Causes, Prevention and Treatment of ACL (anterior cruciate ligament) Injuries
Causes, Prevention and Treatment of ACL (anterior cruciate ligament) Injuries,
An ACL (anterior cruciate ligament) injury is a condition that involves damage to the main ligament located on the inside of the knee. This ligament has an important role in maintaining knee stability and body balance, so that an ACL injury that occurs can affect a person's ability to move and physical activity.
Injury can occur when the knee joint bends backwards or twists. Individuals who experience this injury generally feel pain in their knee followed by swelling. The severity of ACL injuries varies from mild, such as a small tear, to severe, such as a complete tear of the ligament or a ligament and part of the bone separating from another bone.
ACL Injury Diagnosis
Before being diagnosed, the doctor will usually perform a physical examination to ensure there are no broken bones, then continue with a medical history to ask specific questions about knee pain.
- X-ray examination: This test aims to detect fractures in the knee area.
- MRI examination: The test is performed using radio waves and a magnetic field to display images of the hard and soft tissues in the knee on a monitor screen.
- Ultrasound examination: The test is performed using sound waves to visualize the internal structures in the knee area.
ACL Injury Symptoms
To determine whether you have an ACL injury or not, you must undergo an examination at a health facility.
However, before the examination, you will also experience symptoms that indicate signs of an ACL injury. Some of the symptoms you will experience include the following :
- Pain accompanied by swelling around the knee
- The swelling will subside on its own, but when you return to exercise, the knee will be unbalanced and there is a risk of worsening the injury
- Difficulty moving the legs normally
- Uncomfortable when walking
- Feeling pain when carrying weights and resting on the feet
Causes of ACL Injuries
In general, the cause of ACL injuries is any movement or condition that increases stress on the knee. Some conditions or activities that can cause excessive pressure on the knees are as follows :
- Movement slows down or changes direction suddenly when running or walking.
- Turning the knee with the foot firmly on the ground, for example landing after jumping and turning the body in the opposite direction.
- Stop suddenly while running fast
- Turn your body with the soles of your feet still on the floor
- Jumping and landing with the wrong foot position
- Experiencing a blow to the knee
- Doing movements that cause excessive stretching of the knees
Treatment and Management of ACL Injuries
Treatment of ACL injuries varies depending on the severity of the injury, patient age, activity level, and individual functional goals. Treatment approaches can be divided into two main categories: conservative (non-operative) and operative. Here is a detailed explanation of the various treatment options :
1. Conservative (Non-Operative) Treatment
Conservative treatment is usually recommended for partial ACL injuries or for patients who have a low activity level. These methods include :
- Rest: Reduce activities that put stress on the knees.
- Ice: Application of ice to reduce swelling and pain.
- Compress: Use of an elastic bandage to reduce swelling.
- Elevation: Elevating the leg to help reduce swelling.
Physiotherapy :
- Muscle strengthening exercises, especially quadriceps and hamstrings.
- Balance and proprioception exercises.
- Stretch to increase flexibility.
- Manual therapy to improve joint mobility.
- Use of Assistive Equipment:
- Knee brace to provide additional stability to the knee.
- Crutches or a cane to reduce the load on the injured knee.
Pain Management :
- Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling.
- Other analgesics according to doctor's prescription.
Activity Modification :
- Avoid activities that put excessive stress on the knees.
- Switch to a sport with a lower risk of injury.
2. Operative Treatment
ACL reconstruction surgery is generally recommended for athletes, active individuals, or those with significant knee instability. This procedure includes :
ACL Reconstruction :
- Using a graft (graft) to replace the damaged ACL.
- The graft can be taken from the patient's own tendon (autograft) or from a donor (allograft).
- Commonly used types of autograft include patellar tendon, hamstring tendon, or quadriceps tendon.
Arthroscopy Procedure :
- The operation is performed through small incisions using an arthroscopic camera.
- Allows visualization and repair of other knee structures if necessary.
Postoperative Rehabilitation :
- Intensive rehabilitation program that usually lasts 6-12 months.
- Involves progressive physiotherapy to restore knee strength, stability and function.
3. Current Treatment Approaches
- Stem Cell Therapy: Still in the research phase, but shows potential to speed ligament healing.
- Platelet-Rich Plasma (PRP): PRP injections may help speed the healing process, although their effectiveness is debated.
- New Surgical Techniques: Such as “all-inside” reconstruction that minimizes tissue damage.
ACL Injury Prevention
Proper exercise and exercise can help reduce the risk of ACL injury. You can ask a physical therapist or athletic trainer to provide some ACL injury prevention exercises such as :
- Exercises to strengthen core muscles, including the hips, pelvis and lower abdomen.
- Exercises to strengthen the leg muscles, especially hamstring exercises to ensure a balanced overall leg muscle strength
- Exercises that emphasize proper knee position when jumping and landing from a jump;
- Exercises to improve technique when performing twisting movements
This injury can occur suddenly, so you must pay attention to the things you need to do before, during and after exercising. The following include :
- Wear proper protective equipment.
- Stretch and warm up before exercising or physical activity.
- Give the body time to rest and recover after physical activity.
- Cool down and stretch after exercise or physical activity.
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