What are ACL Tears?
Are you an intense athlete? Does your sport require you to pivot back and forth? And, most importantly, are you a woman? All these factors are contributors to an extremely common, yet extremely detrimental injury: ACL tears. Your anterior cruciate ligament, better known as the ACL, is one of the four major ligaments located within the knee, connecting your femur bone and tibia (shin bone). It is crucial for side-to-side and rotational movement and overall stability in the knee. It’s most commonly torn in a non-contact situation, such as cutting, decelerating, and landing. However, a contact situation in which the knee gets hit also puts it at risk. Once torn, you could have no issue walking or even running in a straight line, but cutting side to side? – not an option.
ACL Tears in Women
One thing any female athlete should know is just how prone they are to an injury like this. Anatomically, a female’s knee is significantly weaker than a male’s, making the tears 2-8 times more common. The unfortunate fact is that many of the reasons this happens are unchangeable. To start, the knee alignment is a large factor. The hip-to-knee ratio for women is considerably different than how it is for men, making women more prone to injury. In addition, the hormonal influence of a woman’s cycle has a large effect. You’re more likely to experience a tear during the ovulation cycle due to a hormonal imbalance, causing your ligaments to relax.
How do you fix an ACL tear?
ACL tears cannot heal on their own, and surgical reconstruction of the ligament is the most common form of treatment. However, surgery depends on the patient and his or her activities. If a patient has an active lifestyle and participates in competitive sports, surgery is highly recommended. Still, for patients who are older and/or do not participate in higher-impact physical activity, surgery is not necessary for returning to activities like walking, running, cycling, weightlifting, and exercise classes. If the decision is to get surgery, surgery should be performed generally 3 to 6 weeks after the original injury so that there is time for swelling and inflammation within the knee to decrease. After 3 to 6 weeks, the extra time before surgery increases the risk for cartilage or meniscus damage from the instability in the knee joint. During an ACL surgery, the torn ACL is removed, and a new one is reconstructed from a piece of tissue known as a graft. This graft can be taken from the patient’s hamstring, quadriceps, patellar tendon, iliotibial (IT) band, or it can be an allograft (graft from an organ donor). The patellar tendon is typically seen as the strongest of the grafts with the lowest failure rate. However, in certain cases – like if the patient’s growth plates are still open – the patellar tendon cannot be used, and the other grafts can be just as desirable.
What is recovery from ACL surgery like?
Recovery time varies and depends on the patient. On the day of surgery, patients are released from the hospital and are able to walk with crutches and a hefty knee brace. Two to three days after surgery, the physical therapy program begins, starting with regaining abilities like leg extension and flexion (bending) and quad activation. With enough range of motion and quad strength, the patient progresses off the brace and out of crutches. Once walking is mastered, the main principle of rehabilitation is strengthening the muscles that help stabilize the knee: quadriceps, hamstrings, hips, glutes, and core. With time and hard work, a patient might begin running 3-5 months after the operation. If everything proceeds as normal and with minimal trouble, pivoting exercises begin around 5-9 months post op. Eventually, a patient may return to his or her sport, depending on the amount of cutting and pivoting, around 9 to 12 months after surgery. While it is safe and stable to return to sports at around a year, the ACL graft actually won’t fully mature into the knee bones until after two years.
How do you prevent ACL tears?
Although fully preventing an ACL tear isn’t necessarily possible, there are ways to make you less prone to them. First, pay attention to how you move. For example, make sure your knees are directly over your feet when doing things such as jumping or landing. This means never letting your knees drop inward. Stretching and warming up before a game is also extremely important. Strength training, especially if you’re a high-level athlete, is also helpful in not just keeping your knees safe but also improving your play. Going off of this, balance and core are two extremely important parts of your strength training, which are often overlooked. Overall, preventing an ACL tear is truly only possible through working hard outside of your sport, to make sure your body is strong enough so as not to become a victim of this injury, in addition to rest, and knowing how to stop when reaching your limit.
Why does this matter?
This common but devastating injury is on the rise nationwide at alarming rates. It’s described as the “ACL tear epidemic,” and it’s no exception here at Oak Knoll, where far too many student athletes have been impacted. Though some of the contributing factors are out of our control, education, bringing awareness, and committing to healthy lifestyle changes are some of the small steps we can take to overcome ACL tears.