An important ligament inside the knee is the ACL or anterior cruciate ligament. It connects the thigh bone (femur) and the shin bone (tibia) and holds it firmly. The stability of the knee, especially when moving forward and backward and turning, keeps the knee in the correct position.
Why does the injury occur
ACL injury usually occurs due to sudden pressure, twisting or impact on the knee. ACL injuries are more common in those who play football, basketball, cricket, handball, kabaddi, etc. Especially when running, stopping or changing direction suddenly.
Not having the knee in the right position while exercising or jumping is also a reason. It may be caused by a blow to the front of the knee in a car accident or falling from the stairs. It is more common in women. This is because women have differences in the structure of their knees, hormonal effects and muscle control.
How to tell
There may be a ‘pop’ sound at the time of injury.
The knee swells within a few hours.
There is discomfort in the stability or movement of the knee.
The knee becomes stiff and painful.
The knee feels like it is giving way when running, climbing stairs or turning.
Tests and treatment
Clinical tests such as the Lakeman test, anterior drawer test, pivot shift test, etc. are performed. The most effective way to confirm whether an ACL injury has occurred is MRI. X-rays are needed to see if the bone is broken.
Treatment depends on the patient’s age, type of work and the severity of the injury. Generally, non-surgical treatment is effective for those who do not play much sports or are less physically active. In addition, rest, ice packs and keeping the affected area elevated can also be beneficial. Painkillers can be taken as per the doctor’s advice.
Some physiotherapy is quite effective. These include exercises to strengthen the knee muscles (quadriceps and hamstrings), balance and proprioception training, and using a brace or support for the knee.
For those who play sports regularly, are young, or have a history of knee dislocation, surgery is recommended. Long-term physiotherapy and rehabilitation (6 to 9 months) after surgery is essential.
Do regular knee strengthening exercises. Sports should not be done without warming up or stretching. Maintain proper posture while jumping and turning. Wear shoes that are suitable for your feet.
M. Yasin Ali, Chairman and Chief Consultant, Dhaka City Physiotherapy Hospital
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