ACL Injuries

ACL Injuries in Athletes

Peter A. Looby M.D.

The anterior cruciate ligament provides rotational stability and anterior movement of the tibia from the femur. Up to 10% of the population can function athletically without an ACL. People with ACL deficiencies tend to have feelings of instability, giving away and shifting. ACL injuries frequently occur without physical contact.

Jerry Rice is one of the best-known and most beloved players in the NFL. He is also one of a number of very visible examples of how high-level athletes can recover from ACL reconstruction surgery to participate in sport at a world-class level. Other well-known athletes who have successfully returned after ACL surgery include Rod Woodson and South Dakota's own Brian Schwartz.

Tearing of the anterior cruciate ligament or ACL, is one of the most frequent serious sports-related injuries of the knee. The ACL is a bundle of tough fibrous tissue approximately one inch in length and one-half inch in diameter in the center of the knee. The main purpose of the ACL is to prevent the two main bones in the knee, the femur and the tibia, from slipping or rotating abnormally.

ACLs are commonly injured during athletic activities such as football, basketball, skiing, and soccer. This can happen during contact like blocking and tackling or with non-contact twisting injuries of the knee such as those that occur when cutting and pivoting on a basketball court or falling while skiing. The athlete who tears their ACL usually experiences pain and may feel or hear a "pop" at the time of the injury. Knee swelling typically begins that same day.

The majority of people with torn ACL will experience knee instability. While twisting or pivoting, the knee with a damaged ACL will "give way" or "go out." The athlete may feel the two bones in the knee slip or separate. Sometimes the knee instability is so severe that a person may experience this giving way during nonathletic activities such as getting in or out of a car or walking on uneven ground.

While the importance of a functioning ACL has been appreciated for many years, it was not until the 1970's that an effective treatment for torn ACLs was developed. Called ACL reconstruction, this surgery involves using another piece of tissue from the body to make a new ACL. Tissues commonly used for this purpose included a portion of the patellar tendon and one or two of the hamstring tendons.

Rehabilitation after ACL reconstruction is extensive. Weight-bearing and walking on the knee can in many cases begin the day after surgery. At the Orthopedic Institute - Sports Medicine Center we usually have our patients back to running approximately three months after surgery and returning to full sports participation four to six months following ACL reconstruction.

This content is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem.
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