ACL Reconstruction: The Long Term Implications

In the United States alone, the incidence rate for ACL injury hovers at around 200,000 cases with around half of those knees being reconstructed annually.  Although reconstruction dramatically improves function in the intermedium, especially with Physical Therapy, there is much to be said for the chronic effects of knee reconstruction in the long term. More specifically, the decrease in physical activity and structured exercise individuals experience in fear of reinjury to the knee.

Although there are more cases of males injuring their ACL’s than females, this difference is due to the greater number of male sports participants.  What the research shows is that females actually have a 4 to 6 fold increased risk for ACL injury compared to males who play at similar levels in the same sport with the highest rates of ACL injuries include soccer, basketball, and gymnastics.

Most commonly (about 70% of the time), ACL injuries occur during a non-contact event when the athlete is decelerating, stopping suddenly, twisting, cutting, or jumping.  What’s been found is that when injury occurs, the knee is either in a straight or “knock-kneed” position, or the athlete lands with the foot in a flat position with the leg placed in front of or to the side of the trunk.  

When an ACL injury occurs, a few signs and symptoms are present.  A loud audible “pop” is often heard if the ACL is torn followed by immediate pain and swelling in the knee.  Often, the injured knee feels unstable, demonstrates a loss of full range of motion, pain and tenderness along the joint line, and discomfort with walking.  

Luckily, in addition to an athlete’s usual training program, incorporation of an ACL injury prevention program can reduce the overall risk of severe ACL injuries from 60 to 89%.  ACL injury prevention programs usually incorporate the following in no specific order:

1.  Warm up

2. Stretching

3. Plyometric training

4. Balance training

5. Strength/stability training

6. Agility Drills

7. Cool down

For a comprehensive program that incorporates many of the above ideas, readers can take a deeper look at the FIFA 11+ program which is a complete-warm up program designed to reduce injuries among male and female soccer players 14 years and older.  The program takes only 20 minutes to complete with three parts and a total of 15 exercises. Although the program is designed with soccer players in mind, many of the same activities and body mechanics can be applied to any sport. Please refer to the link below to take a closer look at this program and exercise safely!