Introduction
The anterior cruciate ligament (ACL) is a part of the human knee which is responsible for providing flexibility of the leg for movement. The ACL is part of the posterior cruciate ligament which also forms the cruciate ligament, a part of the human knee. The fibers forming the ACL originate from deep within the distal femur and pass through the femoral condyle into the tibia. The ACL is comprised of two bundles which are attached into the tibia to provide support for the body. The tibia is region responsible for bearing the weight exerted by the body. The ACL is attached to various regions including femur and the femoral condyle to provide resistance of the medial dislocation of the tibia as well as the anterior translation (Azus et al., 2018). This paper assesses the instances of ACL injuries by discussing the biomechanical functions, the symptoms of the injuries, physiotherapy among other aspects.
Biomechanical Function
The ACL is composed of groups of fibers which form bundles responsible for the various biomechanical functions. The bundles undergo through episodes and a series of lengthening and slackening throughout the instances when an individual engages in motion. The ACL engages in complex biomechanical functions such as providing stability to the knee and the generation of receptive feedback into the knee for appropriate functioning. The ACL controls the zero to thirty degrees of rotation of the tibia for supportive movements such as side-stepping (Azus et al., 2018). Therefore, the clinical significance of ACL is that it supports functions such as facilitating 30 degrees of tibia rotation for knee flexion as well as facilitate receptive fiber function for the knee to function appropriately during movements.
Causes
The ACL injuries are some of the common knee injuries whereby the sudden change in the direction of movement contributes to tearing of the fibers comprising the ACL. Changing directions rapidly causes the friction between the femur and tibia which then cause the ACL injury. Another instance when ACL injury may occur is when an individual comes to a sudden stop after engaging in running activity. Subsequently, landing from a high jump could cause the ACL tear due to the pressure that is exerted on the knee joint by the body weight. Also, the act of pivoting or moving side-ways with the foot firmly planted as well as knee collision as it is the case in sports causes the ACL injury (Azus et al., 2018). Often, the ACL injury occurs to individuals who engage in vigorous activities such as sports.
Diagnosis
In assessing the possibility of ACL injuries, the doctor has to check the knee for any signs of swelling or tenderness. In this case, the physician can compare the differences in physical appearance between the injured and the uninjured knee. Subsequently, the physician may be compelled to move the knee into a different position to evaluate the functionality of the knee joint as well as the range of motions that the knee can support. Furthermore, the doctor can utilize other tests such as scanning to complement the physical exams. In this case, the X-rays, the Magnetic Resonance Imaging (MRI), and ultrasound are crucial in facilitating the understanding of the severity of an ACL injury (Azus et al., 2018). The scanning procedures assess the possibility of a bone fracture and possible damages to other internal structures such as ligaments and muscles.
Symptoms
However, besides the diagnostic process, the assessment of the possible symptoms provides an understanding of the possibility of an ACL injury. The first symptom of an ACL injury is a pain within the knee joint. Although an individual may fail to experience pain for minor sores, he or she may experience difficulties while standing or putting pressure on the knee. Further, swelling and tenderness at the knee section is a sign of an ACL injury. Also, the loss of the range of motion or experiencing trouble while walking showcases instances of ACL injury since the affected muscles fail to maintain the same motion as before (Stracciolini et al., 2015). Additionally, the loss of stability is usually caused by the inability of the knee to bear normal weight which is a symptom of the ACL injury. As such, an individual may rely on the various symptoms for self-diagnosis.
Physiotherapy Role
The ACL injuries can happen in two ways, the partial and full rapture of the ligament. After the doctor assesses the severity of an ACL injury through the physical examinations of knee stability and scanning methods, the doctor can prescribe either surgery in full rapture or leave the knee joint to heal with due time. However, the doctor can also prescribe physiotherapy in both the cases to enable the joint to regain muscle strength. The physiotherapy process reduces instances of pain and inflammation, restoring the full range of motion, strengthening leg muscles affected during the injury, improving knee balance as well as fiber proprioception. Further, the physiotherapy focuses on the strengthening of pelvic and hip muscles to reduce to the amount of weight exerted on the knee joint (Patern, Rauh, Schmitt, Ford, & Hewett, 2014). Therefore, physiotherapy plays a crucial role in restoring the functioning capabilities of the muscles in the knee joint.
