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Recovering from an ACL Injury

It’s football season at last. But along with those crisp fall nights, bright field lights, and the cheers from the stands, football season can sometimes also mean football injuries. For most players, a few bumps and bruises come with the territory. In some cases, though, those injuries can be more serious and may even require surgery. 

Knee injuries, which can be particularly common as a result of lower body tackles, can be especially painful. Whether you’re a player or the parent of one, it’s important to watch for leg injuries that include severe pain, swelling, or instability in the knee, particularly if you’ve heard the tell-tale pop of a torn ACL (anterior cruciate ligament). 

“While ACL tears are one of the most common football associated knee injuries, there are many other soft tissue structures in the knee that can also be injured such as the meniscus, articulations surfaces, and surrounding collateral ligaments,” said Dr. Justin Hallock, DOC Orthopaedic Surgeon. “Anytime a young athlete has an acute knee injury resulting in significant swelling in the joint, they should seek treatment from a specialists to ensure they are safe to get back to the field and decrease the risk of subsequent injury.”  

If you see symptoms of an ACL football injury, it’s important to seek medical help immediately. The ACL is one of the stabilizing structures of the knee, which keeps the shin (tibia) from moving too far forward on the thigh bone (femur). It also helps stabilize twisting and pivoting motions at the knee, keeping it from turning too far inward. And because the ACL naturally gets limited blood flow, once it becomes injured, it does not regrow or heal itself.

“The ACL, unlike the MCL, does not have a very good healing capacity and thus athletes with full thickness tears who are wanting to get back to sport really have very few options in terms of nonoperative treatment,” Dr. Hallock explained.

That’s why it’s critical to visit a qualified and experienced surgeon who specializes in the hip and knee, someone who successfully treats ACL injuries every day, like the team at DOC Orthopaedics. They can evaluate the injury, then can help you make the best decision regarding treatment.

What’s the first step?

Your physician will first do a physical examination and may send you for an X-ray or MRI (Magnetic Resonance Imaging scan) to confirm the diagnosis. Once you have been diagnosed with an ACL injury, your doctor will be able to discuss more specific treatment alternatives.

“Diagnosing an ACL tear can typically be done by a specialist off of physical exam alone. MRI is often used to confirm the diagnosis and also look at the surrounding soft tissue structures to ensure there is no concomitant meniscal, cartilage, or ligamentous pathology,” Dr. Hallock said. “ACL injuries are commonly associated with meniscal tears because as the ligament tears, the bones shear the underlying meniscus resulting in a tear. It is important to address all soft tissue pathology at the time of surgery to ensure the best outcome.”

What treatment options are available for an ACL injury?

If you’re an athlete who has suffered a sports injury, surgery is likely your best option, particularly if you plan to return to athletics. However, if you’re planning to take a break from athletics for a while, there may be alternatives to surgery including bracing, ice, elevation, rest, and physical therapy. These options won’t fully restore knee stability, however. 

“The ACL is not needed for certain activities such as straight line jogging, swimming, and golf.  However any sport requiring sprinting, cutting, and jumping would be hard to return to with an ACL-deficient knee.  If you don’t plan to return to sports, then nonoperative treatment is an option and people can do well with this,” Dr. Hallock advised. “But,” he warned, “you are at a slightly increased risk of developing arthritis in the knee at an earlier age.”

If you do plan to return to athletics, you’re likely to face an increased risk of future injury without repair surgery. That’s why doctors often recommend arthroscopic ACL reconstruction surgery for active patients.

What happens during surgery?

During the procedure, your surgeon will use tiny instruments to replace the torn ACL with a tendon from your own body (autograft) or a tendon from a donor (allograft). Your surgeon will talk to you about which treatment option is best for you. Younger athletes tend to have more success with autograft ACL reconstruction, while older patients often respond well to allograft treatment. Only a physician can make a determination about which would be better in your specific case.

“There are many great graft options in this day in time ranging from quad tendon, patellar tendon, and hamstring autograft,” Dr. Hallock said. “The processing and harvest techniques of allograft tendon have drastically improved over the years as well so this is also a viable option especially in the older weekend warrior.  Your surgeon will discuss to graft options and help determine what graft will work best for you.”  

And after surgery?

After surgery, you will be able to move your knee immediately, and you’ll be able to go home the same day. Depending on your specific case, your surgeon may recommend a brace at the start of your recovery period. After a few days at home, you’ll begin physical therapy to strengthen your knee.

“ACL reconstruction is a very good, reliable, reproducible surgery that will allow the athlete to return to sport at a high level. It is a big commitment by the patient though to participate with physical therapy and work hard to get the best outcome. Typically, the athlete can return to sports anywhere from 6-12 months after surgery depending on how well they progress through therapy,” Dr. Hallock concluded.

DOC Orthopaedics and Sports Medicine in Decatur and Hartselle is a multidisciplinary musculoskeletal practice. Since 1972, DOC Orthopaedics and Sports Medicine has been committed to providing exceptional orthopaedic care through innovative techniques, quality services, patient communication, and education. With specialties ranging from general orthopaedics and physical therapy to sports medicine, joint replacement, and more, the doctors at DOC Orthopaedics and Sports Medicine can provide local expert care for any orthopaedic disorder or injury to help put your life back in motion.

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