Feb 2014 15

ACL tears - skiing and football injuries

By: Dave Wheeler

The anterior cruciate ligament (ACL) is located at the front of the knee joint. It connects the femur (thigh bone) to the tibia (shin bone).

Anterior Cruciate ligament (ACL)


It’s called the anterior cruciate ligament because:


  • It’s at the front: anterior is Latin for front or forward

  • With the posterior cruciate ligament (PCL) it forms an X inside the knee joint when viewed from the side: crux is Latin for cross.

  • Ligaments connect bone to bone, they are extremely strong and pretty much inelastic.


When does the ACL get damaged?

The ACL controls movement at the knee joint. It prevents the knee from straightening beyond its proper range of movement – that is, it stops the femur moving forward of the tibia.

ACL tears (or ruptures) often happen when the femur is forced beyond its natural range forward of the tibia - when a person in forward momentum plants their foot suddenly so that the lower legs stops immediately while the upper leg keeps going!

These kind of injuries are common in skiers and football players, but can crop up in any sport.

Interestingly, research has shown that you’re more likely to get an ACL tear if your hamstrings are weak compared to your quadriceps.


Treating an ACL tear

ACL tears are extremely painful. You may hear a “pop” at the time injury.

The immediate treatment, as with any soft tissue tear, is RICE


  • rest

  • ice

  • compress

  • elevate


Your knee will begin to swell, and may feel warm to the touch.

Then seek medical advice. There are different grades of ACL rupture, and a proper medical assessment will be necessary to find out just how bad the tear is - in extreme cases, surgery may be necessary.

Unless we’re talking surgery, there’s not a lot that the doctors can do, so you’re looking a programme of rehabilitation.

Rehabilitation from an ACL tear is time-consuming: 6 months of rehabilitation isn’t unusual.


Remedial sports massage for rehabilitating ACL damage

After an ACL tear, and after reconstruction surgery if you’ve needed it, you’ll find that it will be harder to straighten and bend your knee.  

Remedial massage of the tendons and muscles can help to restore full range of movement to knee-bending - it can also help to make sure that your “patellar tracking” is correct (in other words, that you’re knee bends out straight in front of you, not inwards or outwards).

Since you’ll have not used the muscles in the leg of the damaged knee as much as before, remedial massage therapy can help restore movement and function there.

Perhaps more importantly, over several months you’ll have started to compensate for your injured knee and may find that you’re getting aches and pains in your hip or in the opposite knee! Remedial massage can help you to start sorting those muscular aches and pains out, and rebalance you.

Sports massage therapy techniques can help strengthen your hamstrings, to protect against further ACL damage.

If you’ve had ACL surgery, massage can help scar tissue itself heal more quickly. If you’re going for surgery, then soft tissue (muscle & tendons) that are in the best condition they can be will recover more quickly.

If you’d like to know more, drop me a message or give me a call.