The most common ligament injury around knee is injury to anterior cruciate ligament which bands of tissue that holds the bones together within knee and, it helps in stability of the joint. The stretch or tear to ACL happens by a sudden movement or quick, sharp turn while running or jumping. It is often painful and can make it hard to walk or put pressure on the injured leg.
Acute ACL injuries are most often noncontact injuries, during lateral pivoting, landing, or deceleration maneuvers, with the knee in shallow flexion and the foot planted. As more children and adolescents participate in competitive organized sports, there has been an increase in the reported incidence of anterior cruciate ligament (ACL) injuries in these age groups. ACL injuries in skeletally immature athletes present a challenge, as reconstruction must preserve the physiology of the distal femur and of the proximal tibia to avoid growth disturbances.
An ACL injury is usually a sports-related knee injury. About 80% of sports-related ACL tears are “non-contact” injuries. This means that the injury occurs without the contact of another player, such as a tackle in football. Most often ACL tears occur when pivoting or landing from a jump. Your knee gives out from under you once you tear your ACL.
Female athletes are known to have a higher risk of an ACL tear while participating in competitive sports. Unfortunately, understanding why women are more prone to ACL injury is unclear. There are some suggestions it is biomechanical, strength and hormonally related. In truth, it is probably a factor of all three.
Symptoms of an acute ACL injury or When do you think you need Physiotherapy?
Feeling or hearing a pop in the knee at the time of injury.
Pain on the outside and back of the knee.
The knee swelling within the first few hours of the injury. This may be a sign of bleeding inside the knee joint. Swelling that occurs suddenly is usually a sign of a serious knee injury.
Limited knee movement because of pain or swelling or both.
The knee feeling unstable, buckling, or giving out.
Tests: Your doctor or registered Physiotherapist near you in a Physiotherapy clinic may ask you to lie on your back and bend your hips and/or your knees at certain angles. He will then place his hands on different parts of your leg and gently shift you around. If any of your bones move in a way that isn’t normal, that could be a sign that your ACL is damaged. physical tests include tests like, Lachman Test, Anterior Drawer Test of the Knee and Pivot shift.
X-ray: Soft tissues like the ACL do not appear on X-rays, but your doctor may want to rule out broken bones.
MRI or ultrasound: These exams can show both soft tissue and bone. If you have a damaged ACL, it should appear on the images.
Arthroscopy: This literally means to “look within the joint.” During the exam, an orthopedic surgeon makes a small cut in your skin. He inserts a pencil-sized tool that contains a lighting system and lens (arthroscope) into the joint. The camera projects an image of the joint onto a TV screen. Your doctor can see what type of injury you have and repair or correct it, if needed.
An ACL injury is classified as a grade I, II, or III sprain.
Grade I Sprain:
The knee does not feel unstable or give out during activity. No increased laxity and there is a firm end feel.
Grade II Sprain:
The fibres of the ligament are partially torn or incomplete tear with haemorrhage and there is a little tenderness and moderate swelling with some loss of function.
Painful and pain increase with Lachman’s and anterior drawer stress tests.
Grade III Sprain:
The fibres of the ligament are completely torn (ruptured); the ligament itself is torn completely into two parts.
There is tenderness, but limited pain, especially when compared to the seriousness of the injury.
There may be a little swelling or a lot of swelling.
The ligament cannot control knee movements. The knee feels unstable or gives out at certain times.
Physiotherapy Treatment at Curezone Physiotherapy Clinic
There are some following exercises which can be prescribed as musculoskeletal training. These exercises can be done only in grade 1 and 2 tear. In grade 3, ACL reconstruction is the surgical option as the treatment.
Acute phase of the Injury
Modalities such Laser therapy, Ultrasound Therapy can be done to decrease swelling and inflammation and heal the soft tissues faster.
Gait training: If you are walking with crutches, your physiotherapist can teach you how to use them properly. He or she can also help your progress from walking with crutches to walking normally with no assistive device.
Swelling management: The RICE principle is one of the best ways to decrease swelling in your knee. This involves rest, ice, compression, and elevation of your knee.
Improving quadriceps contraction: After an ACL tear, One of the main goals of physiotherapy after a knee injury is to regain normal quadriceps control. Your physiotherapist may use a form of Electrical stimulation called NMES or Russian Stimulation to help accomplish this task. Quadriceps strengthening exercises, like straight leg raises, will also be prescribed.
Strengthening exercises: In addition to performing exercises to strengthen your quadriceps, other strengthening exercises for your hamstrings and hip muscles may be necessary during your ACL rehab.
Range of motion exercises: After an ACL tear, pain and swelling in your knee may limit your knee range of motion. Knee ROM exercises like the prone hang can be done to help improve and normalize your knee mobility.
Progression of Exercise Program
Your Physiotherapist will make appropriate exercise program based on your specific needs.
Balance training: Your physiotherapist will make you do balance exercises on the Bosu ball, Wobble board or slant board to improve balance and proprioception and prevent further injuries.
Jump training – plyometrics: landing with increased flexion at the knee and hip.
Strengthening that emphasises proximal hip control mediated through gluteus and proximal hamstring activation in a close kinetic chain.
Stretching Movement education and some form of feedback to the athlete during training of these activities
Agility training: agility exercises are some of the ways of rehabilitation in physiotherapy.
Make sure you book your appointment today and get assessed by our physiotherapist now.