Redmond Physical Therapy ACL

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Redmond Physical Therapy
Symptoms & Pathologies

Anterior Cruciate Ligament: ACL

Where is the ACL?

The word "cruciate" loosely defined, means "crossed", referring to the fact that there are two cruciate ligaments, the ACL (a broad ligament) crosses from front to back and the PCL (Posterior Cruciate Ligament) crossing from the back to the front. The ACL begins from the anterior portion of the intercondylar area of the tibia (shin bone), just behind the attachment of the medial mensicus. The ACL courses upwardly and backwards and attaches to the lateral condyle of the femur (thigh bone). The ACL is slack when the knee is flexed (bent as it is at your desk) and taut when fully extended (knee is straight as in standing).

What does the ACL do?

The function of the ACL is to prevent displacement (movement) of the femur on the tibia and hyperextension of the joint. The easiest application of this phenomenon is when going down the stairs. This is noticeably more difficulty when the ligament is torn as a descent down stairs feel unstable to the lowerleg.

Causes of ACL Injury?

Injuries to the ACL are among the most common of all sports-related knee injuries. It's estimated that each year in the United States between 95,000 and 250,000 people sustain a torn or ruptured ACL. The most common cause of ACL rupture is a traumatic force being applied to the knee in a twisting movement. This can occur with either a direct or an indirect force. Typically ACL tears happen when you slow down suddenly or cut or pivot with your foot firmly planted, twisting or overextending the knee. This type of stress in the knee can stretch the ACL beyond its normal elastic range for it's fibers and subsequently tear. Once the ligament tears, it doesn't heal — it remains loose. In our practice, about half of the cases of ACL rupture occur without contact, i.e., while side-stepping, pivoting or landing from a jump. The other half are associated with some type of contact, whether it be on the football field, on the snow fields or in a motor vehicle accident. Skiing injuries usually occur during a fall in the inexperienced skier, on rented skis when the bindings do not release. Women have ACL injuries more often than men do. The exact reason for this isn't clear. It is likely due to differences in anatomy, hormones, strength or conditioning.

What are the symptoms of an ACL tear?

When you tear your ACL, you may feel or hear a pop in the knee, experience significant pain in the knee, and have immediate swelling. When you try to stand and put weight on the injured leg, the knee may give way and feel unstable. In most cases, you must stop physical activity due to pain or because the knee is no longer able to support your weight. This is noticeably more difficulty when the ligament is torn as a descent down stairs will feel unstable in the lowerleg.

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