Community Health Network

Ranked among the nation's most integrated healthcare systems, Community Health Network is Central Indiana's leader in providing convenient access to exceptional healthcare services, where and when patients need them—in hospitals, health pavilions, workplaces, schools and homes.

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ACL injuries

An anterior cruciate ligament, or ACL, injury is a tear in one of the knee ligaments that joins the upper leg bone with the lower leg bone. The ACL keeps the knee stable. ACL injuries in sports can range from a mild tear to severe ligament separation.

About ACL injuries

  • 250,000 ACL injuries/yr in USA
  • $1.5 billion annual cost
  • 80 - 90% return to previous level of play
  • Typical recovery 6-9 mo
  • 70% ACL injuries are NON-contact
    Boden 2000 Physspportsmed

Typical causes of ACL injuries

  • Pivot
  • Deceleration and change of direction, foot planted
  • Causes twisting injury of knee
  • Traction at shoe/playing surface interface
  • Often close to another player
  • Importance of ground-shoe surface interface in pivot mechanism
  • Landing from jump
  • Knee slightly flexed on landing
  • Quad pulls tibia forward
  • Contact
  • Hit on outside of leg
  • Foot planted
  • Twisting of knee

Risk factors for ACL injuries

  • Poor landing and pivot style
  • Places ACL in vulnerable position
  • Additional torsion/twisting can increase injury
  • Stronger quads than hamstrings
  • Hamstrings protect ACL
  • Quads stretch/stress ACL
  • Shoe/playing surface interface
  • Longer cleats at edge of sole with fewer, smaller cleats in the middle of the sole
  • Playing surface quality
  • Unexpected foot position may change muscle activation patterns
  • Balance thrown off
  • Female gender
  • 2-8x more common in girls
  • Poor ham to quad strength ratio
  • Activate hams more slowly
  • Land with knees sl bent
  • Boys land with knees more bent

Prevention strategies

  • Proper shoe selection
  • Playing surface (smooth and even)
  • Bracing (if indicated as beneficial by a physician)
  • Exercise Programs
  • Change muscle strength and activation
  • Change landing/pivoting patterns

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