Anterior Cruciate Ligament Injuries

The recent knee injury sustained by Colm ‘Gooch’ Cooper, in last Saturday’s All-Ireland Club Football Semi-Final, has once again brought the issue of cruciate ligament injuries to the fore. Many people are aware that injury to these ligaments can certainly be a season ending injury; a devastating blow for any sports person, but why are these ligaments so important?The knee contains four main ligaments. The medial and lateral collateral ligaments are on either side of the knee. They control side to side movement of the knee. Two cruciate ligaments run inside the knee joint. The posterior cruciate ligament (PCL) runs from the front of the thigh bone (femur) to the back of the shin bone (tibia). This ligament prevents the thigh bone from sliding forward on the shin bone. This ligament is rarely torn.The anterior cruciate ligament (ACL) runs from the back of the thigh bone to near the front of the shin bone. The ACL stops the shin sliding forward on the thigh. It also has a role in controlling rotation in the knee. This ligament is often torn during a twisting movement when weight-bearing, such as a sudden change in direction or landing awkwardly from a jump. If the ligament is partially torn you may be able to continue activity. These partial tears often do well with physiotherapy rehabilitation, and often do not need surgical repair.In the case of a complete tear, the pain at the time of injury is usually severe. You may feel a ‘click’ or a ‘pop’ at the time of injury and the knee may swell up. A physiotherapist can carry out a physical examination of the knee. If an ACL complete tear is suspected your Chartered Physiotherapist will recommend you have an MRI scan to confirm the diagnosis. Surgery is often required to repair a torn ACL if you are hoping to return to sport involving changing direction. Post-operatively your Chartered Physiotherapist will guide you through a rehabilitation programme to strengthen the knee and help get you back to sport. You can be out of sport for about 9 months after this surgery. However if the ACL is not surgically repaired it would be rare for a patient to be able to return to any sport that involves twisting, turning or quick changes of direction. This would mean sports such as rugby; football and hurling would be out. Some people would also have instability even with walking. This shows the importance of the ACL in the function of the knee. It’s not all bad news though! French snowboarder Pierre Vaultier recently won gold at the Sochi Winter Olympics with a torn ACL!