Physiotherapy Treatment
Although the ACL injuries may affect people differently, the physiotherapy treatment processes involving physical exercises should consider the severity of an ACL injury and the appropriate treatment interventions. For instance, the people who experience full rapture and undergo surgery should rest without engaging in vigorous exercises as a physiotherapy intervention. Further, the age of a patient influences the selection the physiotherapy treatment. Also, it is essential to understand that the difference in age and the severity of the knee injury account for the difference in the amount of time that patients spend in physiotherapy treatment. Thus, physiotherapists should ensure they consider the physical factors, the type of ACL injury, among other modalities before implementing a particular physiotherapy treatment approach (Paterno et al., 2014). Therefore, the selection of a physiotherapy treatment approach depends on some factors including age and the severity of the injury among other factors.
Prevention
On the contrary, there are various ways which individuals at the risk of ACL injury can do to avoid the injuries. First, people who engage in athletics can wear protective gear which reduces the impact when one falls or collides with another player. Also, a person can learn how to jump and land safely to ensure the knee joint does not experience pressure which could lead to an ACL injury. Subsequently, adequate preparation through stretching, squatting, walking, and other forms of warm-up exercises before an actual sport relaxes the muscles to reduces the chances of a knee injury occurring. Lastly, an effective approach to preventing ACL injuries is resting to ensure the muscles do not wear from excessive playing and exercises(Azus et al., 2018). As such, a person who is at the risk of experiencing an ACL injury should consider the various techniques that reduce tension and pressure on the knee joint.
Sports Activities and ACL Incidences
The ACL injuries mostly affect the individuals who are active in sports unlike other types of health issues. The athletes engage in vigorous activities that require rapid knee dispositions. However, there are sports whereby the ACL injuries are more frequent than others. Football leads in the case of ACL injuries whereby it records about 71.2% of injuries. Subsequently, about 7.2% of men and 53.2% of women in high school soccer suffer from ACL injuries. Furthermore, in statistics that involved high school sports, about 5.5% of male and 26.5% of female student-athletes experienced the ACL injuries ("The Knee Doctor," 2018). As such football suffices to the leading sporting activity with higher incidences of ACL injuries followed by soccer, volleyball, and basketball.
Risk Factors
The propensity of women experiencing ACL injuries is higher as compared to men who engage in the same sporting activity. Generally, women portray an instance of strength imbalance which makes their knee muscle unable to bear weight in a sport. In studies that evaluated the jumping and landing techniques in women and men, women were unable to jump and land safely which increases stress on the knee joints increasing the possibility of an ACL injury (Stracciolini et al., 2015). However, appropriate training of women on how to strengthen leg, hip, and lower torso muscles can significantly reduce the instances of ACL injuries in sporting activities.
References
Azus, A., Teng, H. L., Tufts, L., Wu, D., Ma, C. B., Souza, R. B., & Li, X. (2018). Biomechanical Factors Associated With Pain and Symptoms Following Anterior Cruciate Ligament Injury and Reconstruction. PM&R, 10(1), 56-63.
Paterno, M. V., Rauh, M. J., Schmitt, L. C., Ford, K. R., & Hewett, T. E. (2014). The incidence of the second ACL injuries two years after primary ACL reconstruction and return to sport. The American journal of sports medicine, 42(7), 1567-1573.
Stracciolini, A., Stein, C. J., Zurakowski, D., Meehan III, W. P., Myer, G. D., &Micheli, L. J. (2015). Anterior cruciate ligament injuries in pediatric athletes presenting to sports medicine clinic: a comparison of males and females through growth and development. Sports Health, 7(2), 130-136.
The Knee Doctor. (2018). Which Sport Has The Most (Highest Percentage) of ACL Tears? Retrieved from https://williamsterett.com/blog-dr-william-sterett/2016/12/2/which-sport-has-the-most-acl-tears
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