Ligament Injuries
Anterior cruciate ligament tears:
Tears to the anterior cruciate ligament (ACL) are not uncommon. They can occur in sports players where there is a sudden change in direction (i.e. football). Likewise, they can occur in the general population, specifically when the lower leg extends forward too much or the knee rotates inwards under load.
- Assessment
- Treatment
Treatment:
- Initial management should involve protection, rest, ice, compression and elevation (PRICE), issue of crutches.
- Painful activities should be avoided
- Progressive loading of the knee through active rehabilitation
- The treatment regimen can be summarised as follows:
0-48 hrs:
- PRICE
- Active pain-free exercises (gentle range of movement)
After the first 48 hrs:
- Gradually increase strength:
- Active knee flexion and extension
- Knee brace, active single leg raise and inner range quads.
- Hamstring and gluteal strengthening
- Progress loading – Chair/wall squats and stair step-ups
- Knee stability exercises (e.g. pulleys with other leg, one-leg squats)
- Low impact cardio, cycling and swimming, lower limb strengthening exercises if access to a gym
Functional Strengthening:
- Bike
- Pool running
- Jogging
- Swimming
Sport Specific skills:
- Jumping and landing
- Running-straight line
- Running-figure of eight
- Rapid changes of direction (cutting drills)
- Kicking-gradual increase