Anterior cruciate ligament (ACL) injuries

The anterior cruciate ligament (ACL) is one of the four main ligaments in the knee. It binds the back of the thigh bone (femur) to the front of the shin bone (tibia) and prevents the knee from moving excessively in relation to the femur. If the ACL is damaged the knee becomes unstable and feels like if it is "giving out". ACL injury is very common in hockey, skiing, skating, football and basketball due to the amount of pressure, weight and blows the knee withstands during these sports. Women in contact sports such as football and soccer are significantly more vulnerable to ACL injuries because of the difference in the anatomy of the knee.

The symptoms of an ACL injury are:

• A feeling of initial instability, followed by extensive swelling.
• Pain immediately after sustaining the injury.
• There may be an audible pop or crack at the time of injury
• Inability to fully straighten the leg
• Possible widespread mild tenderness

Treatment for an ACL injury may necessitate surgery or reconstruction, or it may be non-surgical. Non-surgical intervention includes the wearing of a knee brace to provide stability and physiotherapy. If surgery is indicated, a pre-surgery program will be implemented to help strengthen the joint and reduce swelling, thereby ensuring a successful surgery.

Following surgery, the joint loses flexibility and the muscles around the knee tend to atrophy (or get smaller). This requires physiotherapy to strengthen the muscles and increase range of motion. The program begins with ice, heat or ultrasound to manage pain. Edema (swelling) control and range of motion exercises performed, if these are not too painful, followed by exercises to strengthen the joint. Walking, swimming or cycling is helpful at this point to maintain fitness. ACL rehabilitation may take a few months, but in the end you will be able to return to the playing field.