Odds are, you or someone you know has suffered from an ACL injury. It is estimated that roughly 100,000 to 200,000 people experience an ACL injury every year in the United States alone (Gordon & Steiner as cited in Friedberg, 2019). Although athletes are the most common victims of this injury, people of all ages and activity levels are at risk of injuring their ACL.
About the ACL
The ACL, or anterior cruciate ligament, performs an essential function within the anatomy of the knee. Its primary role is to provide rotational stability and support for the other bones and ligaments in the knee (OrthoInfo, 2014). The ACL is at the highest risk for injury when patients:
Rapidly change direction
Engage in aggressive sideways motion
Twist their knee while their foot is planted
Suddenly stop or slow down while running
Land unevenly from a jump
Experience direct collision or contact with another person (OrthoInfo, 2014).
These motions most often occur during competitive sports that involve quick, aggressive movements, such as football or soccer; however, skiing and other recreational activities can put enough strain on the ACL to result in injury (especially if the patient has had previous ACL damage).
Types of ACL Injuries
The severity of an ACL injury can be measured as a sprain, partial tear or complete tear to the ligament. The most mild form of ACL injury is a sprain, in which the ligament is stretched slightly (OrthoInfo, 2014). Patients with an ACL sprain can often avoid surgery and treat the injury with routine physical therapy to strengthen the joint and regain stability.
Partial tears to the ACL, where the ligament becomes severely stretched to the point of being loose, are the least common occurrence. “Most ACL injuries are complete or nearly complete tears” (OrthoInfo, 2014).
A complete ACL tear occurs when the ligament is separated into two distinct pieces, making the knee joint relatively dysfunctional and unstable. When the ACL becomes torn, patients will often experience severe pain and swelling along with reduced mobility and stability. Patients with an ACL tear may also face greater strain on the surrounding ligaments compromising for the lack of an ACL.
Meniscus Injuries
“About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments” (OrthoInfo, 2014). The most common pairing of injuries is an ACL tear and a meniscus tear.
The meniscus is the cartilage that essentially acts as a cushion between the bones that connect at the knee joint. In most cases, a meniscus tear is minor enough to be treated through physical therapy. In cases where the meniscus tear is more severe, surgery may be required to either repair the cartilage or, in extreme cases, remove the damaged cartilage altogether (Wedro, 2018).
Surgical Treatment for ACL Injuries
In order for the ACL to be restored to its normal function, surgery is required to repair the broken ligament. The rehabilitation timeframe following this surgery can range anywhere from 6-12 months for full recovery. However, depending on the severity of the injury and desired activity level, some patients choose to forego surgery and support the injury with bracing, physical therapy, and other alternative therapies like chiropractic or massage therapy.
Alternative Treatment for ACL Injuries
Regardless of whether or not the patient undergoes surgery, routine physical therapy is almost always required for ACL injury rehabilitation. The primary focus of ACL rehab is for patients to regain strength and mobility, including full flexion and extension of the knee. Therapeutic exercises are often paired with other therapies, including heat, ice, stimulation, ultrasound, chiropractic, and massage treatments to reduce pain and inflammation that may inhibit the progress of ACL rehab.
Chiropractic care, in particular, assists with ACL rehab at a foundational level. “Chiropractic [treatments] assist in the overall health and functioning of the nervous system…a chiropractic manipulation of the knee joint [can be] quite beneficial in the restoration of joint motion and full function of the knee joint” (Casey, n.d.). Chiropractic care can be extremely beneficial for recovering ACL patients over an extended period of time as the begins to knee fall subject to other joint conditions, like arthritis, as a result of traumatic injury.
Long-Term Care for ACL Injuries
Patients who suffer an ACL injury will likely experience long-term negative effects even after reconstructive surgery is performed. In addition to regular aches and pains in the knee, those who have had damage specifically to the ACL and meniscus are at a heightened risk for developing arthritis. In fact, “individuals who undergo an ACL reconstruction have a 3 to 5 times greater risk of developing post-traumatic arthritis of the knee” (LaPrade, 2019). This is attributed to the fact that damaged cartilage cells have a very low ability to reform properly following a traumatic injury.
To slow the progression of degenerative joint conditions and preserve joint mobility, patients should begin a consistent therapeutic routine immediately following injury or reconstructive surgery. A long-term care plan for patients recovering from ACL damage should involve a consistent routine of therapeutic treatments, such as:
Chiropractic manipulations to support proper nerve functioning, stability, and alignment
Massage therapy and acupuncture to release toxins, reduce joint and muscle pain, and improve circulation (Alcantara, 2014)
Low-impact resistance training and stretching to strengthen and support the muscles surrounding the knee joint
Patients who have experienced a traumatic knee injury should consult with both an orthopedic surgeon and an alternative healthcare provider to repair the injury and/or set up a plan for long-term management of the injury.
For more information about alternative treatment options for ACL injuries, click here.
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This information is not intended to substitute professional medical advice or treatment. Read the full disclaimer here.
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Sources:
Alcantara, M. (2014, Aug. 7). How acupuncture helped heal my ACL knee reconstruction. Alcantara Acupuncture + Healing Arts. Retrieved from http://alcantaraacupuncture.com/acupuncture-helped-heal-acl-knee-reconstruction/
Casey, M. (n.d.). Breaking down an ACL injury and how chiropractic helps. The Joint Chiropractic. Retrieved from https://www.thejoint.com/2017/12/13/breaking-down-an-acl-injury-and-how-chiropractic-helps
Friedberg MD, R.P. (2019, Feb.). Anterior cruciate ligament injury. UpToDate. Retrieved from https://www.uptodate.com/contents/anterior-cruciate-ligament-injury
LaPrade MD, R. (2019). Risk of osteoarthritis after ACL surgery. Robert LaPrade, MD, PhD. Retrieved from https://drrobertlaprademd.com/arthritis-after-acl-surgery-knee-osteoarthritis/
OrthoInfo. (2014, March) Anterior cruciate ligament (ACL) injuries. American Academy of Orthopaedic Surgeons. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/
Wedro MD, B. (2018, July 23). Torn meniscus. MedicineNet. Retrieved from https://www.medicinenet.com/torn_meniscus/article.htm#torn_meniscus_facts
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