An Anterior Cruciate Ligament (ACL) rupture is a common injury seen in the sporting population. Often, it can can take players out of action for the entire season! For athletes playing at a high level, surgery is performed quickly to get back on the field. However, is surgery really necessary for the rest of us?
I get asked this question all the time by people who have recently injured their ACL, so let’s talk about it!
Just to explain a couple things first, the ACL is a band of connective tissue that runs through the middle of the knee. It attaches to the shin bone (tibia) and to the thigh bone (femur). The ACL’s main functions are to stabilise the knee and prevent forward movement of the tibia. Secondly, the ACL is most commonly injured in non-contact situations. For example, in sports such as skiing, netball or soccer that require rapid changes in speed and direction. When you injure your ACL, the feeling is often described as a “pop” or a sensation of your knee “giving way”. Other structures such as your medial collateral ligament (MCL) or medial meniscus can also be damaged in addition to your ACL.
So, you suspect an ACL injury… what do you do now?
A Physiotherapist will be able to assess your knee to determine the cause of your symptoms. We may also recommend having an MRI scan to confirm that you have injured your ACL and look for any collateral damage (i.e. cartilage damage, ligament damage, bone bruising and/or joint capsule damage).
Do I need surgery?
You do have options! There are many factors to consider before opting for the knife. Depending on your age, level of activity, goals, job and other associated injuries, you may choose whether you want to proceed with an ACL reconstruction or trial conservative management (i.e. Physiotherapy!). For example, if your goal is to return to a high-level sport that involves speed and directional changes then seeing a surgeon may be beneficial. However, if you are not limited by time and your goal is to be able to walk, swim or even play sport at a social level they you may consider Physiotherapy first.
There a positives and negatives to both approaches so it is vital that you get all the information. It is important to add that having reconstructive surgery does not guarantee that you will be able to return to playing sport! Another thing to consider is the time taken to return to sport. Rehabilitation following an ACL injury is approximately 9-12 months, whether you have conservative treatment or surgery. I recommend that you start conservative management with a Physiotherapist even if you are planning on having surgery. The research has shown that going into surgery with a stronger knee will help improve your function post surgery.
If you have had or suspect an ACL rupture I would love to chat with you personally about your knee. Just enter your details in the fields below & I’ll be more than happy to discuss with you further how we can help find the best management for you.
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(Please keep in mind, these are general guidelines for the majority of our patients. It is important to consult with your doctor or physiotherapist first and make sure you have a plan tailored specifically for you).