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If not detected and treated on time, several injuries can lead to a mistake, causing pain for a lifetime. One such injury is the tearing of the ACL. But how do you know if you tore your ACL? What are the treatments? Read on to know!
If you have no idea and have never witnessed what it feels like when an ACL is torn, first, let us tell you what an ACL is.
ACL is called the Anterior Cruciate Ligament. The ligament ACL is one of the tissues attached to the center of the knee joint; ACL injury is common.
The ACL tear happens mostly in people engaged in daily physical activity, hence several athletes, sportspersons, bodybuilders, and martial artists are prone to ACL tears.
1. Where Exactly is the ACL Located in the Knee?
The anterior cruciate ligament ACL is situated right in the center of the knee, connecting to the femur and tibia bone.
It is called the anterior cruciate ligament since it is on the front side in between the knee joint. It is adjacent to the posterior cruciate ligament, also known as PCL, and ACL is right before the PCL.
Although both ACL and PCL sound similar, they function differently.
- The ACL is responsible for keeping the knee balance on the front side
- Meanwhile, the PCL is accountable for sustaining balance on the back side.
There are two other ligaments present around the ACL
- LCL (Lateral Collateral Ligament) which connects the femur and fibula bone and
- MCL (Medial Collateral Ligament) connects the femur and tibia bones.
2. Possible Reasons for the ACL Tears
Indeed, for ACL tears, many factors could be taken into consideration. For example, any intense exertion or abrupt movement may tear off the ligament partially or entirely.
Here are all the reasons resulting in an ACL tear.
2.1. Playing Sports
Athletic activities involving all sorts of sports like rugby, basketball, soccer, marathon running, long jump, and various other sports that use the knee pose a higher risk.
They can keep the knee vulnerable to breaking the ACL ligament. All ages of people who play sports are at higher risk of ACL injury.
Rugby is played by catching a ball with hands. However, it involves running vigorously and brutally tackling opposite team players. As a result, the players are open to the risk of breaking their ACL.
The rapid movement of running at a fast pace and stopping suddenly gradually tears the ligaments in the knees if done without any safety measures.
2.1.2. Soccer/ Football
Likewise, soccer also involves quick knee movement; therefore, some activities, like kicking the ball with the wrong technique, can steadily pull apart the ACL ligament.
Soccer/Football is composed of twisting, changing direction, and turning bodily movements to run along with the ball. During such mechanical movements, one must be careful in doing so.
Some players might even mistakenly kick the knees of other players instead of kicking the ball.
Therefore, players must be vigilant and active throughout the gameplay to prevent such painful injuries of ACL. Female athletes are also prone to ACL-related injuries because their bones are thinner than male athletes.
2.1.3. Marathon Running
Marathon runners who endlessly run miles or kilometers by continuously putting more stress on their knees for a prolonged period are highly exposed to cracking their ACL.
Relentless pressure on the knee for extended periods can drastically create inflammation in the middle of ligaments. Therefore, it results in painful ACL injuries.
2.1.4. Long Jump
Long jump is an athletic sport whereby the athlete runs and halts suddenly to jump at the aimed distance. This sport is so risky that players can break their spine if they do not jump properly.
The body’s weight is stressed on the knees to take a long leap; consequently, the ACL can easily break partially when the legs are mistakenly slipped or twisted.
2.1.5. Martial Arts
Martial arts is also an athletic activity involving numerous leg kinetic movements.
Martial arts such as taekwondo, where high kicks are thrown with one leg while putting stress on another leg, and if wrongly kicked, knee, ligament, and even bone injuries may occur.
Many more martial arts could tear the ACL, for instance, jiu-jitsu, kickboxing, muay Thai, and more.
2.1.6. Body Building and Calisthenics Exercises
Bodybuilding and calisthenics exercises where external heavy weights are lifted to focus on muscle growth.
In such a scenario, if heavy-weight exercises like squats and leg presses are done without proper guidance or protocols, it could affect the ACL and the PCL.
2.2. Construction or Labor Works
Construction workers and laborers who are involved in lifting heavy objects or working in harsh physical conditions are also prone to ACL injuries.
