ACL Injury
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The anterior cruciate ligament (ACL) is one of four ligaments that provide stability to the knee. The ACL is located in the center of the knee and helps control forward and rotational movement of the tibia (shin bone). Approximately 30% of ACL injuries are due to contact, for example a tackle.2 The majority of ACL tears are noncontact and are associated with awkward landings, pivoting, accelerating and decelerating.1,2
- High level of friction between shoes and playing surface 2
- Higher than average body mass index (BMI) in women7,8
- Increased knee laxity 1,8
- Certain aspects of knee anatomy and family predisposition (not modifiable, genetic)1,7,8,9
- Female gender with risk increasing during certain times of the menstrual cycle 1, 8
- Prior ACL reconstruction 9
- Awkward jump landings 9
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ACL Injury Prevalence
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In the United States, between 80,000 and 250,000 ACL tears occur annually 1. Most ACL injuries occur between the ages of 15 and 45 and 70% of these are the result of a sporting activity.2 More men sustain this injury due to greater sports participation, but women are 2 to 9.7 times more likely to injure the ACL.1,3
Prevention
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ACL prevention programs can be effective for reducing the risk of ACL injury and many of these programs can be performed as a warm-up prior to engaging in sports.11 Depending on the program, between 5 and 187 athletes must participate to prevent one ACL tear.11 This indicates these programs may be particularly beneficial when implemented in larger groups such as those found in school athletics.
Physical Therapy Treatment
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Surgery may be recommended and in some cases the patient may be managed non-operatively with physical therapy.1,4,5 Approximately 100,000 ACL surgeries are performed a year.1 The percentage of those returning to their prior level of sport participation after reconstruction ranges from 43% to 92%. 6
In the active patient a successful ACL reconstruction outcome requires physical therapy, which may consist of:
- Bracing
- Ice 1
- Range of motion of the knee which is often started early 1,13
- Strengthening 1
- Electrical stimulation 14
- Balance and coordination training 1
References