The anterior cruciate ligament (ACL) is one of the four ligaments that join the thighbone (femur) to the shinbone (tibia). The ACL helps keep the knee stable. You can tear it when you plant your foot and then push off, change direction, or twist. This can happen during sports like soccer or basketball. Your ACL can also tear when you get hit around your knee. This is more common in a sport like football.
Treatment usually starts with staying off the leg and elevating it, icing the knee, and using a compression bandage.
Your doctor may discuss letting your knee heal with time and physical therapy (PT). You may choose surgery to repair your ACL, especially if you're very active, if other parts of your knee are injured, or if your knee is unstable. Whether you have surgery or not, PT to help you strengthen the muscles around your knee is important.
An anterior cruciate ligament (ACL) injury is a tear in a knee ligament that connects the thighbone (femur) to the shinbone (tibia). The ACL helps keep your knee stable.
You can tear your ACL when the upper leg bone is moving in a different direction from the lower leg bone. Sometimes the ACL is completely torn. Other times it is only partially torn. It can happen during sports or from trauma when you fall or are hit around the knee.
You'll most likely know it when you have an ACL injury. You may feel or hear a pop. The knee may give out, causing you to fall. The knee swells and often is too painful or unstable for you to keep doing any activity.
An ACL injury can cause partial tears of the ligament or a complete tear (rupture). It can also cause the ligament to separate from the upper or lower leg bone (avulsion). Or it can cause the ligament and part of the bone to separate from the rest of the bone (avulsion fracture). When any of these occur, the lower leg bone moves abnormally forward on the upper bone, with a sense of the knee giving out or buckling.
An ACL injury can lead to long-term knee pain and instability. This is more likely to happen if the injury isn't treated. Treatment to strengthen muscles that support the knee may help.
Symptoms of a severe and sudden (acute) ACL injury include:
After an acute injury, you will probably have to stop whatever you are doing because of the pain. But you may be able to walk.
Treatment for an ACL injury includes using first aid right away. For example, put ice on the knee, prop up the leg, and use over-the-counter pain medicines. You may need to use crutches or a knee immobilizer. You will have exercises and training (rehab) or surgery. If you have surgery, you'll need rehab afterward.
One way to help prevent ACL injuries is to stretch and strengthen the muscles in the legs and body. There are also training programs that teach movements that may prevent injury and help with balance. Warming up before training or competing may also help. Some ACL injuries can happen anyway.
To diagnose an ACL injury, your doctor will ask you to describe how you injured your knee and what you felt. The doctor will check your knee for swelling or tenderness. They may gently push and pull on your leg to see if the knee joint moves in an abnormal way. The exam is usually done on both legs so the doctor can compare one leg to the other to see what's normal for you.
You may have an X-ray to help make sure there isn't a different injury, like a broken bone. Ligaments can't be seen on an X-ray. An MRI is an imaging test that can help show the ACL. It can help your doctor see if you have an ACL tear. Often an injury that causes an ACL tear also injures other ligaments or the cartilage called the meniscus. An MRI can help your doctor diagnose these other injuries.
Surgery for an ACL tear can help you stabilize your knee and return to activity. Surgery may include:
Things that increase your risk of ACL injuries include:
You can tear your ACL when you plant your foot and then push off, change direction, or pivot. This can happen during certain sports, like soccer or basketball.
You can also tear it from getting hit in your leg or knee during a contact sport like football or in high-speed sports like skiing.
Injuries like those from a car crash, stepping in a hole, or jumping or falling from a height can also cause an ACL tear.
An anterior cruciate ligament (ACL) injury is a tear in one of the knee ligaments that joins the upper leg bone with the lower leg bone. Injuries range from mild, such as a small tear, to severe, such as when the ligament tears completely.
If you have an acute (sudden) anterior cruciate ligament (ACL) injury, use the following first aid steps to reduce pain and swelling.
Use them until you can see your doctor. Crutches can be rented from most drugstores.
Put ice or a cold pack on your knee for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
Do this while applying ice or anytime you are sitting or lying down. Try to keep your knee above the level of your heart.
Use an elastic bandage or neoprene sleeve (available at a drugstore).
Use acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs). Be safe with medicines. Read and follow all instructions on the label.
Rehabilitation (rehab) is needed after most ACL injuries, with or without surgery. It'll help you regain normal range of motion and flexibility in your knee. Rehab programs also strengthen the knee and the muscles around it, leading to better knee stability.
Your doctor or physical therapist will design a rehab program for you that considers your normal level of activity, your physical fitness, and the extent of your injury.
A rehab program should include exercises for:
How quickly you recover from your ACL injury depends on how severe the injury was, how extensive any surgery was, and how consistent you are to follow the program. The rehab program usually lasts from several months to a year.
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