- For instance, a civil engineer who works with heavy machinery or indulges in rapid mechanical movements can also accidentally break their ACL.
- Also, laborers who lift and transport bricks and cement bags during construction tend to cause ACL tears.
2.3 Household Works, Daily Chores and Errands
Household work such as arranging heavy valuables, cleaning at a certain height, and accidentally falling on the knees can also tear off the ACL Ligament.
3. 4 Tests to Detect
It is crucial to know whether the ACL is torn after strenuous exercise or physical movements of the legs. The pain sensation after an ACL tear can vary from person to person.
Suppose some people feel mild pain and some feel severe pain followed by the breakage of the ligament.
3.1. Swelling on Any Side of the Knee
Eventually, after the ACL is ripped off, symptoms like swelling may occur around the knee. After the tear-off of the ACL, a person may feel a burning sensation in the knee and perhaps become challenging to stand correctly.
As the ligament is connected to the large thigh and shin bone, the legs can no longer withstand balance in the body.
3.2. Popping Sound
Another symptom that includes an audible snapping sound can be heard strictly at the moment of tear-off when the ACL is torn.
As the ACL breaks, a snap sound occurs, then the knees cannot fold and extend the legs. Even though after the tearing of the ligament, the snapping sound can be consistently heard alongside pain.
3.3. Loss of Mobility
The common symptom after an ACL tear is a loss of mobility in the knee joints.
The knees become inflamed to such an extent that the movement of the joint becomes severely painful after it is completely torn. The critical knee movement to walk, fold, and stand can become challenging.
3.4. Procedural Imaging Tests & Scans by Doctors
If you have persistent pain in the knee accompanied by any physical activity and cannot find out by examining the knee, then a doctor’s visit is a must.
Occasionally, people get confused between regular knee sprain and ACL tear. If anyone neglects the pain, thinking of it as a simple sprain, the pain will become drastically debilitating.
4. Types of ACL Tears
There are typically three types of ACL injuries. They are:
4.1. Mild Tear
In mild damage of the ACL, the ligament is not torn, but the minute fibers of the ligament barely become inflamed.
This type of tear is not severe and can be quickly rehabilitated by proper diet and rest. Moreover, the tear is healed within a shorter period.
4.2. Partial Tear
If the ligament is partially torn, it is ruptured slightly from the joint; this is a mild to moderate tear where the ligament is torn up to a limited extent. This tear can be merely painful and can take weeks to recover.
4.3. Complete ACL Tears
In a complete tear, the ligament is completely torn, and the ache can be very excruciating. The whole ACL ligament is detached from the femur thighbone and tibia shinbone, making it feel unstable.
To alleviate such an exhausting ache, it can take months to recover completely after the reconstruction surgery.
5. Best ACL Treatments
Rehabilitation and recovery of the ACL tear depends on the type and intensity of the tear. Healing from a mild, partial, and complete ACL tear may take days, weeks, and even months.
There are multiple ways of treating the anterior cruciate ligament tear. One of the best treatments is hot and cold therapy.
However, in the case of an absolute ACL injury, reconstruction is the only best treatment.
5.1. Hot and Cold Ice Pack Physical Therapy
Hot and cold ice pack physical therapy is highly effective in treating mild ACL tears or sprains. A rubber bag is used wherein hot water is poured and gently applied around the knee. Doing so increases the blood flow to the affected site, speeding up healing.
On the other hand, a polythene bag is used to fill with ice cubes and softly applied on all sides of the knees.
As a result, the cool touch of the ice cubes ward off inflammation for some hours. The ice pack should be applied two to three times daily to avoid aching.
5.2. Rest, Diet, Stretching, and Physical Therapy
The tissue is slightly detached in case of a partial tear of the injured ACL ligament. This type of tear can only be treated with appropriate rest, diet, and stretching for weeks.
One must always avoid walking as much as possible until one can finally stand without pain.
Some other ways to recover from ACL injury:
- A physical therapist or a sports medicine physician also provides proper treatment and stretching techniques to recover from ACL injuries.
