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Anterior Cruciate Ligament (a.C.L) Tear

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Ligaments are tough, non-stretchable fibers that hold bones together. Damage to cruciate ligaments, which crisscross the knee to give it stability, is one of the most common sports injuries. The "tear" occurs from changing direction rapidly, slowing down from running, or landing from a jump improperly. The A.C.L tear is one injury that worries athletes in all sports at all levels because of its devastating effects. People ages 15-25 that participate in basketball and other sports that require pivoting are especially at risk.

General Information

"The anterior cruicate ligament is a strong band that arises from the posterior middle part of the lateral condyle of the femur, it passes anteriorly and inferiorly between the condyle, and is attached to the depression in front of the intercondylar eminence of the tibia (MosbyÐ''s page. 105)." The tear of the A.C.L is described as a partial or complete rupture of the anterior cruciate ligament. The A.C.L. does not repair by itself. It is so important to an athlete in most sports because an athlete has to be able to rotate the knee in specific directions. The tear happens more frequently in soccer, basketball, and volleyball. Athletes who started participating in a sport while they were young have a greater chance of sustaining a tear. Women are more susceptible to this injury than men. Theories for this include hormonal, environmental, and biomechanical factors. "WomenÐ''s muscles react differently in landing. Doctors say that women land with straighter legs than men do; thus, they pass their shock to the A.C.L. resulting in a tear. Environmental factors are shoes and playing surfaces." (Patrick, Dick)

Causes and Symptoms

The most common way to tear the A.C.L is by violently twisting the knee. This can happen with or without contact. Most people say they hear "a pop". It can occur when youÐ''re slowing down from running, planting and suddenly changing direction, or hyperextending the knee. "When this happens immediate pain results, the knee will fully swell, tenderness occurs around the knee, and the range of motion will be greatly affected." ( Micheli, Dr. Lyle J. ) The first thing to do if an injury occurs is to use R.I.C.E., which stands for rest, ice, compression, and elevation.

Diagnosis

After the injury has occurred, the injured should see the family doctor or possibly a specialist to see if something is torn. The doctor will do some range of motion testing. Theses test are the Lachman, Dynamic extension and the pivot jerk. If the doctor suspects that there is an injury to the knee in some way, the he or she will order a M.R.I. of the knee. M.R.I. stands for magnetic resonance dimensional image of the knee. Energy from a powerful magnet stimulates knee tissue to produce signals that are detected by a scanner and then analyzed by a computer.(Mosby, Inc.) A three- dimensional image of the knee is created. Another way of finding out if something is torn is by an arthroscopy. The doctor inserts a small, lighted optic tube through a small incision into the knee. At the end of the tube is a tiny camera that the doctor can see the inside of the knee on a TV monitor. The doctor uses this procedure to confirm the clinical diagnosis. (Sports injuries handbook)

Treatment

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