The Eagles have just confirmed Nic Nat has a rupture of the other ACL after his innocuous landing from a jump on the weekend. Image source: abc.net.au
Stats about how ACL injuries can change your sporting life:
- 30% of recreational athletes don’t return to sport following repair and rehabilitation
- 25% of AFL players do not return, of those who do 30% of repairs fail
- 25% chance of sustaining an ACL injury in the first year of returning to sport
- It is more likely the ‘good knee’ will sustain the ACL injury than the repaired knee
Facts about ACL injuries:
1
70% of ACL injuries are non-contact in nature. WHY?
A knee is vulnerable at 30° bending, inward collapse, at speed;
- Changing direction running at high speed
- Regaining balance after kicking
- Landing after a jump
2
Who needs an operation?
If you want to return to a sport that requires pivoting (see our Blog article on ACL Rupture and whether you need to have an operation)
3
A “quiet” knee is the best knee to operate on
- Minimal swelling, heat, inflammation
- Bending > 110°
- Lock out into complete straightening (unless there is a meniscal tear)
4
The tendon graft is weakest at 3 months
- Rehab has specific exercises for specific times
- If you overdo it, the graft will stretch, then it will ultimately fail when you return to your sport
5
Rehab takes at least 12 months;
- Quieting the knee for surgery
- Reducing surgery inflammation
- Muscle weights for strength and movement control
- Running and agility exercises
- Returning to sport
- Preventing re injury with exercises to re enforce knee strength
So what is being done to help reduce the incidence of ACL injuries?
- Traditionally rehabilitation was focused on time frames which meant at 9 months you were allowed to run
- Rehabilitation is now goal based which means you can only start running at 9 months when you can control movement, with loading, into knee bending positions
- A huge focus on rehabilitation is ensuring a patient has trust and confidence in their knee which is measured with surveys throughout the whole process
- There must be follow up injury prevention routines built into the training warm up and performed routinely
