ACL Tear Symptoms And Diagnosis
ACL injuries, encompassing both tears and sprains, are not uncommon and they primarily affect individuals engaged in athletic activities, though they can occur in anyone.
Disclaimer - It is important to contact your physio if you have injured yourself for a full plan of treatment.
The knee is a complex joint formed by the intersection of three bones: the femur, or thigh bone; the tibia, or shinbone; and the patella, or kneecap. These bones are held in place by a group of four ligaments that provide stability, with the anterior cruciate ligament (ACL) playing a crucial role by crossing diagonally in the middle of the knee.
What Leads to ACL Injuries?
Injuries to the ACL are typically sustained during activities that involve intense knee motions such as aggressive stop-start movements, pivoting, or sudden changes in direction. These actions may cause the knee to move in ways it is not designed to, such as excessive bending in any direction or twisting motions, particularly when several of these movements occur simultaneously.
Sports-Related ACL Tears
Athletes may experience ACL injuries in various scenarios, including planting their feet firmly during a movement, making abrupt directional shifts, decelerating from a run, or landing from a height. Sports like soccer, skiing, football, and basketball are especially prone to these kinds of injuries due to the dynamic and high-impact nature of the movements involved.
Other ACL Injury Scenarios
Beyond sports, everyday activities like falling from a height or misstepping can result in an ACL injury. Additionally, natural wear and tear on the ACL increases with age, making tears more likely in those over 40.
Signs of an ACL Injury
Often, a notable 'pop' sound accompanies an ACL injury, followed by several symptoms including swelling, pain, tenderness around the joint, limited movement, and difficulty bearing weight on the affected leg. The severity of these symptoms can differ significantly from person to person.
How ACL Injuries Are Diagnosed
Healthcare practitioners specialising in sports medicine can diagnose an ACL injury through a thorough medical history review and a physical examination of both knees. They will assess the knees for stability, range of motion, and tenderness. Common tests are the anterior drawer test to determine how much, or how little, stability the knee has.
Diagnostic Procedures for ACL Injuries
To further evaluate the injury, tests like the Lachman test and the pivot shift test may be employed to gauge the knee's stability and range of motion. Imaging tests such as X-rays can rule out bone fractures, while an MRI can reveal the extent of damage to the ligaments, tendons, and cartilage. There may be damage to other structures of the knee.
Classifying ACL Injuries
The grading system for ACL injuries is as follows:
Grade 1: The ACL is stretched but not torn, retaining its ability to keep the knee joint stable.
Grade 2: This partial tear renders the ACL loose and less capable of stabilising the knee.
Grade 3: Representing the most severe and common form, this grade involves a complete tear or a near-complete tear, where the ligament is split and unable to provide stability to the knee.
Understanding the nature of ACL injuries is the first step in creating a clear pathway to recovery. If you've experienced an ACL injury or are undergoing rehabilitation, we invite you to share your insights or seek advice in the comments below. Your experiences can provide invaluable support to others on a similar path.
At Full Speed Performance we have a dedicated ACL rehab program, find out more here.
