Injured your ACL (anterior cruciate ligament) in your knee?

As we hit peak skiing season we tend to see more ACL ruptures in our clinic. This is a common knee injury and one for which management has evolved quite significantly over the years.

After the assessment and diagnosis of an ACL injury, the main priorities are to manage the swelling, regain the range of movement of the knee, and prevent muscle wasting. We have a bespoke pathway for our ACL rupture patients which has been developed and approved by many consultants who refer their patients in the local area.

We use the hydrotherapy pool in the early phases of rehab - an environment that accelerates swelling resolution and hence range of movement much quicker than land alone, and, because the pool is 34 degrees, it is also a pain free way of exercising. We combine this with manual treatment, mobilisations, soft tissue massage and the use of electrical stimulation units to help build muscle up quicker (these are also available to hire so our patients can continue at home). Once range of movement is gained, swelling resolved and muscles are starting to activate again we work on strengthening the limb.

Once the limb has regained strength, together, with your consultant, we can test the stability of your knee. If the knee is stable then great, rehab continues, if your knee remains unstable then you may be the ideal candidate for a ACL reconstruction.

So what is the ACL?

The ACL is a band of dense connective tissue that connects the thigh bone (Femur) to the shin bone (tibia) and prevents the tibia from moving forwards on the femur. It also resists rotational loads.

What are the symptoms of an ACL injury?

There may be an audible noise (pop or crack) at the time of the injury

Feeling of instability

Immediate swelling

Episodes of giving way, especially on pivoting movements

A completely torn ACL can be very painful particularly at the time of injury

If you suspect you have damaged your ACL, it is recommended you see a Physiotherapist straight away. They will be able to take a clinical history, complete a clinical examination and begin treatment accordingly and sign-post to an appropriate consultant for imaging and further management if required.