Ligaments are elastic bands of tissue that attach bones together. In the knee, four ligaments connect the thighbone (femur) to the shin bone (tibia), allowing the knee joint to move and rotate with strength and stability. The anterior cruciate ligament (ACL), located in the centre of the knee, controls forward movement and rotation, and helps prevent the knee from hyperextending. ACL injuries are the most common and happen when too much force is placed on the ligament and the tissue is stretched or torn. ACL sprains and tears most often result from sudden stops, abrupt changes in direction, or jumping and landing which are all common movements in sports such as soccer, football, and basketball. Less often, ACL injuries happen when players collide during sport. Women are more likely to injure their ACL as well as people aged between 15-25.
Griffin LY, Albohm MJ, Arendt, EA, et al. Understanding and Preventing Noncontact Anterior Cruciate Ligament Injuries: A Review of the Hunt Valley II Meeting, January 2005. American Journal of Sports Medicine. 2006 34:9. 1512-1532.
There are several symptoms that point towards an ACL injury:
Pop Many people report hearing a loud “pop” or a “popping” sensation in the knee when the ACL is injured.
Pain A sprained or ruptured ACL causes severe, immediate pain. You will not be able to continue activity and may not be able to put weight on the knee at all.
Rapid swelling Your knee will quickly become swollen and may feel warm and tender to the touch.
Instability A tear or sprain of the ACL will cause the knee to “buckle” or give out. The joint will feel unstable and will be unable to bear weight.
If you have signs or symptoms of an ACL injury, seek medical care right away. In addition to doing a physical exam of your knee, joint function, and range of motion, your doctor may order tests to assess the severity of the injury, including x-rays, an ultrasound exam, or an MRI.
Your options for managing your ACL injury depend on several factors, including how severe the injury is and your lifestyle. Minor sprains may just need rest and home care, while ruptures almost always require surgery to repair. Here are some of the most common treatments:
RICE Rest, ice, compression and elevation may be enough for minor ACL injuries. Applying ice, wrapping the knee with an elastic wrap and keeping it elevated all help reduce swelling. Ice can help reduce both swelling and pain.
Medications Anti-inflammatory medications available over the counter or by prescription can help relieve swelling and pain. Your doctor may recommend a cortisone injection to ease severe inflammation, but cortisone will not restore stability to the knee.
Bracing A knee brace can help provide support to an injured ACL while it heals. Moderate-support braces may be enough for everyday activities, while runners and athletes may need greater support for their sports.
Physical Therapy As your ACL heals, physical therapy can help strengthen the muscles around your knee joint and restore mobility and range of motion.
Surgery Surgery may be required if your ACL has ruptured or is severely injured, especially if you are an athlete. The surgeon will remove the damaged ACL and reconstruct it with tissue to help promote new ligament growth. Recovery may include a series of braces along with physical therapy.
The right brace for your knee depends on several factors, including the severity of your injury, your symptoms, and your lifestyle and activity level. The first step is to make an appointment with your primary care physician who may refer you to get medical imaging or may provide you with a referral to a specialist who has experience in managing ACL injuries. Often, once the imaging reports have been reviewed, your physician will prescribe a knee brace and other treatment options for you. One of our Certified clinicians will assess you to review what bracing options may address your specific needs and help you return to the activities you love. Many private insurance plans and government programs will cover some if not all of the costs of the brace.
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