Part 1 of a three part series on ACL tears…

ACL injuries are the most common sports-related injury of the knee. Seventy to 80% of ACL injuries are non-contact, with only 20 to 30% resulting from direct contact.

Pivoting and cutting sports such as soccer and basketball are the most common scenarios, whereas most direct contact ACL injuries occur in American football. Injuries often occur in relatively young athletic individuals 15 to 45 years of age. Females are two to eight times more likely to injure their ACL than males. Also, female basketball players are 7.8 times more likely to injure their ACL than male basketball players.

Mechanism of injury
The mechanism of injury often involves a maneuver of deceleration combined with twisting, pivoting, or side-stepping.

Signs/Symptoms
Most often a client will report hearing or feeling a “pop” during the activity, followed by immediate swelling, insta- bility, decreased ROM, and tenderness often occurs at the lateral line. This typically requires immediate medical care to immobilize and protect the joint, followed by a visit to the orthopedic doctor for further diagnosis and intervention.

Early Intervention
Postsurgery clients typically will be in physical therapy for the first three to four months, depending on the physician’s preferences and the client’s insurance constraints. The client is generally able to perform full weight bearing with crutches and a brace for the first two to six weeks. Physical therapy and a strengthening program continue until the injured knee has 90% of the strength of the other knee.

Common among protocols is a return to functional activity between 12 and 16 weeks after surgery and a return to sporting activities around six months. Clinical results of the ACL reconstruction are quite good, with very low reinjury rates.

The most common complication is residual anterior knee pain.

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