Every year there are more than 200,000 anterior cruciate ligament (ACL) injuries. Seventy percent of these injuries occur while playing an agility sport such as football. In 2015, the National Collegiate Athletic Association (NCAA) reported that in every 1,000 exposure games, 2.1 medial collateral ligament (MCL) injuries occur over the course of a year. As fall approaches and football season begins, ACL and MCL injuries are some of the most common football related injuries.
What is an ACL/MCL injury?
A partial or complete tear of the anterior cruciate ligament (ACL) is caused by the overstretching or tearing of the ligament. An ACL tear usually occurs with a sudden pivot while the knee is hyperextended. A tear can take place with and without contact to the knee. Taking a hard hit on the side of the knee during football practice or at a game commonly results in an ACL injury. The repetitive motion of quick stops and changing direction while running, landing from a jump, and quick turns in football makes football players prone to an ACL injury.
A medial collateral ligament (MCL) injury occurs quite often alongside an ACL injury. The MCL is the ligament that runs along the inside of the knee and prevents the knee from bending inward, and is the most commonly injured ligament in the knee. An MCL injury is caused by inward and outward stress away from the midline of the body, to the knee and extreme lateral rotation of the knee. Like an ACL tear, and MCL injury can occur with or without contact to the knee. MCL tears are graded on a scale from I to III in severity. A grade I tear is an incomplete tear, where the ligaments are just stretched. A grade II tear is an incomplete or partial tear of the MCL, and a grade III tears is a complete MCL tear and often occurs in combination with other knee injuries.
How do you know if you have an ACL tear?
Most athletes will notice a loud popping noise when the ACL tears. The knee will begin to swell within the next few hours as blood fills the knee joint. The athlete will have difficulty walking and will feel as though their knee is unstable and will give out on them.
What to do after an ACL/MCL tear?
All ACL and MCL injuries require a prompt evaluation from an orthopaedic specialist. Immediate treatment includes the PRICE method.
P-protect from further injury
More severe injuries should be protected with a pad, split or crutch.
Restricting activity can help prevent worsening the injury.
Using heat during the first 48 hours after the injury can increase swelling and inflammation.
Applying pressure with an elastic Ace bandage will help reduce swelling and provide support to the injured area.
E-elevate the injured area
Swelling will reduce if the injury is raised above the heart
It is crucial to have all knee injuries evaluated by a specialist before continuing physical activity to the injured area.
Is surgery required?
After having the knee injury evaluated by an orthopaedic specialist, surgery may be considered to repair the damaged ligament. There are a variety of techniques that may be used, but most commonly used is a minimally invasive surgery using an arthroscope. This approach leaves the athlete with minimal scarring due to the elimination of large incisions. The recovery period varies among patients but usually last for about six to nine months before returning to contact sports. Physical therapy is beneficial during the recovery period to strengthen the muscle, regain full range of motion in the knee, and regain balance.
For more information about ACL and MCL treatments contact Hampton Roads Orthopaedics and Sports Medicine by calling 757-873-1554 or filling out our online appointment request form.