“Pop” goes the knee! ACL injuries in athletes

submitted by The Medical Center

Anyone who has had the misfortune of experiencing it will tell you nothing compares to the loud “pop” that seems to travel right up from your knee through the middle of your body or to the excruciating pain that follows. This is the dreaded ACL injury – a knee injury that once upon a time was the end of an athlete’s career.

The ACL is the anterior cruciate ligament that sits at the center of your knee between the shinbone (tibia) and the thighbone (femur). It may not be much to look at, but it has a very important role to play in keeping you up and walking or running. Along with the posterior cruciate ligament and the collateral ligaments on the inside and outside of your knee, the ACL limits the knee’s range of motion and keeps the shinbone from sliding forward from the thighbone. Stepping wrong, pivoting or turning suddenly can stress the knee and cause an ACL tear.

Athletes going down as ACL injuries on the rise

ACL tears have been increasing over the years as athletes put increased demands on their bodies, particularly in football and basketball. If you watch football and basketball games from 20 or 30 years ago, you’ll notice the players mostly running in straight lines – but, today, there is a lot of twisting, sudden stops, and quick changes in direction, such as with “Euro stepping” in basketball. All of those can spell bad news for knees.

Most ACL injuries are not caused by being hit by another player. Instead, they happen when players try to avoid other players or deceive them with a sudden, pivoting move that stresses the knee in a direction it was never meant to go. Unfortunately, in the heat of the moment, a player may forget about the biomechanics of his knee, and down he goes, clutching his knee in agonizing pain.

Getting back into the game

So, after the injury, what can be done to return to sport? Chaitu Malempati, D.O., orthopaedic surgeon with Medical Center Orthopaedics, assistant professor of Orthopaedic Surgery & Sports Medicine at the University of Kentucky and head team physician for Western Kentucky University Athletics, said that athletes can return to full activity after surgery and rehabilitation.

“Returning to sport or a high level of activity after an ACL injury usually involves a surgical reconstruction of the ligament using either hamstring, patellar tendon or quadriceps tendon from the patient’s own tissue,” Malempati said. “Once surgical reconstruction has been accomplished, an intensive rehabilitation program is necessary to gain back full range of motion of the knee as well as adequate quadriceps strength to allow a safe return to activity.”

Returning to full activity after an ACL reconstruction can occur seven to nine months after surgery when the injured leg’s quadriceps strength is at least 90% that of the opposite leg. This allows a safe return without increasing risk of re-injury, or injury caused by putting too much stress on the opposite leg.

How to avoid the “pop”

Dr. Malempati said there are several ways to avoid ACL injuries.

“Maintaining adequate quadriceps and hamstring strength is crucial to decreasing stress on the ligament. Also, proper landing mechanics for sports that require running and jumping are important. Having a good, strong core and leg muscles can also help prevent these injuries. A proper warmup prior to playing sports and physical activity is also crucial.”

Keep your knees in mind while preparing for and playing the game and hopefully you’ll never experience an ACL injury. But if you do, rest assured that with proper treatment and determination on your part, you can recover and return to your favorite sport.

Medical Center Orthopaedics is staffed by fellowship-trained physicians who practice exclusively at The Medical Center. All of the physicians serve as Assistant Professors in the Department of Orthopaedics for the University of Kentucky. Medical Center Orthopaedics is located in the Riverside Professional Center on The Medical Center campus, 825 Second Avenue East, Suite C2. Medical Center Orthopaedics has opened its doors to provide walk-in clinic hours for acute sports injuries every Monday through Friday from 7:45 to 8:30 a.m. For more information about Medical Center Orthopaedics, visit . To make an appointment, call 270-780-2750.

Medical Center Orthopaedics is part of Enspire Quality Partners, a patient-focused, value-based, and physician-led clinically integrated network. For more information about Enspire, visit EnspireQuality.com.