ACL – What you ‘Kneed’ to Know

By Liz Pattison

The anterior cruciate ligament, or ACL, is an important ligament that stabilises your knee joint.

The rate of ACL injuries is increasing rapidly in Australia, with 72% of injuries being sport-related. ACL injuries occur most frequently in sports such as football, netball, soccer, skiing and basketball.

Clinical Features of an ACL injury:
The majority of ACL tears occur in a non-contact situation. For example, when an individual is landing from a jump or pivoting when changing direction. ACL injuries can also occur in a contact situation, where contact is made directly to the knee, resulting in the ACL tearing or completely rupturing. Most ACL injuries occur in combination with other pathologies, which include a meniscal tear, articular cartilage damage or MCL injuries.

The individual will often describe an audible ‘pop’ sound and may feel like their knee has ‘collapsed’ or ‘given way’. There is often significant pain and immediate swelling after the injury has occurred.

If you have sustained a knee injury, which sounds similar to the features described above, it is best to be assessed by your PhysioHealth physiotherapist as soon as possible.

ACL Surgery
The majority of ACL injuries require surgical reconstruction, known as an ACL reconstruction. This procedure involves replacing the torn ligament with a graft, which aims to restore the normal function of the ACL. This graft is often taken from a suitable piece of tissue elsewhere in the body, commonly the hamstring or patella tendon. PhysioHealth work closely with a number of leading orthopaedic surgeons, who perform the ACL reconstruction surgery.

ACL Rehabilitation
Physiotherapists play a key role in the rehabilitation of ACL injuries. The rehabilitation process starts immediately after the operation.
Your physiotherapist will work intensively to:
 Reduce pain and swelling
 Restore a normal walking pattern
 Achieve full knee range of movement, and:
 Commence a targeted exercise program

Exercise is an integral component to ACL rehabilitation. Your physiotherapist will devise a targeted exercise program, which aims to enhance range of movement, strength, balance and proprioception. A number of muscle groups are targeted – including the quadriceps, hamstrings, gluteals, calves and core to ensure adequate strength and stability. Our PhysioHealth physiotherapists will use a range of equipment, including our gym facilities and Alter-G treadmill as part of your rehabilitation process.

The average time for return to sport is a 12-month period. Your physiotherapist will include sport-specific exercises into your rehabilitation, to ensure you have achieved key benchmarks that will facilitate a safe return to sport. Our physiotherapists have experience in a range of different sports, so make sure to mention your sport-related goals during your rehabilitation process.


References: 1. Zbrojkiewicz, D., Vertullo, C., & Grayson, J.E. (2018). Increasing rates of anterior cruciate ligament reconstruction in young Australians, 2000-2015. The Medical Journal of Australia, 208(8), 354-358.
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