What is the ACL?
By Andrew Kao PT
The anterior cruciate ligament, also known as the ACL, is a ligament that is found inside the knee that helps stabilize it during dynamic movement. It connects the femur (the thigh bone) and the tibia (the shinbone), primarily preventing the tibia from sliding too far forward in relation to the femur, as well as controlling knee rotation.
(Image by Freepik)
What is an ACL tear?
When a ligament is stretched beyond what it can normally handle, it can become damaged and cause a partial or complete tear of the fibers that make it up. This most commonly occurs with sudden stops or changes in direction, jumping, and landing.
Some factors may contribute to a higher risk of tearing an ACL. These include:
- Females – higher incidence may be attributed to difference in anatomy, muscle strength, or hormonal factors
- Participation in sports that involve sudden stops, such as basketball, soccer, and football.
- Lack of strength and conditioning in the lower body
- Poor knee control
- Improper footwear
How can Physiotherapy help?
An ACL tear can bring on swelling, pain, weakness, and limitation in how far the knee can bend. Physiotherapy can help reduce the swelling and pain during the early stages of recovery using precise manual skills and modalities as needed. Physiotherapy can also help improve strength, coordination, and range of motion to get you back to normal and to the activities you love, through guided exercises tailored to your functional level.
How long does it take to recover?
With a partial tear, an ACL tear can expect to recover in 6-8 weeks with the proper guidance and rehab. It is important to address any underlying issues that might have caused the ACL injury, as they may lead to more extensive injuries in the future.
With a full tear, the ACL will not reconnect without surgical intervention. However, even after a complete tear, recovery to full functional ability without surgery has been found to be similar to surgical options.
Recovery from ACL surgery typically takes about 8-10 months, and involves a period of immobilization, then gradually working on knee range of motion, strength, and functional tasks, before a return to dynamic movements. You can discuss if surgery is appropriate for you by consulting with an orthopedic surgeon.
What are some safe home exercises I can do for this condition?
Exercises that engage the muscles around the knee while also not bending the knee too much can be helpful to maintain strength in the leg.
Terminal knee extension
This exercise is good for activation of the quadriceps, the group of muscles on the front of the thigh that help straighten your leg and also stabilize the knee. First, sit with your legs straight in front of you, and place a rolled towel underneath your knee. Slowly straighten your knee while keeping the back of your leg on the towel. Hold for 3 seconds, then slowly lower the foot back down again.
Hamstring Isometrics
Hamstring isometrics are a good exercise for activating the hamstrings, the group of muscles on the back of the thigh that bend your leg and also stabilize the knee. First, bend your knee to about 45 degrees, then gently push your heel towards the floor, holding for about 5 seconds. Repeat 10 times.
When swelling and pain have subsided, compound exercises like squats and lunges can help build up strength in the lower body and transition to dynamic and functional movements.
Squat
Stand with your feet shoulder-width apart. Keeping your arms straight ahead, sit back on an imaginary chair while keeping your weight on your heels and your back straight.
Lunge
Take a large step forward, lowering yourself until both knees are at 90 degrees, then step back to starting position. Make sure your front knee is directly above the ankle and pointing forwards.
At The Physio Approach, a Physiotherapist will first perform a comprehensive assessment to determine the type and severity of your injury, provide an individualized treatment plan suited to your needs, and guide you through your exercises and movements and ensure that your recovery is smooth and safe.
If you or someone you know is suffering from knee arthritis, our team at The Physio Approach can help. Our Sports Medicine Physician/Physiatrist can help with the medical management while our Physiotherapists can improve range of motion, strength and guide you back to living your best life. Contact us today!