Whether you have had an Anterior Cruciate Ligament Reconstruction or have lived with a torn ACL for many years or have heard so much about it that you want to avoid ending up with one, there are a number of ways that you can tear your ACL. The danger is different in each of these activities but the result can be the same - a torn Cruciate Ligament.
Having torn the Anterior Cruciate Ligament on both knees and been through two complete ACL Reconstructions, here are the top 7 ways that you can tear your Anterior Cruciate Ligament from personal experience and from hearing the experiences of others.
1. Stairs - walking down stairs in particular. After ACL surgery care must be taken in the way you walk down a staircase as there is a change in approach during the early weeks (and possibly months) to ensure you don't re-tear your cruciate ligament. Take the stairs the wrong way, and you may find yourself back on the operating table!
2. Slopes - It is the downhill slopes that are the most dangerous. Whether you've had ACL Surgery or not, walking down a steep hill without care can be a recipe for a torn ACL. Running down a hill is even worse. Firstly because of the risk of slipping, and secondly because of the pressure on the knee joint and ACL. In simple terms, the anterior cruciate ligament is what keeps the top half of your leg in line with the bottom half of your leg. If you are older, or have a knee injury, you are especially at risk. If you have just had ACL knee surgery, you actually need to avoid walking down slopes for a period of time following your operation.
3. Physical Contact - getting knocked or bumped during sport is a common way that people end up with an ACL tear. It could be playing soccer, football, hockey or any number of other activities. Getting knocked on either side of the knee or from the front of the knee can result in a cruciate ligament tear. One way to minimise the risk of this is to ensure that the right muscle groups supporting the knee (eg. quads and hamstring) are sufficiently conditioned for the activities you participate in.
4. Twisting - of all the ways to tear your Anterior Cruciate Ligament, twisting is the easiest of all. While this can happen playing sports like netball, tennis, soccer, and oztag, it can also happen in the kitchen or the park from a twisting movement at the knees. It can happen from a sudden twist, or by twisting too far. It can happen during sport by changing direction while running or by turning your body while your feet are stationary. Changing direction or twisting during motion or with added weights (eg. carrying boxes, baby, equipment) will increase the risk of an ACL injury.
5. Uneven ground - the dangers of a rocky path and non-flat surfaces can leave you flat on your back. On the operating table. When you walk on uneven ground, the most obvious danger is that you might put your foot down where you don't have sufficient stability and your leg slips out to one side - which the knee is not prepared for! This results in the ligaments in the knee receiving a sudden strain and the anterior cruciate ligament (along with the medial and lateral ligaments on either side of the knee) is susceptible and at risk of tearing or straining. The key with uneven ground is to watch where you are stepping and tread slowly if the ground is rocky, bumpy, or simply not flat.
6. Pot Holes - these can be treacherous. And one close to my heart as this is how I suffered my most recent torn ACL. My personal experience is that I was playing football (ie. soccer for the Aussies and Americans) in my semi-finals and was running quite quickly with the ball and managed to run straight through a pot hole in the ground which I didn't see. My right leg went straight into it, I lost my balance and footing, and I tumbled over with my right knee bending inwards. At high speed, there was never going to be any outcome other than a fully torn ACL. Pot holes are prevalent on playing fields, on old roads, on dirt roads, on construction sites, and in the bush! If you find yourself in any of these settings, beware the pot hole!
7. Not treating another knee injury - This is actually a fairly common problem for those people who get injured but "tough it out" and keep on going with their activity without getting their injury treated or those that don't want to pay for physiotherapy treatment or trip to the orthopaedic specialist. For example, from personal experience, I injured my medial ligament (on the inside of the knee) during a football game and kept returned to playing within a couple of weeks without treating it. This meant that I kept re-injuring the same ligament and I played with a much weaker knee. Eventually, I tore the Cruciate Ligament during one of my games because having a strained or torn ligament had reduced the support for my knee joint. The lesson here is to get your injuries checked and treated properly. And if your doctor tells you to rest it for 4 weeks, then make sure you do!
There are obviously other ways you can tear your ACL, including over-stretching the knee, tripping, and car accidents, however these are the 7 most common ways that you can tear your Anterior Cruciate Ligament. If you have torn yours, then you will need to consider having an ACL Reconstruction. If you are going ahead with ACL surgery, it is essential that you do your research and find out how to prepare for it, what to expect from your surgery, be aware of the risks and dangers afterwards, and ensure you complete a full rehabilitation program.
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