ACL Injuries: What Athletes Should Know


Athletes must cope with a variety of different injuries in their athletic careers. Although many injuries are equally common between men and women, there is one injury that is much more common in females compared to males: an ACL rupture. Individuals who have or are likely to experience this injury should be aware of its treatment, as well as the likely rehabilitation.

What is the ACL?

The ACL, or anterior cruciate ligament, is a ligament located within the knee joint. Its primary role is to provide stability to the knee when cutting or pivoting. It prevents the knee from rotating. It is an extremely strong ligament, but there are certain characteristics of female athletes that make it more likely to be injured.

What Causes an ACL Tear?

An ACL tear occurs when an excessive load is placed on the ligament beyond what it is capable of handling. The most common mechanism of injury for an ACL tear is planting and pivoting on one foot. When the ACL tears, the athlete may or may not hear a pop.

Females are more likely to experience excessive strain on the ACL due to a lack of muscular strength compared to males. With relative muscular weakness, the ligament is forced to take a larger amount of the load of the knee.

Female athletes are also more likely to place an excessive load on the ACL due to their hip anatomy. Females have a much larger Q angle than males, which increases the load placed on the knee. The Q angle is the angle formed by the front of the pelvis, the kneecap, and the tibia (shin bone).

Signs and Symptoms of an ACL Tear

The signs and symptoms of an ACL tear will vary depending on the severity of the tear. However, the most common signs and symptoms experienced by athletes who have torn the structure include:

  • An audible pop at the time of injury
  • Swelling in the knee that occurs rapidly
  • The knee gives out
  • Pain in incomplete ruptures
  • No pain in complete ruptures

How is an ACL Tear Treated?

Surgery is the most common form of treatment for an ACL tear. However, once the surgery is completed, the athlete is likely to face an extended period of physiotherapy.

Physiotherapy after an ACL reconstruction begins with strengthening of the quadriceps and hamstring muscles. Once the strength surrounding the knee is regained, the athlete is likely to begin returning to functional training, including walking stairs, practicing balance, and performing other dynamic exercises.

There are several return-to-sport criteria utilized by physiotherapists. However, most typically utilize a general guideline that the athlete must have 90–95% of the strength of the unaffected knee on their surgical knee. Additionally, they must complete a functional test consisting of a single leg hop, a vertical jump, a timed hop, and other similar dynamic sport-specific activities.

If you tear your ACL or have questions, visit a sports medicine doctor like Dr. Lisa M. Schoene.


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