It’s a normal weekend you go out to play football as you do every Saturday. Warm up goes well and you’re feeling good ready to play. The whistle signals kick off and after running around for 5 minutes the ball goes over your head and you quickly try to turn to chase the ball. As you turn you hear a pop and find yourself on the floor in a heap. Pain can be felt in the knee. After the initial pain subsides you try to get up and put weight on your leg, but it feels too unstable and uncomfortable.
It is quite possible you have sprained your anterior cruciate ligament (ACL) injury. Sometimes with this type of pain people go to A&E, often an x-ray will be taken which won’t show any damage, it is often then advised that you follow the PRICE (protect, rest, ice, compression, elevation) protocol and go to your gp to be referred for an MRI, crutches may also be given to help you get around. So, below is a brief overview of knee function and the important role played by the ACL in stabilising the knee during all phases of movement.
The knee is known as a modified hinge joint meaning its main plane of movement is flexion/extension (bending/straightening the knee). Bones making up the joint are; the femur (thigh), tibia (shin) and fibula (bone of lateral lower leg) and the patella (knee cap) which sits over the knee and acts as protection for the structures underneath. There are 4 major ligaments in the knee; the medial and lateral collateral ligaments and the anterior and posterior cruciate ligaments. You have 2 menisci which add extra support and cushioning for the knee. Strong muscles surround the knee to enable movement.
This type of injury often occurs in sports involving sudden changes in direction. This type of injury happens because the lower leg is planted in one position and the femur (thigh bone) rotates whilst causing the ACL to over stretch and tear. Sprains can vary in severity from a small overstretch to a full tear; they are usually classified by grades 1-3, depending on the degree will depend on the ability to use the knee as most with this type of injury find simple movements such as bending the knee a struggle.
Because of the poor blood supply to the ligaments recovery can be prolonged often taking several months. Surgery may be needed if the tear is a full thickness tear and stability is reduced dramatically, however this is usually a last resort and so manual therapy is often suggested in the first instance to see if strengthening the muscles around the joint and getting a full range of movement back can be achieved. Low impact exercises will also be advised such as cycling or swimming.
A full assessment would be carried out to assess the injury and then manual therapy including soft tissue massage, articulation, dry needling/medical acupuncture and exercises will be completed in order to decrease the recovery time and get the knee working as well as possible by restoring strength for the knee.
Osteopath at BeActive Clinic