Anterior Cruciate Ligament Injury!
Acl injuries occur mostly as a result of excessive valgus stress, forced external rotation of the femur on a fixed tibia (with the knee in full extension, or forced hyperextension. These injuries are common in contact sports and those involving a sudden change of direction, twisting or jumping.
Clinical features:-
- Age:-14-30 yrs
- Pain
- Rapid swelling
- Tenderness in the joint line
- Audible pop or crack at the time of injury
- Feeling of instability
- Haemarthrosis
- Limited rom (range of motion)
Positive:- anterior drawer test, Lachman test and pivot shift test
Treatment for ACL injuries-
Price principles:-
- Protection
- Rest
- Ice
- Compression elevation.
Electrotherapy:
- Ultrasound
- Inferential
- Tens
When & who requires ACL surgery?
The decision of whether to operate is based on a number of factors, including:
Age; lifestyle; sporting involvement; occupation; the degree of knee instability and any other associated injuries.
Exercises:-
- Mobility:- heel slide exercises, hamstring stretch, groin stretch
- Strengthening exercises:- static quadriceps, static hamstrings, calf raise, hip abduction, hip extension, hamstring curls with the band, eccentric squats, step up, pelvic bridging
- Proprioceptive exercises:- (only at the advanced recovery stage) hopping and step jump
If surgery is indicated then pre-surgery exercises are done to build up the strength in the muscle.
Isometric or static strengthening exercises which do not involve movement can usually begin early on.
Taping
Supports & braces: A hinged knee brace is often recommended for support both before and after surgery.