- In terms of diet, food abundant in protein, good fats, and carbs must be eaten. Collagen-rich foods, such as bone broth, bone soup, and lamb steak, must be consumed to acquire cartilage buildup in the ACL ligament.
- Stretching and folding the leg slowly two to three times a day can give the ligament space to increase the blood flow and heal faster.
- A leg brace can also extend support while walking after recovery. The knee may be unable to withstand excess weight gained due to resting.
- An elastic bandage can also be a great substitute to wear as it provides flexible movement and avoids stiffness. Using a knee brace is also a great alternative.
5.3 Critical Rehab Plan Adherence and Challenges
If the anterior cruciate ligament is completely torn and if the person is unable to walk even for seconds and feels unstable, then they need surgery on the ACL.
In this case, the ligament is detached from the femur and tibia. It results in severe and chronic pain for months.
The orthopedic surgeon performs ACL reconstruction surgery, whereby the torn ligament is replaced by a donor or repaired using the other tissues of the patient’s knee.
- After the orthopedic surgery, the patient is advised not to walk for a few days.
- Later, the patient is encouraged to walk independently to observe the improvement. This ACL reconstruction method will help the patient to recover fully.
In this orthopedic surgery, there are various surgical treatments wherein the cartilage of the patella tendon or hamstring tendon is used as a graft to replace the torn ACL tendon. These tissues eventually bind up with the femur and shin bone.
After the successful surgery, the patient is given nonsteroidal anti-inflammatory drugs and physiotherapy.
6. Possible Future Complications of ACL Surgery
A successful surgery may sound good, but few people tend to develop osteoarthritis later on. People who have a genetic history of arthritis may develop those symptoms in the future.
After surgery or reconstruction of an injured ACL, there are many chances of developing various problems and side effects following the recovery.
- The injury may change the structure of the ligament and make it less robust than before.
- The bones may be intact, but the joints can develop osteoporosis conversely due to injury.
- The movement of the legs may change gradually after the recovery, or occasional aches may happen.
- Furthermore, the sensation may also feel different, and adjacent ligaments could be affected.
- A few people might also lose their strength and performance after the surgery. It takes them quite a reasonable amount of time to regain their previous range of motion.
Consistent mobility exercises and therapy may provide relief; however, it would not last longer. As we age progressively, the ache associated with torn ACL surgery may return.
There is also a tendency that some people may not be exposed to any side effects after surgery. It relies primarily on person to person according to their lifestyle. Proper health care must be taken.
Frequently Asked Questions
1. Is ACL tear painful?
A complete ACL tear is unquestionably very painful, as the entire ligament is disconnected from the thigh bone and shin bone.
The pain is highly excruciating, and it cannot bear weight even to stand for a minute. In the case of a mild or partial tear, the ache is usually less and can be controlled using non-steroidal anti-inflammatory drugs.
2. How can ACL tear be prevented?
Certain precautions must be taken to prevent most ACL tears before being involved in strenuous physical activity.
One must use proper technique and safety measures when performing a mechanical movement using the legs, including the hips, knees, and calves. Moreover, protective gear such as knee braces and stretchable protectors can be used.
3. What nutrients are required to heal after ACL surgery?
High-quality protein, calcium, collagen, and healthy fats like unsaturated fats, B vitamins, and vitamin D are essential to speed up the healing process followed by torn ligament surgery.
4. Can we walk right after surgery?
After surgery, immediate care must be taken. Some people can walk right after surgery, but only for a few minutes.
The ache increases after hardly walking for a few minutes, so avoiding walking post-torn ACL surgery is highly advised.
ACL injuries can be identified by physical examination or scans done by doctors. Sometimes, pain may not occur right after impact but after a few hours in case of mild or partial tear.
ACL injuries quickly accompany pain and discomfort. In some rare cases, people might not feel pain at all; however, after a passage of time, the pain initiates slowly until noticed.
Even if the pain goes unnoticed, the symptoms appear after a few days. So, staying vigilant and visiting a doctor as soon as possible is better.