Anterior Cruciate ligament (ACL) rupture

 The ACL is a very important ligament which is positioned deep inside the knee. It crosses the posterior cruciate ligament (PCL) to form a crucifix. Hence the name “Cruciate”.

The ACL runs from the front of the tibia (Shin Bone) to the back of the femur (thigh bone) which makes it effective at stopping the tibia from sliding forwards underneath the femur and preventing the knee from bending backwards (hyper extending). It’s not surprising that a common way of damaging it is by receiving a heavy blow to the back of the shin bone when the foot is fixed.

The ligament doesn’t run parallel but obliquely from the inside of the tibia (shin bone) to the outside of the femur (thigh bone). This means it’s able to protect the knee by resisting valgus stress (force pushing outside of the knee inwards) especially when the knee is flexed (bent).  An excellent example of this type of injury can be seen in this video of Jimmy Bullard playing in the Premier League http://www.youtube.com/watch?v=j_Mdm4v-ty8&feature=related

Not all ACL injuries involves physical contact but they usually involve bent knee twisting type action and can be as simple as jumping off a step or pivoting.

http://www.youtube.com/watch?v=oHgu5e9K3Ww

When the ligament is ruptured the patient is aware of hearing a popping sound and may describe the knee giving way underneath them. There is often accompanied by  intense pain and very obvious rapid swelling of the joint an indication hemarthrosis (blood entering the joint capsule).

treament for ACL rupture

Depends largely on how active a lifestyle the patient has. In most cases patients are offered specialist rehabilitation and strengthening exercises and this may be enough to support the knee but if they wish to perform activities that involve twisting type actions such as skiing it’s advisable to have surgery. This a very common and  effective procedure where they take a strip of the patients semitendonosus (hamstring) tendon or Patella (tendon) and secure it to the joint to act as a new ACL. In rare cases of elite Sportsman such as Micheal Owen they will use donor ligament from a cadaver (dead person).

It’s not unusual for our chiropractors to examine a patient who describes a knee injury in the history and when we test them and send them for a subsequent MRI scan discover they have in fact ruptured there ACL. This is because the clever way in which the body can compensate by increasing the activity of muscles such as the hamstrings.  

if you have any questions regarding this injury, please do not hesitate to contact us at enquiries@body-motion.co.uk