Anterior Cruciate Ligament Injury

What is the anterior cruciate ligament?

There are 4 main ligaments that stabilize the knee, 2 collateral ligaments (medial and lateral) and 2 cruciate ligaments both anterior (front) and posterior (back). These are fixed to the femur (thigh bone) and travel within the knee joint to the upper surface of the tibia (shin bone). The ligaments pass each other in the middle of the joint forming a cross shape, hence the name 'cruciate'.

The main function of the anterior cruciate ligament (ACL) is to prevent the tibia from shifting forwards below the femur. Both The ACL and PCL are vital for the stability of the knee particularly in sports that require a lot of twisting and changing of direction such football and rugby.

How can the ACL be injured?

Normally through twisting or impact at the side of the knee- often the outside, such as a rugby tackle.

Most ACL injuries come from twisting of the knee when the foot is firmly planted on the ground, deceleration or landing from a jump. If the ACL is injured through impact then it is very likely the medial ligaments and the menisci may also be injured - this known as "O'Donohue's triad".

Symptoms of an ACL injury:

• It is often signified by an audible pop or crack at the time of injury.
• They are normally extremely painful, in particular immediately after sustaining the injury.
• Rapid swelling of the knee.
• Inflammation of the injury
• Difficulty in straightening the knee.
• Positive signs in the anterior drawer test.
• Meniscal damage may be indicated by tenderness at the medial side of the joint.

ACL Treatment

• If you suspect an Anterior Cruciate Ligament injury stop play or training immediately.
• Apply cold therapy (Rest, Ice, Compression, Elevation) to the knee immediately
• See a Doctor or Physiotherapist as soon as possible so they can assess the injury.
• An MRI scan or X-ray may be required.
• Surgery is often indicated for an ACL injury.
• A pre-surgery strengthening programme for the knee is important as this will aid recovery following surgery.

Recommended Products:

• Cold Therapy Wraps - A cold therapy wrap such as the Coldone Knee Wrap or Taylor Made Cold Compression wrap will provide compression and cold therapy which will help reduce pain and swelling both after injury and following surgery.
• Hinged Knee Braces - A knee brace or support with a hinge will provide a high level of support for the knee joint in general. To protect the ACL ligament specifically is difficult and something like the Don Joy Armour is specifically designed to do this. Other supports like the McDavid 429 Hinged Knee Brace or the Mueller Hg80 Knee Brace with Kevlar provide a good amount of support and protection at a lower price.
• Elastic Rehabilitation Bands - Elastic rehab bands or stretch bands can be used to aid strengthening and rehabilitation both before and following surgery.

Further information and ACL rehabilitation:

• Assessment & Diagnosis for ACL injury
• ACL Surgery
• ACL Taping

Please see the Virtual Sports Injury Clinic for more information on how to treat Anterior Cruciate Ligament Injuries and other causes of knee pain.