knee Surgery, Sport. Traumatol. Arthrosc., vol. 22, no. 5, pp. 1131–1141, 2014, doi: 10.1007/s00167-013-2514-z.
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