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ACL Tear - Download PDF
What is an Anterior Cruciate Ligament Tear?
The Anterior Cruciate Ligament (ACL) is one of the four main ligaments of the knee attaching the femur to the tibia. The ligament is responsible for not allowing too much motion in the knee joint by keeping the tibia from sliding too far forward on the femur. The tears can range from small partial tears to a complete rupture of the ligament.
Symptoms
A "pop" or tearing may be heard and felt at the time of the tear resulting in immediate and intense pain in the knee. After the injury, the knee may feel unstable or that it gives way.
Causes
ACL tears most commonly occur when the knee is in a flexed position and is forced to the inside (medially) and rotated often times from impact during sporting activities, a sudden change in direction (cutting) or when landing incorrectly (knee going too far in or valgus). Females have been shown to have a higher incidence of ACL tears versus males.
Physical Therapy Treatment
Non-Operatively-Strengthening the muscles surrounding the knee joint is extremely important if an ACL tear is not going to be repaired as the muscles need to compensate for the loss of stability the ACL would normally provide.
Post-Operatively physical therapy will initially focus on regaining the range of motion (ROM) with active and passive techniques, controlling and reducing swelling and walking safely with the assistive device provided at the time of surgery. Modalities and manual techniques such as massage for swelling may be used as well as massage to the scars from the incision to ensure they heal correctly without adhesions. Strengthening exercises will be added to help regain the strength of the surrounding muscles especially the quadriceps and hamstrings. As therapy progress and full ROM is achieved more weight bearing exercises, strengthening, flexibility and balance exercises will be added.
Norkin, C and Levangie, P:Joint Structure and Function A Comprehensive Analysis, 2nd ed. F.A. Davis Company, Philadelphia, 1992. King S, Butterwick D, Cuerrier J. The Anterior Cruciate Ligament: A Review of Recent Concepts. J Orthop Sports Phys Ther 1986;8(3):110-122.
