• Yurika Tarui

What is an ACL Injury?


Imagine an athlete at the top of their game coming to a screeching halt because of a life-altering injury: tearing their ACL. Athletes of all levels sustain ACL tears for various reasons, primarily a lack of awareness and lack of prevention. To a non-athlete, this injury might not sound life-altering. However, when an athlete hears that they have torn their ACL, it affects them physically and mentally, especially when it comes to the sport or activity they love. Until an athlete endures the hardships of recovering from this injury, they often do not understand the intricacies and pains an athlete faces when facing this game-changing injury.


ACL injuries have gained attention during the last 15 to 20 years because of the high incidence of ACL tears in young athletes. These sports injuries are severe and generally require surgery and a lengthy rehabilitation process. Because of the increased incidence of ACL injuries, student-athletes must be proactive by getting an assessment to determine their risk. With the right knowledge and training, athletes can prevent or mitigate ACL injuries to stay happy, healthy, and well.


What is an ACL Injury?



A torn anterior cruciate ligament (ACL) is a second- or third-degree sprain of the ACL. The ACL arises from the front of the medial femoral condyle and passes through the middle of the knee to attach between the bony outcroppings (called the tibia spine) located between the tibia plateaus. The ACL, one of two ligaments that cross in the middle of the knee, connects your thigh bone (femur) to your shinbone (tibia) and helps stabilize your knee joint.



What are the signs and symptoms of a torn ACL?

People often report a loud pop, followed by intense pain in the knee. The pain makes it hard to walk and bear weight. The knee joint will begin to swell within a few hours because of bleeding within the joint, making it difficult to straighten the knee. If left untreated, the knee will feel unstable. The patient may complain of recurrent pain and swelling and giving way, especially when walking on uneven ground or climbing up or down steps.



Causes



ACL injuries happen during sports and fitness activities that can put stress on the knee, such as:

  • Suddenly slowing down and changing direction (cutting)

  • Pivoting with your foot firmly planted

  • Landing awkwardly from a jump

  • Stopping suddenly

  • Receiving a direct blow to the knee or collision, such as a football tackle

When the ligament is damaged, there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact.


Prevention



Proper training and exercise can help reduce the risk of ACL injury. A sports medicine physician, physical therapist, or athletic trainer can provide tips, instruction, and feedback that can help you reduce risks. Some steps to reduce the risk of an ACL injury include:

  • Exercises that strengthen leg muscles, particularly hamstring exercises, to ensure an overall balance in leg muscle strength

  • Exercises to strengthen the core, including the hips, pelvis, and lower abdomen

  • Training and practice emphasizing proper technique and knee position when jumping and landing from jumps

  • Training to improve technique when performing pivoting and cutting movements

Risk factors for ACL injury in women



Women are more prone to ACL injuries than men because of their slightly different anatomy. Women have a wider pelvis than men, which causes the femur to meet the tibia at a greater angle (called the Q angle). This angle increases the force that the ACL has to withstand with any twisting motion, increasing the risk of damage. Another risk factor for women is how Female muscles tend to be more elastic and decrease the protection that the hamstring muscles can provide to the ACL.


ACL Recovery Time



Recovery for an ACL can be one of the most challenging experiences an athlete can go through, and trust me, I know; I had two ACL injuries on both of my knees. The recovery for an ACL injury often includes surgery, followed by six to nine months of rehabilitation. The first three weeks are tough since you're getting used to moving with a bulky brace with crutches while increasing the knee's range of motion. The new ligament needs time to heal, and care is taken not to rip the graft. You may be able to begin putting your full weight on your repaired leg without crutches 2 to 3 weeks after surgery if your surgeon says it is OK.


More than just an Injury



Since ACL injury recovery includes physical therapy and surgery, the recovery isn't always quick and straightforward. An ACL tear can significantly affect a person's current and future activity levels. The changes in lifestyle and the physical pain involved can break a person's spirit and leave them feeling defeated. A few of the common symptoms to watch for after an ACL tear during mental recovery include:

  • Fear of reinjury: Athletes may be afraid to return to their sport due to fear of reinjury. They don't want to go through the pain and healing process again, so they avoid activity. Their fear puts limits on what they do, even if their body could physically handle it.

  • Depression: If sports or other activities were a big part of a person's life, and they are now afraid to participate in those activities, they may become depressed. They feel a large part of their identity has been stripped away, and athletes can feel immense hopelessness and despair. Depression can quickly intensify, so it is especially critical to stay aware of common symptoms.

  • Isolation: During recovery from an ACL injury, a person may feel alone because they cannot participate in many activities due to their limited mobility. Even after physical recovery, they may feel isolated because of what they missed out on during recovery or because they are no longer as active in sports as they used to be.

  • Anger: An ACL injury may cause a person to miss out on the rest of the sports season and miss out on things they want to do. They can become frustrated and angry. They wonder why this happened to them and sometimes blame themselves. They often become frustrated that physical recovery isn't faster.

  • Lack of motivation: Motivation goes hand in hand with an ACL tear and mental recovery. Suppose the person is convinced that things won't get better or is afraid to return to activities once their treatment is complete. In that case, they may lack the motivation to try to get better and may quit their activity/sport they love to do.

  • Sleep issues: Due to the physical and emotional pain involved, those suffering from ACL injuries may struggle with sleep disturbance. Physical discomfort, as well as concerns about future abilities, can keep them awake at night. The lack of proper rest can worsen their struggles with frustration and depression, and increase the risk of reinjury.


Although an ACL injury may take you away from your favorite activities temporarily, it is important to take your time with the healing process to ensure proper, sustainable recovery. And while it can feel like the end of the world, with time, it will get better. As long as you hold onto your passion and love for your sport, you will get through this and come out stronger. Everyone at resilientHer is here to support you through this journey, so please reach out to us if you need anything!


In an upcoming article, I will be discussing my personal experiences with ACL Injuries and how I continue to strive towards my passion for soccer. Stay tuned!



Works Cited:


“ACL Injury.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 30 Mar. 2019, www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738.


Benjamin Wedro, MD. “Torn ACL Symptoms, Recovery Times, Surgery, Women.” MedicineNet, MedicineNet, 12 Dec. 2019, www.medicinenet.com/torn_acl/article.htm.


“More than a Knee Injury: ACL Tears Cause Harmful Changes in Our Brain Structure.” ScienceDaily, ScienceDaily, 29 Jan. 2020, www.sciencedaily.com/releases/2020/01/200129104731.htm.


Silvers, Holly J., and Bert R. Mandelbaum. “ACL Injury Prevention in the Athlete.” Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology, Urban & Fischer, 10 Feb. 2011, www.sciencedirect.com/science/article/abs/pii/S0949328X11000111.


“Recovery & Follow Up.” Rehab Timeline Expectations, www.emoryhealthcare.org/centers-programs/acl-program/recovery/rehab-timeline.html.


“How Emotional Health Affects Recovery After ACL Surgery.” PowerPlay, 3 Oct. 2018, powerplay.us/emotional-health-affects-recovery-acl-surgery/.


"ACL Tear" by Bruce Blaus is licensed under CC BY-SA 4.0












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